Journal ArticleCirculation. Cardiovascular interventions · December 2024
BackgroundIn STREAM-1 (Strategic Reperfusion Early After Myocardial Infarction), excess intracranial hemorrhage occurred in patients aged ≥75 years receiving full-dose tenecteplase as part of a pharmaco-invasive strategy, whereas no further intrac ...
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Journal ArticleESC Heart Fail · October 22, 2024
AIMS: The VICTORIA trial demonstrated a significant reduction in the primary composite outcome of heart failure (HF) hospitalization or cardiovascular death with vericiguat relative to placebo in high-risk HF. This study aimed to contextualize treatment ef ...
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Journal ArticleJACC Heart Fail · October 2024
BACKGROUND: Type 2 diabetes mellitus (T2DM) significantly worsens heart failure (HF) prognosis. OBJECTIVES: This study sought to investigate the impact of T2DM on outcomes in patients enrolled in VICTORIA and assess the efficacy of vericiguat in patients w ...
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Journal ArticleEur J Heart Fail · October 2024
AIMS: Reverse ventricular remodelling, defined as a decrease in left ventricular end-systolic volume indexed to body surface area (LVESVI) or an increase in left ventricular ejection fraction (LVEF), is associated with improved clinical outcomes in patient ...
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Journal ArticleJ Card Fail · September 7, 2024
BACKGROUND: In VICTORIA (Vericiguat Global Study in Subjects with Heart Failure with Reduced Ejection Fraction), participants with heart failure (HF) and reduced ejection fraction, vericiguat decreased the primary composite outcome (time to first HF hospit ...
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Journal ArticleJACC Heart Fail · May 2024
BACKGROUND: In VICTORIA (Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction), vericiguat compared with placebo reduced cardiovascular death or heart failure (HF) hospitalization in patients with HF with reduced ejection f ...
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Journal ArticleEur J Heart Fail · March 2024
AIMS: In VICTORIA, vericiguat compared with placebo reduced the risk of cardiovascular death (CVD) and heart failure hospitalization (HFH) in patients enrolled after a worsening heart failure (WHF) event. We examined clinical outcomes and efficacy of veric ...
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Journal ArticleESC Heart Fail · February 2024
AIMS: The relationship between accelerometry data and changes in Kansas City Cardiomyopathy Questionnaire-Physical Limitation Score (KCCQ-PLS) or 6 min walk test (6MWT) is not well understood. METHODS AND RESULTS: VITALITY-HFpEF accelerometry substudy (n = ...
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ConferenceCirculation · October 3, 2023
BACKGROUND: The VICTORIA trial (Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction) demonstrated that, in patients with high-risk heart failure, vericiguat reduced the primary composite outcome of cardiovascular death or ...
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Journal ArticleCirc Heart Fail · October 2023
BACKGROUND: Selecting high-risk patients with heart failure with potentially modifiable cardiovascular events is a priority. Our objective was to evaluate NT-proBNP (N-terminal pro-B-type natriuretic peptide) changes during a 30-day screening to establish ...
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Journal ArticleEur J Heart Fail · October 2023
AIMS: Whether electrocardiographic (ECG) measurements predict mortality in chronic heart failure with reduced ejection fraction (HFrEF) is unknown. METHODS AND RESULTS: We studied 4880 patients from the Vericiguat Global Study in Subjects with Heart Failur ...
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Journal ArticleJCI Insight · September 8, 2023
Metabolic mechanisms underlying the heterogeneity of major adverse cardiovascular (CV) event (MACE) risk in individuals with type 2 diabetes mellitus (T2D) remain unclear. We hypothesized that circulating metabolites reflecting mitochondrial dysfunction pr ...
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Journal ArticleCirc Heart Fail · September 2023
BACKGROUND: We examined whether the primary composite outcome (cardiovascular death or heart failure hospitalization) was related to differences in background use and dosing of guideline-directed medical therapy in patients with heart failure with reduced ...
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Journal ArticleJACC Heart Fail · September 2023
BACKGROUND: Age and sex influence treatment and outcomes in patients with heart failure (HF). OBJECTIVES: The authors examined the associations of age and sex with clinical characteristics, background therapies, outcomes, and response to vericiguat in this ...
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Journal ArticleCirculation · August 29, 2023
BACKGROUND: ST-segment-elevation myocardial infarction (STEMI) guidelines recommend pharmaco-invasive treatment if timely primary percutaneous coronary intervention (PCI) is unavailable. Full-dose tenecteplase is associated with an increased risk of intrac ...
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Journal ArticleJ Card Fail · August 2023
BACKGROUND: Hospitalization due to heart failure (HFH) is a major source of morbidity, consumes significant economic resources and is a key endpoint in HF clinical trials. HFH events vary in severity and implications, but they are typically considered equi ...
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Journal ArticleEuropean journal of heart failure · July 2023
AimVericiguat significantly reduced the primary composite outcome of heart failure (HF) hospitalization or cardiovascular death in the VICTORIA trial. It is unknown if these outcome benefits are related to reverse left ventricular (LV) remodelling ...
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Journal ArticleJACC Heart Fail · May 2023
BACKGROUND: Vericiguat reduced the risk of cardiovascular death (CVD) or hospitalization for heart failure (HF) in patients with worsening HF and reduced left ventricular ejection fraction (LVEF). OBJECTIVES: The authors assessed the association of LVEF wi ...
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Journal ArticleJACC Heart Fail · April 2023
BACKGROUND: The association between frailty and health status in patients with heart failure with preserved ejection fraction (HFpEF) is not well known. OBJECTIVES: The authors examined the association between: 1) patient-reported frailty, measured by the ...
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Journal ArticleEur Heart J · November 21, 2022
Remarkable advances in the management of coronary artery disease have enhanced our approach to left main coronary artery (LMCA) disease. The traditional role of coronary artery bypass graft surgery has been challenged by the less invasive percutaneous coro ...
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Journal ArticleClin Pharmacol Ther · November 2022
Vericiguat, a novel stimulator of soluble guanylate cyclase (sGC), is indicated for the treatment of patients following a hospitalization for heart failure or need for outpatient intravenous diuretics, with symptomatic chronic heart failure and ejection fr ...
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Journal ArticleEur J Heart Fail · September 2022
AIM: We assessed a subset of the 5040 patients in VICTORIA receiving sacubitril/valsartan, either at randomization (n = 731) or post-randomization drop-in use (n = 425), to evaluate the relationship between the efficacy and safety of combination therapy wi ...
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Journal ArticleJACC Heart Fail · September 2022
BACKGROUND: The effect of vericiguat on sequential N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and influence of this relationship on clinical outcomes is unknown. OBJECTIVES: This study assessed the relationship between changes in NT-proBN ...
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Journal ArticleJ Card Fail · July 2022
BACKGROUND: For patients hospitalized for heart failure with reduced ejection fraction (HFrEF), guidelines recommend optimization of medical therapy prior to discharge. The degree to which changes in medical therapy occur during hospitalizations for HFrEF ...
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Journal ArticleCirc Heart Fail · June 2022
BACKGROUND: We examined the effects of vericiguat compared with placebo in patients with heart failure with reduced ejection fraction enrolled in VICTORIA (Vericiguat Global Study in Patients With Heart Failure With Reduced Ejection Fraction) on health sta ...
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Journal ArticleJ Thromb Thrombolysis · May 2022
Early prediction of significant morbidity or mortality in patients with acute ST-segment elevation myocardial infarction (STEMI) represents an unmet clinical need. In phenotypically matched population of 139 STEMI patients (72 cases, 67 controls) treated w ...
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Journal ArticleEur J Heart Fail · May 2022
AIMS: Coronary artery disease (CAD) portends worse outcomes in heart failure (HF). We aimed to characterize patients with CAD and worsening HF with reduced ejection fraction (HFrEF) and evaluate post hoc whether vericiguat treatment effect varied according ...
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Journal ArticleJ Am Heart Assoc · November 16, 2021
Background Although safety and tolerability of vericiguat were established in the VICTORIA (Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction) trial in patients with heart failure with reduced ejection fraction, some sub ...
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Journal ArticleCirculation · November 2, 2021
BACKGROUND: In the VICTORIA trial (Vericiguat Global Study in Patients with Heart Failure with Reduced Ejection Fraction), anemia occurred more often in patients treated with vericiguat (7.6%) than with placebo (5.7%). We explored the association between v ...
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Journal ArticleCirc Heart Fail · September 2021
BACKGROUND: Randomized controlled trials (RCTs) often target enrollment of patients with demographics and outcomes less representative of the broader population of interest. To provide context for the VICTORIA trial (Vericiguat Global Study in Subjects Wit ...
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Journal ArticleEur J Heart Fail · August 2021
AIMS: Vericiguat reduced the primary composite outcome of cardiovascular death or heart failure (HF) hospitalization in patients with worsening HF with reduced ejection fraction (HFrEF) and a lower limit of baseline estimated glomerular filtration rate (eG ...
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Journal ArticleEur J Heart Fail · August 2021
AIMS: We evaluated the relation between baseline and new-onset atrial fibrillation (AF) and outcomes, and assessed whether vericiguat modified the likelihood of new-onset AF in patients with worsening heart failure (HF) with reduced ejection fraction in VI ...
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Journal ArticleJ Card Fail · June 24, 2021
BACKGROUND: The prediction of outcomes in patients with heart failure (HF) may inform prognosis, clinical decisions regarding treatment selection, and new trial planning. The VerICiguaT Global Study in Subjects With Heart Failure With Reduced Ejection Frac ...
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Journal ArticleJAMA Cardiol · June 1, 2021
IMPORTANCE: The period following heart failure hospitalization (HFH) is a vulnerable time with high rates of death or recurrent HFH. OBJECTIVE: To evaluate clinical characteristics, outcomes, and treatment response to vericiguat according to prespecified i ...
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Journal ArticleEur Heart J · March 1, 2021
Proposed framework for foundational and provisional secondary prevention therapy over time in low-risk post-MI patients. Foundational therapies should be considered in all patients without contraindications, while provisional therapies should be considered ...
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Journal ArticleEur Heart J Acute Cardiovasc Care · December 2020
BACKGROUND: Emerging evidence suggests that coronary intensive care units are evolving into intensive care environments with an increasing burden of non-cardiovascular illness, but previous studies have been limited to older populations or single center ex ...
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Journal ArticleEur J Heart Fail · November 2020
AIMS: Whether glycaemic control is associated with cardiovascular outcomes in patients with type 2 diabetes (T2D) is unclear. Consequently, we assessed the relationship between glycated haemoglobin (HbA1c ) and cardiovascular outcomes in a placebo-controll ...
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Journal ArticleJAMA Cardiol · November 1, 2020
IMPORTANCE: Conducting a clinical trial involves significant risks, time, and resources. The return on investment for these trials, measured by advancing health care and contributions to the scientific literature, is often uncertain. OBJECTIVE: To assess t ...
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Journal ArticleJACC Heart Fail · November 2020
OBJECTIVES: The purpose of this study was to examine the treatment effect of vericiguat in relation to N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels at randomization. BACKGROUND: Vericiguat compared with placebo reduced the primary outcome o ...
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Journal ArticleJAMA · October 20, 2020
IMPORTANCE: Patients with heart failure and preserved ejection fraction (HFpEF) are at high risk of mortality, hospitalizations, and reduced functional capacity and quality of life. OBJECTIVE: To assess the efficacy of the oral soluble guanylate cyclase st ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · September 2020
BACKGROUND: Longitudinal bleeding risk scores have been validated in patients treated with dual antiplatelet therapy (DAPT) following percutaneous coronary intervention. How these scores apply to the population of patients with acute coronary syndrome (ACS ...
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Journal ArticleAm Heart J · August 2020
BACKGROUND: The STREAM study demonstrated that a pharmaco-invasive strategy was at least as effective as primary PCI (pPCI) in patients presenting early with ST-elevation myocardial infarction (STEMI). The current trial is a response to the finding that re ...
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Journal ArticleJ Am Coll Cardiol · July 14, 2020
BACKGROUND: The long-term prognostic impact of post-discharge bleeding in the unique population of patients with acute coronary syndrome (ACS) treated without percutaneous coronary intervention (PCI) remains unexplored. OBJECTIVES: The aim of this study wa ...
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Journal ArticleJACC Cardiovasc Interv · July 13, 2020
OBJECTIVES: The aim of this study was to evaluate the long-term outcomes of patients with acute coronary syndromes (ACS) with multivessel disease undergoing percutaneous coronary intervention (PCI). BACKGROUND: Controversy exists regarding the benefit of m ...
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Journal ArticleJ Am Heart Assoc · July 7, 2020
Background Despite restoration of epicardial flow following primary percutaneous coronary intervention (PPCI), microvascular reperfusion as reflected by ST-elevation resolution (ST-ER) resolution remains variable and its pathophysiology remains unclear. Me ...
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Journal ArticleEur J Heart Fail · June 2020
AIMS: Non-cardiac comorbidities are highly prevalent in patients with heart failure (HF). Our objective was to define the association between non-cardiac comorbidity burden and clinical outcomes, costs of care, and length of stay within a large randomized ...
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Journal ArticleN Engl J Med · May 14, 2020
BACKGROUND: The effect of vericiguat, a novel oral soluble guanylate cyclase stimulator, in patients with heart failure and reduced ejection fraction who had recently been hospitalized or had received intravenous diuretic therapy is unclear. METHODS: In th ...
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Journal ArticleJ Intern Med · March 2020
BACKGROUND: Although frailty is known to be an important prognostic factor in heart failure (HF), HF risk-adjustment models do not incorporate frailty measures and the interplay between frailty, age and pharmacotherapy is unclear. OBJECTIVES: To explore th ...
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Journal ArticleEur Heart J Acute Cardiovasc Care · March 2020
BACKGROUND: Despite guideline recommendations, the majority of patients with symptoms suggestive of acute coronary syndrome do not use emergency medical services to reach the emergency department (ED). The aim of this study was to investigate the factors a ...
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Journal ArticleAm Heart J · February 2020
BACKGROUND: Although spontaneous reperfusion (SR) prior to primary percutaneous coronary intervention (pPCI) is associated with improved outcomes, its pathophysiology remains unclear. The objective of the study was to explore associations between SR in ST- ...
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Journal ArticleAm Heart J · February 2020
BACKGROUND: Type 2 diabetes (T2D) patients are at increased risk for cardiovascular (CV) events. Most guidelines recommend treating low-density lipoprotein cholesterol (LDL-C) levels to ≤70 mg/dL (1.8 mM) for patients with T2D and established atherosclerot ...
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Journal ArticleAm Heart J · December 2019
BACKGROUND: The effects of β-blocker therapy in patients with type 2 diabetes (T2D) and established atherosclerotic cardiovascular disease (ASCVD) are unclear. We sought to evaluate associations between β-blocker use in T2D with ASCVD and cardiovascular (C ...
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Journal ArticleEur J Heart Fail · December 2019
AIM: Describe the distinguishing features of heart failure (HF) patients with reduced ejection fraction (HFrEF) in the VICTORIA (Vericiguat Global Study in Patients with Heart Failure with Reduced Ejection Fraction) trial. METHODS AND RESULTS: Key backgrou ...
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Journal ArticlePhysiol Genomics · October 1, 2019
The genomic regulatory networks underlying the pathogenesis of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) are incompletely understood. As intermediate traits, protein biomarkers report on underlying disease severity and prognosis in NSTE-A ...
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Journal ArticleCirc Cardiovasc Interv · October 2019
BACKGROUND: Recent clinical trial data support a pharmacoinvasive strategy as an alternative to primary percutaneous coronary intervention (pPCI) in ST-segment elevation myocardial infarction. We evaluated whether this is true in a real-world prehospital S ...
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Journal ArticleJ Card Fail · September 2019
BACKGROUND: Amino-terminal pro-B-type natriuretic peptide (NTproBNP) is closely associated with prognosis in acute decompensated heart failure (ADHF). As a result, there has been great interest measuring it during the course of treatment. The prognostic im ...
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Journal ArticleEur Heart J Acute Cardiovasc Care · September 2019
AIMS: The purpose of this study was to compare outcomes associated with medical management of ST-elevation myocardial infarction and non-ST-elevation myocardial infarction patients presenting to hospitals with and without onsite catheterization facilities. ...
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Journal ArticleEur Heart J · July 1, 2019
Randomized clinical trials initially used heart failure (HF) patients with low left ventricular ejection fraction (LVEF) to select study populations with high risk to enhance statistical power. However, this use of LVEF in clinical trials has led to oversi ...
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Journal ArticleCirc Heart Fail · May 2019
Background The VITALITY-HFpEF trial (Evaluate the Efficacy and Safety of the Oral sGC Stimulator Vericiguat to Improve Physical Functioning in Daily Living Activities of Patients With Heart Failure and Preserved Ejection Fraction) is designed to determine ...
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Journal ArticleJ Am Heart Assoc · April 2, 2019
Background Vascular risk factors have been associated with differences in cognitive performance in epidemiological studies, but evidence in patients with coronary heart disease is more limited. Methods and Results The Montreal Cognitive Assessment score ob ...
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Journal ArticleCan J Cardiol · April 2019
BACKGROUND: The effect of sex on self-reported frailty in acute coronary syndromes (ACS) is unclear. We examined the prevalence of self-reported frailty and its association with all-cause death among men and women. METHODS: Elderly (≥ 65 years) male (n = 2 ...
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Journal ArticleCan J Cardiol · February 2019
Rapid reperfusion of the infarct-related artery is the cornerstone of therapy for the management of acute ST-elevation myocardial infarction (STEMI). Canada's geography presents unique challenges for timely delivery of reperfusion therapy for STEMI patient ...
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Journal ArticleJ Am Heart Assoc · December 18, 2018
Background Vorapaxar, a protease-activated receptor-1 antagonist, is approved for secondary prevention of cardiovascular events but is associated with increased intracranial hemorrhage. Methods and Results TRACER (Thrombin Receptor Antagonist for Clinical ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · December 2018
Background Cardiovascular clinical trials have traditionally incorporated separate time-to-first-event analyses for their primary efficacy and safety comparisons, but this framework has a number of limitations, including limited patient-centeredness and a ...
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Journal ArticleAm J Cardiol · November 1, 2018
We aimed to study whether jugular venous distension (JVD) and peripheral edema were associated with worse outcomes in patients with acute heart failure in the Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure trial. Of 7,14 ...
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Journal ArticleDiabetes Obes Metab · October 2018
AIM: To examine sex differences in baseline characteristics and outcomes in patients with type 2 diabetes and atherosclerotic vascular disease. MATERIALS AND METHODS: Cox models were used to analyse the association between sex and outcomes in the Trial Eva ...
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Journal ArticleCirc 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 ...
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Journal ArticleCoron Artery Dis · September 2018
BACKGROUND: In the Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes (TRILOGY ACS) trial of patients with non-ST-segment elevation acute coronary syndrome managed medically without revascularization, ...
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Journal ArticleBlood Cells Mol Dis · September 2018
Variation in platelet response to thrombin may affect the safety and efficacy of PAR antagonism. The Thr120 variant of the common single nucleotide polymorphism (SNP) rs773902 in the protease-activated receptor (PAR) 4 gene is associated with higher platel ...
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Journal ArticleEur Heart J Acute Cardiovasc Care · September 2018
AIMS: The STREAM study randomly assigned ST-elevation myocardial infarction (STEMI) patients to receive a pharmacoinvasive versus primary percutaneous coronary intervention reperfusion strategy. We assessed whether there was an association between outcomes ...
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Journal ArticleInt J Cardiol · August 1, 2018
BACKGROUND: Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a known clinical conundrum with limited investigation. Using a large population-based cohort, we examined the incidence, demographic profile, use of evidence-based medicin ...
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Journal ArticleAm Heart J · August 2018
BACKGROUND: Although bradyarrhythmias have been observed with ticagrelor and its use with advanced atrioventricular block is not recommended, questions arise regarding its use in patients with mild conduction abnormalities. The objectives were to compare r ...
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Journal ArticleJ Card Fail · August 2018
BACKGROUND: Circulating cardiac troponin levels (cTn), representative of myocardial injury, are commonly elevated in heart failure (HF) and related to adverse clinical events. However, whether cTn represents a spectrum of risk in HF is unclear. METHODS: Ba ...
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Journal ArticleAm Heart J · July 2018
BACKGROUND: Length of stay after non-ST-segment elevation myocardial infarction (NSTEMI) continues to decrease, but information to guide duration of hospitalization is limited. METHODS: We used landmark analyses, in which the landmark defined potential day ...
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Journal ArticleClin 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 ...
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Journal ArticleJACC Cardiovasc Interv · May 14, 2018
OBJECTIVES: In 13,038 patients with non-ST-segment elevation acute coronary syndrome undergoing index percutaneous coronary intervention (PCI) in the EARLY ACS (Early Glycoprotein IIb/IIIa Inhibition in Non-ST-Segment Elevation Acute Coronary Syndrome) and ...
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Journal ArticleJACC Heart Fail · April 2018
OBJECTIVES: As the largest acute heart failure (AHF) trial conducted to date, the global ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure) trial database presented an opportunity to systematically describe the r ...
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ConferenceEur 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 ...
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Journal ArticleDiabetes Care · March 2018
OBJECTIVE: Severe hypoglycemic events (SHEs) in type 2 diabetes are associated with subsequent cardiovascular (CV) event risk. We examined whether CV events were associated with subsequent SHE risk. RESEARCH DESIGN AND METHODS: Time-dependent associations ...
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Journal ArticleCan J Cardiol · March 2018
Antiplatelet therapy (APT) has become an important tool in the treatment and prevention of atherosclerotic events, particularly those associated with coronary artery disease. A large evidence base has evolved regarding the relationship between APT prescrip ...
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Journal ArticleJ Am Heart Assoc · February 3, 2018
BACKGROUND: Higher body mass index (BMI) is associated with lower circulating levels of N-terminal-pro-b-type natriuretic peptide (NT-proBNP). The Interaction between BMI and NT-proBNP with respect to clinical outcomes is not well characterized in patients ...
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Journal ArticleJACC Heart Fail · February 2018
This trial sought to evaluate whether vericiguat, a novel oral soluble guanylate cyclase (sGC) stimulator, was superior to placebo, on a background of standard of care, in increasing the time to the first occurrence of the composite endpoints of cardiovasc ...
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Journal ArticleEur J Heart Fail · February 2018
AIMS: Patients hospitalized for heart failure (HF) are at high risk for 30-day readmission. This study sought to examine the timings and causes of readmission within 30 days of an HF hospitalization. METHODS AND RESULTS: Timing and cause of readmission in ...
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Journal ArticleAm Heart J · February 2018
BACKGROUND: Type 2 myocardial infarction (MI) is characterized by an imbalance between myocardial blood supply and demand, leading to myocardial ischemia without coronary plaque rupture, but its diagnosis is challenging. METHODS: In the TRACER trial, patie ...
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Journal ArticleJ Intern Med · January 2018
OBJECTIVES: Assess the risk of ischaemic events associated with psychosocial stress in patients with stable coronary heart disease (CHD). METHODS: Psychosocial stress was assessed by a questionnaire in 14 577 patients (median age 65.0, IQR 59, 71; 81.6% ma ...
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Journal ArticleDiabetes Care · December 2017
OBJECTIVE: We evaluated the specific causes of death and their associated risk factors in a contemporary cohort of patients with type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD). RESEARCH DESIGN AND METHODS: We used data from the Trial Ev ...
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Journal ArticleHypertension · November 2017
Systolic blood pressure (SBP) treatment targets for adults with diabetes mellitus remain unclear. SBP levels among 12 275 adults with diabetes mellitus, prior cardiovascular disease, and treated hypertension were evaluated in the TECOS (Trial Evaluating Ca ...
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Journal ArticleAm Heart J · November 2017
BACKGROUND: The efficacy and safety of pharmacoinvasive strategy following fibrinolysis for ST-elevation myocardial infarction (STEMI) in relation to renal function have not been established. METHODS: Using patient-level data from 4 randomized controlled t ...
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Journal ArticleCirc Cardiovasc Interv · November 2017
BACKGROUND: Using a comprehensive ST-segment-elevation myocardial infarction registry, we evaluated the relationships of baseline Q waves, time from symptom onset, and reperfusion strategy with in-hospital clinical outcomes. METHODS AND RESULTS: Consecutiv ...
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Journal ArticleJ Am Coll Cardiol · October 3, 2017
BACKGROUND: Recommendations for physical activity in patients with stable coronary heart disease (CHD) are based on modest evidence. OBJECTIVES: The authors analyzed the association between self-reported exercise and mortality in patients with stable CHD. ...
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Journal ArticleCirculation · September 26, 2017
BACKGROUND: Intensive risk factor modification significantly improves outcomes for patients with diabetes mellitus and cardiovascular disease. However, the degree to which secondary prevention treatment goals are achieved in international clinical practice ...
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Journal ArticleEur Heart J Acute Cardiovasc Care · September 2017
AIMS: Current guidelines for patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) recommend early invasive treatment in intermediate-to-high risk patients based on medical history, electrocardiogram (ECG) and elevated troponin. Patients with n ...
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Journal ArticleJ Am Heart Assoc · August 22, 2017
BACKGROUND: The major determinants and prognostic importance of self-reported health in patients with stable coronary heart disease are uncertain. METHODS AND RESULTS: The STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Thera ...
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Journal ArticleInt J Cardiol · August 15, 2017
BACKGROUND: We examined variation in hospital treatment and its relationship to clinical outcome in a large population-based cohort of ACS patients within a single payer-government funded health care system. METHODS: Patients hospitalized in 106 hospitals ...
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Journal ArticleJ Am Coll Cardiol · August 15, 2017
BACKGROUND: Currently, there is no generally accepted model to predict outcomes in stable coronary heart disease (CHD). OBJECTIVES: This study evaluated and compared the prognostic value of biomarkers and clinical variables to develop a biomarker-based pre ...
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Journal ArticleHeart · August 2017
OBJECTIVES: Dual antiplatelet therapy (DAPT) with aspirin + a P2Y12 inhibitor is recommended for at least 12 months for patients with acute coronary syndrome (ACS), with shorter durations considered for patients with increased bleeding risk. However, there ...
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Journal ArticleClin Chem · July 2017
BACKGROUND: There are conflicting data on whether changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity C-reactive protein (hs-CRP) concentrations between time points (delta NT-proBNP and hs-CRP) are associated with a change ...
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Journal ArticleJ Am Coll Cardiol · June 27, 2017
BACKGROUND: It is unclear how patients hospitalized for acute heart failure (HF) who are long-term chronic HF survivors differ from those with more recent HF diagnoses. OBJECTIVES: The goal of this study was to evaluate the influence of HF chronicity on ac ...
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Journal ArticleCirculation · June 6, 2017
Advances in cardiovascular medicine fueled by innovative clinical trials have dramatically improved the lives of patients worldwide. Commensurate with this progress has been a decline in morbid and mortal events. Accordingly, an increased propensity to col ...
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Journal ArticleAm Heart J · June 2017
OBJECTIVE: Patients with diabetes mellitus (DM) presenting with acute coronary syndrome (ACS) and undergoing percutaneous coronary intervention (PCI) derived enhanced benefit with dual antiplatelet therapy (DAPT) with prasugrel vs. clopidogrel. The risk pr ...
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Journal ArticleAm Heart J · June 2017
BACKGROUND: Most patients with acute heart failure (AHF) admitted to critical care units (CCUs) are low acuity and do not require CCU-specific therapies, suggesting that they could be managed in a lower-cost ward environment. This study identified the pred ...
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Journal ArticleAtherosclerosis · June 2017
BACKGROUND AND AIMS: Although circulating microRNA (miRNAs) have emerged as biomarkers predicting mortality in acute coronary syndrome (ACS), more data are needed to understand these mechanisms. Mapping miRNAs to high-risk traits may identify miRNAs involv ...
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Journal ArticleAcad Emerg Med · June 2017
BACKGROUND: Several accelerated diagnostic protocols (ADPs) have been developed to allow emergency department (ED) physicians to identify appropriate patients for safe early discharge after presentation with symptom of chest pain. Most ADPs require chest p ...
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Journal ArticleAm Heart J · May 2017
OBJECTIVE: Acute coronary syndrome (ACS) trials typically use a composite primary outcome (myocardial infarction [MI], stroke, or cardiovascular death), but differential patient characteristics, timing, and consequences associated with individual component ...
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Journal ArticleEur Heart J · March 14, 2017
AIMS: Dual antiplatelet therapy reduces non-fatal ischaemic events after acute coronary syndrome (ACS) but increases bleeding to a similar extent. We sought to determine the prognostic impact of myocardial infarction (MI) vs. bleeding during an extended fo ...
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Journal ArticleEur Heart J Acute Cardiovasc Care · March 2017
BACKGROUND: Vorapaxar is effective in the prevention of secondary atherothrombotic events, although the efficacy/safety balance appears less favorable in the treatment of patients with non-ST-segment elevation (NSTE) acute coronary syndrome (ACS). We hypot ...
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Journal ArticleEur J Heart Fail · February 2017
AIMS: Heart failure (HF) can be associated with a higher resting heart rate (HR), and an elevated HR is associated with adverse long-term events. However, the mechanistic and causal role of HR in HF is unclear. This study aimed to investigate changes in HR ...
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Journal ArticleDiabetes Obes Metab · January 2017
AIM: To examine fracture incidence among participants in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS). RESEARCH DESIGN AND METHODS: We used data from 14 671 participants in the TECOS study who were randomized double-blind to sitagl ...
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Journal ArticleCan J Cardiol · January 2017
International registries have reported a wide variation in coronary care unit (CCU) admission rates for patients hospitalized with acute coronary syndrome (ACS) or heart failure (HF). Little is known about variation in Canadian interprovincial use and outc ...
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Journal ArticleJACC Heart Fail · January 2017
OBJECTIVES: This study sought to examine the relationships between in-hospital and post-discharge body weight changes and outcomes among patients hospitalized for acute heart failure (AHF). BACKGROUND: Body weight changes during and after hospitalization f ...
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Journal ArticleJ Am Heart Assoc · November 4, 2016
BACKGROUND: The relationship between "on-treatment" low platelet reactivity and longitudinal risks of major bleeding dual antiplatelet therapy following acute coronary syndromes remains uncertain, especially for patients who do not undergo percutaneous cor ...
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ConferenceEur Heart J Acute Cardiovasc Care · October 2016
AIMS: We aimed to study the relationship of chronic kidney disease stages with long-term ischemic and bleeding outcomes in medically managed acute coronary syndrome patients and the influence of more potent antiplatelet therapies on platelet reactivity by ...
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Journal ArticleJ Thromb Thrombolysis · October 2016
Coronary plaque rupture mediating acute ST segment elevation myocardial infarction (STEMI) is associated with a systemic inflammatory response. Whether early temporal changes in inflammatory biomarkers are associated with angiographic and electrocardiograp ...
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Journal ArticleClin Cardiol · September 2016
Associations between atrial fibrillation (AF), outcomes, and response to antiplatelet therapies in patients with acute coronary syndrome (ACS) managed medically without revascularization remain uncertain. We examined these associations for medically manage ...
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Journal ArticleCirc 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 ...
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Journal ArticleCatheter Cardiovasc Interv · August 2016
OBJECTIVES: We evaluated outcomes associated with transradial vs. transfemoral approaches and vorapaxar in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) in the TRACER trial. BACKGROUND: Vorapaxar reduces ischemi ...
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Journal ArticleHeart · August 1, 2016
OBJECTIVE: We investigated whether prior clopidogrel influenced long-term ischaemic and bleeding risks and modified the randomised treatment effect of clopidogrel versus prasugrel among medically managed patients with acute coronary syndromes (ACS) treated ...
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Journal ArticleAm Heart J · August 2016
BACKGROUND: Albuminuria is associated with cardiovascular (CV) outcomes. We evaluated albuminuria, alone and in combination with estimated glomerular filtration rate (eGFR), as a predictor of mortality and CV morbidity in 12,944 patients with non-ST-segmen ...
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Journal ArticleAm Heart J · August 2016
BACKGROUND: Few studies have assessed treatment effects on health-related quality of life (HRQoL) in patients with acute coronary syndrome (ACS) treated without revascularization. The TRILOGY ACS trial randomized patients with ACS to either prasugrel or cl ...
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Journal ArticleAm Heart J · August 2016
BACKGROUND: Antithrombotic therapy plays an important role in the treatment of non-ST-segment elevation acute coronary syndromes (NSTE ACS) but is associated with bleeding risk. Advanced age may modify the relationship between efficacy and safety. METHODS: ...
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Journal ArticleCan J Cardiol · August 2016
BACKGROUND: At the first sign or symptoms consistent with an ST-elevation myocardial infarction (STEMI), patients are encouraged to call 9-1-1 and activate emergency medical services immediately. We examined: (1) temporal trends and provincial variations i ...
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Journal ArticleJ Am Heart Assoc · June 21, 2016
BACKGROUND: We evaluated lipoprotein-associated phospholipase A2 (Lp-PLA2) activity in patients with stable coronary heart disease before and during treatment with darapladib, a selective Lp-PLA2 inhibitor, in relation to outcomes and the effects of darapl ...
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Journal ArticleJ Am Heart Assoc · June 13, 2016
BACKGROUND: The effectiveness of radial access (RA) in ST-elevation myocardial infarction (STEMI) has been predominantly established in primary percutaneous coronary intervention (pPCI) with limited exploration of this issue in the early postfibrinolytic p ...
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Journal ArticleEur Heart J Acute Cardiovasc Care · June 2016
AIMS: Little is known regarding consequences of frailty in patients with acute coronary syndrome (ACS). We assessed the associations of frailty and outcomes in ACS patients who were participating in a clinical trial. METHODS AND RESULTS: The TaRgeted plate ...
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Journal ArticleEur J Heart Fail · June 2016
AIMS: It remains unclear if early administration of i.v. nesiritide in patients hospitalized with acute heart failure (AHF) is associated with improved clinical outcomes. METHODS AND RESULTS: We analysed data from 7007 patients enrolled in ASCEND-HF to exa ...
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Journal ArticleAm J Cardiol · June 1, 2016
A growing number of countries and geographical regions are involved in major clinical trials. Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure is the largest trial in acutely decompensated heart failure (HF) with patients ...
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Journal ArticleClin Cardiol · June 2016
BACKGROUND: Low levels of high-density lipoprotein cholesterol (HDL-C; <40 mg/dL) are associated with increased risk of cardiovascular events, but it is unclear whether lower thresholds (<30 mg/dL) are associated with increased hazard. HYPOTHESIS: Very low ...
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Journal ArticleQJM · June 2016
BACKGROUND: Anaemia is common among patients with heart failure (HF) and is an important prognostic marker. AIM: We sought to determine the prognostic importance of anaemia in a large multinational pooled dataset of prospectively enrolled HF patients, with ...
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Journal ArticleJ Am Coll Cardiol · May 10, 2016
BACKGROUND: The Bleeding Academic Research Consortium (BARC) scale has been proposed to standardize bleeding endpoint definitions and reporting in cardiovascular trials. Validation in large cohorts of patients is needed. OBJECTIVES: This study sought to in ...
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Journal ArticleCirc Cardiovasc Interv · May 2016
BACKGROUND: Stent thrombosis (ST) is an important end point in cardiovascular clinical trials. Adjudication is traditionally based on clinical event committee (CEC) review of case report forms and source documentation rather than angiograms. However, the d ...
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Journal ArticleJAMA Cardiol · May 1, 2016
IMPORTANCE: Previous trial results have suggested that dipeptidyl peptidase 4 inhibitor (DPP4i) use might increase heart failure (HF) risk in type 2 diabetes mellitus (T2DM). The DPP4i sitagliptin has been shown to be noninferior to placebo with regard to ...
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Journal ArticleCirculation · April 19, 2016
BACKGROUND: Representation by age ensures appropriate translation of clinical trial results to practice, but, historically, older patients have been underrepresented in clinical trial populations. As the general population has aged, it is unknown whether c ...
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Journal ArticleEur J Heart Fail · April 2016
AIMS: We aimed to characterize abnormal liver function tests in patients with heart failure (HF), as they are commonly encountered yet poorly defined. METHODS AND RESULTS: We used data from ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in ...
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Journal ArticleHeart · April 2016
OBJECTIVE: Uncertainty exists concerning the relative merits of pharmacological versus mechanical coronary reperfusion in patients presenting early with ST-elevation myocardial infarction (STEMI) with extensive myocardium at risk. Accordingly, we investiga ...
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Journal ArticleStroke · April 2016
BACKGROUND AND PURPOSE: The role of more intense, sustained platelet inhibition in preventing stroke after acute coronary syndrome (ACS) is unclear. We observed a signal for reduced stroke risk in the Targeted Platelet Inhibition to Clarify the Optimal Str ...
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Journal ArticleClin Trials · April 2016
BACKGROUND: Adjudication by an adjudication committee in clinical trials plays an important role in the assessment of outcomes. Controversy exists regarding the utility of adjudication committee versus site-based assessments and their relationship to subse ...
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Journal ArticleJAMA Cardiol · April 1, 2016
IMPORTANCE: In the current therapeutic era, the risk for sudden cardiac death (SCD) after non-ST-segment elevation acute coronary syndrome (NSTE ACS) has not been characterized completely. OBJECTIVE: To determine the cumulative incidence of SCD during long ...
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Journal ArticleJ Am Coll Cardiol · March 22, 2016
BACKGROUND: Patients with acute coronary syndrome (ACS), especially those receiving medical management without revascularization, are at high risk for spontaneous myocardial infarction (MI), but its frequency and predictors are unknown. OBJECTIVES: This st ...
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Journal ArticleBMJ Open · March 17, 2016
OBJECTIVES: Limited data exist assessing the relationship between ambulance versus self-presentation and outcomes in patients with acute heart failure (AHF). SETTING: Clinical trial sites in North America. PARTICIPANTS: 1068 patients enrolled in the Acute ...
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Journal ArticleEur J Heart Fail · March 2016
AIMS: A longitudinal and comprehensive analysis of health-related quality of life (HRQOL) was performed during hospitalization for heart failure (HF) or soon after discharge. METHODS AND RESULTS: A post-hoc analysis was performed of the ASCEND-HF trial. Th ...
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Journal ArticleEur J Heart Fail · March 2016
AIMS: Endothelin-1 (ET-1) is an endogenous vasoconstrictor implicated in pulmonary and systemic hypertension, as well as ventricular dysfunction, through effects on vascular smooth muscle, the kidneys, and cardiomyocytes. We aimed to determine the associat ...
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Journal ArticleAm Heart J · March 2016
BACKGROUND: Among patients presenting with ST-segment elevation myocardial infarction (STEMI) for primary percutaneous coronary intervention (PCI), the associations between clinical outcomes and both baseline renal function and the development of acute kid ...
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Journal ArticleJ Am Coll Cardiol · March 1, 2016
BACKGROUND: Certain alleles of the CYP2C19 gene are associated with higher platelet reactivity and increased ischemic events among patients treated with clopidogrel. However, the relationship of CYP2C19 genotype and outcomes in medically managed patients w ...
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Journal ArticleAm J Cardiol · February 1, 2016
Furosemide is the most commonly used loop diuretic in patients with heart failure (HF) despite data suggesting potential pharmacologic and antifibrotic benefits with torsemide. We investigated patients with HF in Acute Study of Clinical Effectiveness of Ne ...
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Journal ArticleDrugs Aging · February 2016
Elderly patients constitute a large and growing proportion of ST-elevation myocardial infarction (STEMI) patients, yet they have been under-represented or even excluded from reperfusion trials. Despite evidence that fibrinolysis improves outcomes irrespect ...
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Journal ArticleLancet · January 23, 2016
BACKGROUND: REG1 is a novel anticoagulation system consisting of pegnivacogin, an RNA aptamer inhibitor of coagulation factor IXa, and anivamersen, a complementary sequence reversal oligonucleotide. We tested the hypothesis that near complete inhibition of ...
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Journal ArticleEur Heart J · January 21, 2016
AIMS: Studies have suggested increased cancer incidence associated with long-term dual antiplatelet therapy (DAPT) for acute coronary syndrome (ACS). We evaluated cancer incidence and treatment-related differences in an analysis of DAPT for ACS. METHODS AN ...
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Journal ArticleJ Am Coll Cardiol · January 19, 2016
ST-segment elevation myocardial infarction (STEMI) remains a significant global public health concern. Practice guidelines in both the United States and Europe have been major contributors to providing evidence-based care. Rapid advances in contemporary th ...
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Journal ArticleJACC Heart Fail · January 2016
OBJECTIVES: The study sought to investigate the association between soluble growth stimulation expressed gene 2 (sST2) level and adverse outcomes in acute heart failure (HF). BACKGROUND: Several studies have demonstrated the prognostic utility of sST2 leve ...
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Journal ArticleAm Heart J · January 2016
UNLABELLED: Non-ST-segment myocardial infarction (NSTEMI) can be complicated by high-degree atrioventricular (AV) block, asystole, or electromechanical dissociation (EMD), but these events are not well characterized in the contemporary era. This analysis a ...
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Journal ArticleJ Am Heart Assoc · December 15, 2015
BACKGROUND: Perioperative antiplatelet agents potentially increase bleeding after non-ST-segment elevation (NSTE) acute coronary syndromes (ACS). The protease-activated receptor 1 antagonist vorapaxar reduced cardiovascular events and was associated with i ...
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Journal ArticleStat Methods Med Res · December 2015
Composite endpoints are commonly used in cardiovascular clinical trials. When using a composite endpoint a subject is considered to have an event when the first component endpoint has occurred. The use of composite endpoints offers the ability to incorpora ...
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Journal ArticleJ Am Heart Assoc · December 1, 2015
BACKGROUND: Whether prehospital point-of-care (POC) troponin further accelerates the time to diagnosis in patients with chest pain (CP) is unknown. We conducted a randomized trial of POC-Troponin testing in the ambulance. METHODS AND RESULTS: Patients with ...
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Journal ArticleAm Heart J · October 2015
BACKGROUND: Women with acute coronary syndromes (ACS) are less likely to undergo invasive revascularization than men, but sex-specific differences in long-term outcomes and platelet reactivity among medically managed ACS patients remain uncertain. We exami ...
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Journal ArticleAm Heart J · October 2015
UNLABELLED: Concomitant use of proton-pump inhibitors (PPIs) has been implicated in diminished antiplatelet response to clopidogrel and an increased risk of ischemic events, but primarily among patients undergoing percutaneous coronary intervention. We sou ...
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Journal ArticleJACC Heart Fail · October 2015
OBJECTIVES: This study sought to determine the relationship of KIM-1 levels with adverse clinical outcomes in acute decompensated heart failure (ADHF). BACKGROUND: Kidney injury molecule (KIM)-1 is a biomarker expressed by the nephron in acute tubular inju ...
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Journal ArticleJ Am Heart Assoc · August 24, 2015
BACKGROUND: Patients with acute heart failure (AHF) frequently have atrial fibrillation (AF), but how this affects patient-reported outcomes has not been well characterized. METHODS AND RESULTS: We examined dyspnea improvement and clinical outcomes in 7007 ...
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Journal ArticleJ Am Heart Assoc · August 24, 2015
BACKGROUND: A pharmacoinvasive (PI) strategy for early presenting ST-segment elevation myocardial infarction nominally reduced 30-day cardiogenic shock and congestive heart failure compared with primary percutaneous coronary intervention (PPCI). We evaluat ...
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Journal ArticleAm Heart J · August 2015
BACKGROUND: Despite initial in-hospital treatment of acute heart failure (HF), some patients experience worsening HF (WHF). There are limited data about the outcomes and characteristics of patients who experience in-hospital WHF. METHODS AND RESULTS: We as ...
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Journal ArticleAm Heart J · August 2015
BACKGROUND: Patients hospitalized for acute decompensated heart failure (ADHF) are at high risk for early mortality and rehospitalization. Risk stratification of ADHF using clinically available data on admission is increasingly important to integrate with ...
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Journal ArticleAm J Med · August 2015
BACKGROUND: The prognostic value of time from symptom onset to reperfusion may be enhanced by the identification of Q waves on the presenting electrocardiogram (ECG) in patients with ST-segment elevation myocardial infarction (STEMI). We evaluated whether ...
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Journal ArticleN Engl J Med · July 16, 2015
BACKGROUND: Data are lacking on the long-term effect on cardiovascular events of adding sitagliptin, a dipeptidyl peptidase 4 inhibitor, to usual care in patients with type 2 diabetes and cardiovascular disease. METHODS: In this randomized, double-blind st ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · July 2015
BACKGROUND: Adequate representation by sex in trials allows generalizability of results. We examined representation of women in clinical trials during a 17-year period in which inclusion criteria were broadened and federal mandates for representativeness w ...
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Journal ArticleN Engl J Med · June 18, 2015
BACKGROUND: Statin therapy reduces low-density lipoprotein (LDL) cholesterol levels and the risk of cardiovascular events, but whether the addition of ezetimibe, a nonstatin drug that reduces intestinal cholesterol absorption, can reduce the rate of cardio ...
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Journal ArticleJ Am Heart Assoc · June 18, 2015
BACKGROUND: Little is known about the incidence, predictors, or outcomes of intracranial hemorrhage (ICH) in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS). We aimed to determine the incidence and timing of ICH, characterize the ...
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Journal ArticleAm Heart J · June 2015
Recent developments have highlighted the challenges facing cardiovascular clinical research in global contemporary practice, particularly in North America, including shifting priorities for drug development targets, increasing regulatory requirements, and ...
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Journal ArticleAm J Cardiol · June 1, 2015
Cardiac magnetic resonance imaging is an attractive noninvasive metric and has genuine potential to constitute a reliable surrogate end point in ST-elevation myocardial infarction. However, these measures must be demonstrated as a valid proxy to predict cl ...
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Journal ArticleAm Heart J · June 2015
BACKGROUND: Elderly patients with ST-segment elevation myocardial infarction (STEMI) have worse outcomes and a greater risk of intracranial bleeding than nonelderly patients. Baseline characteristics, clinical outcomes, and the relationship of the tenectep ...
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Journal ArticleCirc Cardiovasc Interv · June 2015
BACKGROUND: In patients with non-ST-segment-elevation acute coronary syndrome (NSTE ACS), elevated troponin levels identify patients at high risk for adverse outcomes; however, it is unknown whether the magnitude of troponin elevation during hospitalizatio ...
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Journal ArticleAm J Cardiol · May 15, 2015
We evaluated the interaction between protease-activated receptor-1 antagonist vorapaxar and concomitant glycoprotein (GP) IIb/IIIa receptor inhibitors in patients with non-ST-segment elevation acute coronary syndromes who underwent PCI. In Thrombin Recepto ...
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Journal ArticleCirc Heart Fail · May 2015
BACKGROUND: Pay for performance programs compare metrics that are risk-adjusted, but goals of care are not considered in current models. We conducted this study to explore the associations between do not resuscitate (DNR) designations, quality of care, and ...
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Journal ArticleHeart · May 2015
OBJECTIVES: Primary percutaneous coronary intervention (P-PCI) is the preferred reperfusion option in ST-elevation myocardial infarction, but its benefits become attenuated as time to its potential delivery becomes prolonged. Based on the STrategic Reperfu ...
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Journal ArticleJ Am Coll Cardiol · April 21, 2015
Despite the global burden of cardiovascular disease, investment in cardiovascular drug development has stagnated over the past 2 decades, with relative underinvestment compared with other therapeutic areas. The reasons for this trend are multifactorial, bu ...
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Journal ArticleDiabetes Obes Metab · April 2015
AIMS: To report baseline characteristics and cardiovascular (CV) risk management by region, age, sex and CV event type for 14 724 participants in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS), a randomized, double-blind, placebo-con ...
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ConferenceEur J Heart Fail · March 2015
AIMS: Loop diuretics are a cornerstone of heart failure (HF) treatment, but data regarding diuretic dose adjustments after a HF hospitalization and the association with subsequent outcomes are limited. This study was therefore conducted to determine these ...
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Journal ArticleEur Heart J · February 7, 2015
AIMS: Several methods provide new insights into understanding clinical trial composite endpoints, using both conventional and novel methods. The TRILOGY ACS trial is used as a contemporary example to prospectively compare these methods side by side. METHOD ...
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Journal ArticleHeart · February 2015
OBJECTIVE: To study the impact of national economic and human development status on patient profiles and outcomes in the setting of acute coronary syndrome (ACS). METHODS: We conducted a retrospective analysis of the Targeted Platelet Inhibition to Clarify ...
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Journal ArticleAm Heart J · February 2015
AIMS: To determine the feasibility of conducting a randomized controlled trial comparing a low-sodium to a moderate-sodium diet in heart failure (HF) patients. METHODS AND RESULTS: Patients with HF (New York Heart Association classes II-III) were randomize ...
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Journal ArticleJACC Heart Fail · January 2015
OBJECTIVES: The purpose of this study was to investigate the predictive values of baseline and changes in cystatin C (CysC) and its derived equations for short-term adverse outcomes and the effect of nesiritide therapy on CysC in acute decompensated heart ...
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Journal ArticleCardiology · 2015
The earth's climate is changing and increasing ambient heat levels are emerging in large areas of the world. An important cause of this change is the anthropogenic emission of greenhouse gases. Climate changes have a variety of negative effects on health, ...
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Journal ArticleAm Heart J · January 2015
BACKGROUND: Traditionally, clinical outcomes comprising composite end points in cardiovascular trials are assigned equal weights in statistical analyses. However, the importance of weighting outcomes according to their relative severity is now recognized. ...
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Journal ArticleJACC Cardiovasc Interv · January 2015
OBJECTIVES: This study investigated the relationship between time to invasive assessment and outcomes among ST-segment elevation myocardial infarction patients randomized to early angiography after fibrinolysis. BACKGROUND: The optimal timing of coronary a ...
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Journal ArticleInt J Cardiol · December 20, 2014
INTRODUCTION: Given the rising prevalence of heart failure (HF), our objective is to explore the relationships between meteorological events and acute HF (AHF) globally. METHODS: We used data from 30 countries participating in the ASCEND-HF trial. Paramete ...
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Journal ArticleAm Heart J · December 2014
BACKGROUND: Protease-activated receptor 1 antagonism with vorapaxar represents a novel strategy for platelet inhibition. In TRACER, vorapaxar was compared with placebo plus standard of care among 12,944 patients with non-ST-segment elevation acute coronary ...
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Journal ArticleJAMA · November 19, 2014
IMPORTANCE: Little information exists about the anatomical characteristics and clinical relevance of non-infarct-related artery (IRA) disease among patients with ST-segment elevation myocardial infarction (STEMI). OBJECTIVES: To investigate the incidence, ...
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Journal ArticleCatheter Cardiovasc Interv · November 15, 2014
OBJECTIVES: We evaluated patients at tertiary [both percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) capable] and primary hospitals in the EARLY-ACS trial. BACKGROUND: Early invasive management is recommended for high-ris ...
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Journal ArticleCirc Heart Fail · November 2014
BACKGROUND: Outcomes associated with episodes of hypotension while hospitalized with acute decompensated heart failure are not well understood. METHODS AND RESULTS: Using data from Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart ...
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Journal ArticleAm Heart J · November 2014
BACKGROUND: The efficacy of a routine invasive strategy early after fibrinolysis in relation to baseline risk status is unclear. We sought to characterize the interaction between patient risk and treatment with routine invasive strategy early after fibrino ...
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Journal ArticleAm Heart J · October 2014
BACKGROUND: Peak creatine kinase (CK)-MB concentration is related to reperfusion success and clinical outcomes after fibrinolytic therapy for acute myocardial infarction. However, prognostic implications of CK-MB measurements after primary percutaneous cor ...
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Journal ArticleAm Heart J · October 2014
BACKGROUND: In the TRACER trial, vorapaxar, a protease-activated receptor-1 antagonist, plus standard care in non-ST-segment elevation acute coronary syndrome (NSTE ACS) patients did not significantly reduce the primary composite end point but reduced a ke ...
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Journal ArticleHeart · October 2014
BACKGROUND: We evaluated the prespecified endpoint, aborted myocardial infarction (AbMI), according to the use of a pharmacoinvasive (PI) strategy versus primary percutaneous coronary intervention (PCI) in 1754 patients randomised within 3 h of symptom ons ...
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Journal ArticleCan J Cardiol · October 2014
BACKGROUND: The outcomes of acute cardiovascular symptom presentations are potentially modifiable with the use of biomarkers to accelerate accurate diagnosis. This randomized trial tested troponin and B-type natriuretic peptide before hospital guidance in ...
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Journal ArticleCirculation · September 30, 2014
BACKGROUND: In the Strategic Reperfusion Early After Myocardial Infarction (STREAM) trial, a pharmaco-invasive (PI) strategy was compared with primary percutaneous coronary intervention (pPCI) in ST-segment-elevation myocardial infarction patients presenti ...
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Journal ArticleAm J Cardiol · September 15, 2014
Although a fibrinolytic pharmacoinvasive strategy is recommended for patients with ST elevation myocardial infarction (STEMI) unable to undergo timely primary percutaneous coronary intervention (PCI), there are limited data addressing outcomes specific to ...
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Journal ArticleEur Heart J Acute Cardiovasc Care · September 2014
BACKGROUND: This study characterized a medically managed population in a non-ST-segment elevation acute coronary syndrome (NSTEACS) cohort and evaluated prognosis and outcomes of vorapaxar vs. placebo. METHODS: In the TRACER study, 12,944 NSTEACS patients ...
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Journal ArticleAm J Cardiol · September 1, 2014
The therapeutic potential of vorapaxar in patients with non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention (PCI) is unknown. This prespecified analysis of a postrandomization subgroup evaluated the effects of vor ...
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Journal ArticleAm Heart J · August 2014
Independent data monitoring committees (IDMCs) were introduced to monitor patient safety and study conduct in randomized clinical trials (RCTs), but certain challenges regarding the utilization of IDMCs have developed. First, the roles and responsibilities ...
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Journal ArticleAm Heart J · August 2014
BACKGROUND: The relationship of metabolic syndrome and its individual components (obesity, hypertension, glucose intolerance, high triglycerides, and low high-density lipoprotein cholesterol) with 1-year mortality in non-ST-segment elevation acute coronary ...
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Journal ArticleJ Am Heart Assoc · July 10, 2014
BACKGROUND: Clinical trials traditionally use time-to-first-event analysis embedded within the composite endpoint of cardiovascular death (CVD), myocardial infarction (MI), or stroke. However, many patients have >1 event, and this approach may not reflect ...
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ConferenceAm Heart J · July 2014
BACKGROUND: To further explore the impact of smoking on antiplatelet activity and treatment response, we evaluated time-dependent relationships between smoking status with on-treatment platelet reactivity and clinical outcomes for prasugrel vs. clopidogrel ...
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Journal ArticleEur Heart J · June 14, 2014
The organization of networks in order to better coordinate and to faster offer reperfusion strategies for acute ST-elevation myocardial infarction (STEMI) is an important recommendation of recent versions of international guidelines. This article focusses ...
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Journal ArticleN Engl J Med · May 1, 2014
BACKGROUND: Elevated lipoprotein-associated phospholipase A2 activity promotes the development of vulnerable atherosclerotic plaques, and elevated plasma levels of this enzyme are associated with an increased risk of coronary events. Darapladib is a select ...
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Journal ArticleAm Heart J · May 2014
Prompt reperfusion therapy in acute myocardial infarction enhances clinical outcome. However, reperfusion itself may contribute to myocardial cell death. The current review outlines the multifocal mechanisms of reperfusion injury and focuses on understandi ...
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Journal ArticleAm J Cardiol · April 15, 2014
Early administration of glycoprotein IIbIIIa inhibitors results in improved angiographic parameters, including thrombolysis in myocardial infarction (TIMI) flow grade, corrected TIMI frame count, and TIMI myocardial perfusion grade (TMPG) among patients wi ...
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Journal ArticleJ Am Coll Cardiol · March 25, 2014
OBJECTIVES: This study evaluated effects of protease-activated receptor-1 antagonist vorapaxar (Merck, Whitehouse Station, New Jersey) versus placebo among the TRACER (Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome) st ...
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Journal ArticleAm J Cardiol · March 15, 2014
Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) trial compared vorapaxar and placebo in 12,944 high-risk patients with non-ST-segment elevation acute coronary syndrome. We explored aspirin (ASA) use and its ass ...
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Journal ArticleEur J Heart Fail · March 2014
AIM: Acute decompensated heart failure (ADHF) is associated with significant morbidity and mortality but the relationship between LVEF and outcomes is unclear. We explored the association between LVEF and 30 and 180 day mortality in 7007 ADHF patients enro ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · March 2014
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) initiated after myocardial infarction (MI) reduce mortality and are American College of Cardiology/American Heart Association guideline recommended. Yet the ...
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Journal ArticleJ Electrocardiol · 2014
OBJECTIVES: To evaluate quantitative relationships between baseline Q-wave width and 90-day outcomes in ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Baseline Q-waves are useful in predicting clinical outcomes after MI. METHODS: 3589 STEM ...
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Journal ArticleThe American journal of cardiology · January 1, 2014
Although a fibrinolytic pharmacoinvasive strategy is recommended for patients with ST elevation myocardial infarction (STEMI) unable to undergo timely primary percutaneous coronary intervention (PCI), there are limited data addressing outcomes specific to ...
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ConferenceJ Electrocardiol · 2014
After about a century since its clinical introduction, the 12-lead electrocardiogram (ECG) remains a cornerstone in diagnosis and management of acute ST-elevation myocardial infarction (STEMI). It provides clinicians and researchers with invaluable informa ...
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Journal ArticleExperimental and Clinical Cardiology · January 1, 2014
Background: QT interval (QTc) prolongation and increased dispersion (cQTd) have been implicated as risk factors for sudden death. We examined their prognostic value in patients with ST-segment elevation myocardial infarction (STEMI) before and after reperf ...
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Journal ArticleJ Electrocardiol · 2014
OBJECTIVES: We evaluated inter-reader agreement of the ST-segment between two electrocardiogram (ECG) core laboratories. BACKGROUND: Accurate measurement of the ST-segment is key to diagnosis and management of acute coronary syndromes (ACS). Clinical trial ...
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Journal ArticleJACC Heart Fail · December 2013
OBJECTIVES: The aim of this study was to compare clinical outcomes, resource utilization, and health-related quality of life between Canadian and U.S. patients enrolled in ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Hear ...
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Journal ArticleEur Heart J · November 2013
AIMS: Despite the known benefits of regular exercise, the reasons why many coronary heart disease (CHD) patients engage in little physical activity are not well understood. This study identifies factors associated with low activity levels in individuals wi ...
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Journal ArticleClin Biochem · November 2013
OBJECTIVES: Pentraxin 3 (PTX3) is the prototype of the long pentraxin family. PTX3 is involved in inflammatory processes affecting the cardiovascular system, and PTX3 levels have been shown to be elevated and independently prognostic in ST-elevation myocar ...
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Journal ArticleAm Heart J · November 2013
BACKGROUND: Left ventricular end-diastolic pressure (LVEDP) is frequently measured during primary percutaneous coronary intervention (PCI). However, little is known of this measurement's utility in predicting outcomes or informing treatment decisions. We s ...
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Journal ArticleInt J Cardiol · October 3, 2013
BACKGROUND: Considerable uncertainty exists concerning the interaction between climate and human health. We explored this issue by evaluating the relationship between meteorological events and acute coronary syndrome (ACS) events. METHODS: 9406 patients in ...
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Journal ArticleInt J Cardiol · October 3, 2013
BACKGROUND: Plaque rupture, acute ischemia, and necrosis in acute coronary syndromes are accompanied by concurrent pro- and anti-inflammatory cascades. Whether STEMI clinical prediction models can be improved with the addition of baseline inflammatory biom ...
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Journal ArticleInt J Cardiol · October 3, 2013
BACKGROUND: We assessed the incidence and timing of post-acute coronary syndrome (ACS) atrial fibrillation (AF) related and not related to coronary artery bypass grafting (CABG); described the use of antithrombotic therapy; and evaluated the association of ...
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Journal ArticleEur J Heart Fail · October 2013
Endpoint selection is a critically important step in clinical trial design. It poses major challenges for investigators, regulators, and study sponsors, and it also has important clinical and practical implications for physicians and patients. Clinical out ...
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Journal ArticleAm Heart J · October 2013
BACKGROUND: Female sex is an established risk factor for bleeding, which is an important safety end point in patients presenting with non-ST-segment elevation acute coronary syndromes (NSTE ACS). However, it is unknown whether the association between bleed ...
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Journal ArticleInt J Cardiol · September 10, 2013
BACKGROUND: Elderly patients with acute coronary syndromes (ACS) are at high risk for death and recurrent thrombotic events. We evaluated the efficacy and safety of intensive treatment with glycoprotein IIb/IIIa inhibitors in an elderly population, and the ...
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Journal ArticleCrit Care Med · September 2013
OBJECTIVES: To assess whether systemic inflammatory response syndrome is associated with morbidity and mortality in ST-elevation myocardial infarction. DESIGN AND SETTING: Secondary analysis of multicenter randomized controlled trials. PATIENTS: Complement ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · September 1, 2013
BACKGROUND: Translation of evidence-based heart failure (HF) therapies to clinical practice is incomplete and may vary internationally. We examined common measures of quality of care in patients enrolled in the international Acute Study of Clinical Effecti ...
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Journal ArticleAm Heart J · September 2013
AIMS: In the EARLY ACS trial, routine early eptifibatide was not superior to delayed provisional use at percutaneous coronary intervention (PCI); however, among PCI-treated patients, numerically fewer ischemic end points occurred in the upstream eptifibati ...
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Journal ArticleJ Card Fail · September 2013
BACKGROUND: The Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure (ASCEND-HF) randomly assigned 7,141 participants to nesiritide or placebo. Dyspnea improvement was more often reported in the nesiritide group, but there wer ...
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Journal ArticleEur Heart J Acute Cardiovasc Care · September 2013
BACKGROUND AND OBJECTIVES: Eptifibatide is indicated during percutaneous coronary intervention (PCI) with continuation for 18-24 hours post procedure but is associated with bleeding. We examined the efficacy and safety of shorter post-PCI eptifibatide infu ...
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Journal ArticleCirculation · August 20, 2013
BACKGROUND: Dual antiplatelet therapy in older versus younger patients with acute coronary syndromes is understudied. Low-dose prasugrel (5 mg/d) is recommended for younger, lower-body-weight patients and elderly patients with acute coronary syndromes to m ...
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Journal ArticleLancet · August 17, 2013
BACKGROUND: Treatment with prasugrel and aspirin improves outcomes compared with clopidogrel and aspirin for patients with acute coronary syndrome who have had angiography and percutaneous coronary intervention; however, no clear benefit has been shown for ...
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Journal ArticleAm J Med · August 2013
BACKGROUND: We evaluated whether electrocardiogram (ECG) characteristics were aligned with clinical outcomes and the effect of ticagrelor within the diverse spectrum of non-ST-elevation acute coronary syndrome patients enrolled in the PLATelet inhibition a ...
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Journal ArticleAm Heart J · August 2013
BACKGROUND: Lead aVR ST-segment deviation has been associated with increased mortality in ST-elevation myocardial infarction patients treated with fibrinolysis. However, its prognostic value in a contemporaneous population undergoing primary percutaneous c ...
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Journal ArticleInt 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 ...
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Journal ArticleJ Am Coll Cardiol · July 16, 2013
OBJECTIVES: This study sought to review cardiac troponin (cTn) trends during non-ST-segment elevation acute coronary syndrome (NSTE ACS) in patients undergoing percutaneous coronary intervention (PCI) in the EARLY ACS (Early Glycoprotein IIb/IIIa Inhibitio ...
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Journal ArticleCirc Heart Fail · July 2013
BACKGROUND: Hospital readmission is an important clinical outcome of patients with heart failure. Its relation to length of stay for the initial hospitalization is not clear. METHODS AND RESULTS: We used hierarchical modeling of data from a clinical trial ...
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Journal ArticleEur Heart J · June 2013
AIMS: The TRA·CER trial compared vorapaxar, a novel platelet protease-activated receptor (PAR)-1 antagonist, with placebo in 12 944 patients with high-risk non-ST-segment elevation acute coronary syndromes (NSTE ACS). In this analysis, we explored the effe ...
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Journal ArticleAm Heart J · June 2013
In recent years, international clinical trials have increasingly included large numbers of patients and research sites from developing countries. In South America particularly, enrollment in randomized clinical trials has increased substantially. Despite t ...
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Journal ArticleJACC Heart Fail · June 2013
OBJECTIVES: This study sought to describe the occurrence and timing of heart failure (HF), associated clinical factors, and 30-day outcomes in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS). BACKGROUND: Little is known about HF- ...
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Journal ArticleTrials · May 2, 2013
BACKGROUND: Larger infarct size measured by creatine kinase (CK)-MB release is associated with higher mortality and has been used as an important surrogate endpoint in the evaluation of new treatments for ST-segment elevation myocardial infarction (STEMI). ...
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Journal ArticleInt J Biometeorol · May 2013
The aim of this study was to develop a method for the identification of global weather parameters and patient characteristics associated with a type of heart attack in which there is a sudden partial blockage of a coronary artery. This type of heart attack ...
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Journal ArticleN Engl J Med · April 11, 2013
BACKGROUND: It is not known whether prehospital fibrinolysis, coupled with timely coronary angiography, provides a clinical outcome similar to that with primary percutaneous coronary intervention (PCI) early after acute ST-segment elevation myocardial infa ...
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Journal ArticleCirc Cardiovasc Interv · April 2013
BACKGROUND: Stroke is a rare but potentially devastating complication of acute myocardial infarction. Little is known about stroke timing, characteristics, and clinical outcomes in patients with ST-segment elevation myocardial infarction treated with prima ...
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Journal ArticleAm Heart J · April 2013
BACKGROUND: Bleeding is a major limitation of antithrombotic therapy among invasively managed non-ST-segment elevation acute coronary syndromes (NSTE-ACS) patients; therefore, we examined the use of radial access and its association with outcomes among NST ...
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Journal ArticleEur Heart J · March 2013
AIMS: The selection of optimal endpoints for cardiovascular clinical trials continues to be challenging. We examined an alternative interpretation of a series of trials when the individual event severity is considered. METHODS AND RESULTS: We analysed thre ...
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Journal ArticleAm Heart J · March 2013
BACKGROUND: The long-term incidence of heart failure (HF) in ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), or unstable angina (UA) patients is uncertain. We examined the 1-year incidence of HF and its associat ...
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Journal ArticleEur Heart J · March 2013
Myocardial infarction (MI) is a key endpoint in randomized controlled trials (RCTs), but heterogeneous definitions limit comparisons across RCTs or meta-analyses. The 2000 European Society of Cardiology/American College of Cardiology MI redefinition and th ...
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Journal ArticleAm Heart J · March 2013
AIMS: Dynamic risk models update the risk profile of ST-elevation myocardial infarction (STEMI) patients over the acute period following the event and have implications to clinical practice and research. METHODS AND RESULTS: Multivariable survival models w ...
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Journal ArticleAm Heart J · February 2013
BACKGROUND: Aborted myocardial infarction (AbMI) in patients with ST-elevation MI defined by ST resolution with less than 2-fold elevation in biomarkers has been previously reported. We examined the association among AbMI, other metrics of infarct size, an ...
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Journal ArticleJ Am Coll Cardiol · December 4, 2012
OBJECTIVES: This study compared prognoses of myocardial infarction related to percutaneous coronary intervention (PCI, procedural MI) using increasing creatine kinase-myocardial band (CK-MB) thresholds with spontaneous MI. BACKGROUND: Procedural MI usually ...
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Journal ArticleAm J Cardiol · December 1, 2012
Q waves have been shown to be a stronger prognostic marker than time from symptom onset to percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction. We examined whether the relative importance of these 2 measurements is modula ...
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Journal ArticleJAMA · November 4, 2012
CONTEXT The relationship of platelet function testing measurements with outcomes in patients with acute coronary syndromes (ACS) initially managed medically without revascularization is unknown. OBJECTIVE To characterize the differences and evaluate clinic ...
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Journal ArticleEur J Heart Fail · November 2012
AIMS: We examined the prognostic importance of cardiac troponin I (cTnI) in a cohort of patients enrolled in the ASCEND-HF study of nesiritide in acute decompensated heart failure (ADHF). Circulating troponins are a prognostic marker in patients with ADHF. ...
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Journal ArticleCirc Heart Fail · November 2012
BACKGROUND: Randomized controlled trials (RCT) are limited by their generalizability to the broader nontrial population. To provide a context for Acute Study of Nesiritide in Decompensated Heart Failure (ASCEND-HF) trial, we designed a complementary regist ...
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Journal ArticleN Engl J Med · October 4, 2012
BACKGROUND: The effect of intensified platelet inhibition for patients with unstable angina or myocardial infarction without ST-segment elevation who do not undergo revascularization has not been delineated. METHODS: In this double-blind, randomized trial, ...
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Journal ArticleCMAJ · July 10, 2012
BACKGROUND: Baseline Q waves may provide additional value compared with time from the onset of symptoms in predicting outcomes for patients with ST-segment elevation. We evaluated whether baseline Q waves superseded time from symptom onset as a prognostic ...
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Journal ArticleJ Thromb Thrombolysis · July 2012
The adequacy of anticoagulation with enoxaparin as an adjuvant to fibrinolytic therapy for STEMI is unclear and has implications for both efficacy and safety; especially in patients undergoing a pharmacoinvasive reperfusion strategy. A subset of fibrinolyt ...
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Journal ArticleCurr Opin Cardiol · July 2012
PURPOSE OF REVIEW: Fibrinolysis remains a key therapeutic alternative mode of reperfusion in patients with ST segment elevation myocardial infarction (STEMI). Its venerability relates to the wealth of clinical efficacy evidence, ease of administration, and ...
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Journal ArticleJACC Cardiovasc Interv · July 2012
OBJECTIVES: The aim of this study was to address the knowledge gap using the APEX-AMI (Assessment of Pexelizumab in Acute Myocardial Infarction) trial database. We also assessed the association between serious infections and 90-day death or death/myocardia ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · July 1, 2012
BACKGROUND: Transfer delays for primary percutaneous coronary intervention may increase mortality in patients with ST-segment-elevation myocardial infarction. We examined the association between door 1-to-door 2 (D1D2) time, a measure capturing the entire ...
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Journal ArticleAm Heart J · July 2012
BACKGROUND: Reasons for pexelizumab lack of benefit in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention remain unclear. In a substudy of the APEX-AMI trial, we explored the hypothesis that early complement a ...
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Journal ArticleJ Thromb Thrombolysis · July 2012
Coronary plaque rupture is associated with a systemic inflammatory response. The relationship between baseline N-terminal pro B-type natriuretic peptide (NT-proBNP), a prognostic marker in patients with acute coronary syndromes, and systemic inflammatory m ...
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Journal ArticleEur Heart J Acute Cardiovasc Care · June 2012
BACKGROUND: Early restoration of blood flow of the infarct-related artery is associated with an improved outcome in patients with ST-elevation myocardial infarction (STEMI). Previous studies have shown a low mortality in patients with TIMI 3 flow before pr ...
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Journal ArticleCirc Heart Fail · May 1, 2012
BACKGROUND: Low testosterone is an independent predictor of reduced exercise capacity and poor clinical outcomes in patients with heart failure (HF). We sought to determine whether testosterone therapy improves exercise capacity in patients with stable chr ...
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Journal ArticleHealth Serv Manage Res · May 2012
To discover whether the period lifetable provides more valid estimates of length of wait in prospect than are obtained using the lengths either of (current) waits captured at the time of the mid-period census or of the (prior) waits of those extracted over ...
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Journal ArticleAm Heart J · May 2012
BACKGROUND: Information on practice patterns and outcomes in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary interventions (PCIs) in Canada vs United States is limited. METHODS: We evaluated differences in clinical ...
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Journal ArticleJ Am Coll Cardiol · April 17, 2012
OBJECTIVES: This study hypothesized that peak expiratory flow rate (PEFR) would increase with acute heart failure (AHF) treatment over the first 24 h, related to a Dyspnea Index (DI) change and treatment effect. BACKGROUND: Dyspnea is a key symptom and cli ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · March 1, 2012
BACKGROUND: Regional differences in the profile and prognosis of non-ST-segment elevation acute coronary syndrome (NSTE ACS) patients treated with medical management after angiography remain uncertain. METHODS AND RESULTS: Using data from the Early Glycopr ...
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Journal ArticleCoron Artery Dis · March 2012
OBJECTIVES: Predictors of adverse outcomes following myocardial infarction (MI) are well established; however, little is known about what predicts enzymatically estimated infarct size in patients with acute ST-elevation MI. The Complement And Reduction of ...
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Journal ArticleAm J Cardiol · February 1, 2012
Gender-related differences in the incidence of bleeding and its relation to subsequent mortality in patients with ST-segment elevation myocardial infarction (STEMI) treated with fibrinolysis are not well understood. We studied patients with STEMI receiving ...
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Journal ArticleCirculation · January 24, 2012
BACKGROUND: Ticagrelor, when compared with clopidogrel, reduced the 12-month risk of vascular death/myocardial infarction and stroke in patients with ST-elevation acute coronary syndromes intended to undergo primary percutaneous coronary intervention in th ...
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Journal ArticleN Engl J Med · January 5, 2012
BACKGROUND: Vorapaxar is a new oral protease-activated-receptor 1 (PAR-1) antagonist that inhibits thrombin-induced platelet activation. METHODS: In this multinational, double-blind, randomized trial, we compared vorapaxar with placebo in 12,944 patients w ...
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Journal ArticleJAMA · January 4, 2012
CONTEXT: ST-segment elevation myocardial infarction (STEMI) treatment has improved outcomes and shortened hospital stay. Recently, 30-day readmission rates have been proposed as a metric for care of patients with STEMI. However, international rates and pre ...
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Journal ArticleCoron Artery Dis · January 2012
OBJECTIVES: Liver enzyme elevations occur with ST-segment elevation myocardial infarction (STEMI); however, their significance in the modern era is not well-defined. The incidence of liver enzyme elevations in STEMI, temporal trends, correlations with crea ...
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Journal ArticleAm Heart J · November 2011
BACKGROUND: Dose adjustment of renally excreted antithrombotic drugs is recommended for patients with reduced renal function. We examined the influence of dose modification on bleeding and efficacy. METHODS: Based on initial study drug infusion rate, Early ...
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Journal ArticleAnn Intern Med · September 20, 2011
A transformation in ST-segment elevation myocardial infarction (STEMI) care in the United States has unfolded. It asserts superior reperfusion with primary percutaneous coronary intervention (PPCI) over fibrinolysis on the basis of studies showing the form ...
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Journal ArticleAm J Cardiol · September 15, 2011
We compared the clinical features, laboratory and coronary angiographic findings, treatments, and outcomes among patients with ST-segment elevation myocardial infarction (MI) with and without left bundle branch block (LBBB). We examined 5,742 patients with ...
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Journal ArticleAm Heart J · September 2011
INTRODUCTION: Contemporary non-ST-elevation myocardial infarction-acute coronary syndrome guidelines emphasize early-risk stratification and optimizing therapy including an invasive strategy in high-risk patients. To assess the feasibility of initiating th ...
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Journal ArticleJ Thromb Thrombolysis · August 2011
To discuss and share knowledge around advances in the care of patients with thrombotic disorders, the Third International Symposium of Thrombosis and Anticoagulation was held in São Paulo, Brazil, from October 14-16, 2010. This scientific program was devel ...
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Journal ArticleN Engl J Med · July 7, 2011
BACKGROUND: Nesiritide is approved in the United States for early relief of dyspnea in patients with acute heart failure. Previous meta-analyses have raised questions regarding renal toxicity and the mortality associated with this agent. METHODS: We random ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · July 2011
BACKGROUND: The use of upstream small-molecule glycoprotein (GP) IIb/IIIa inhibitors in non-ST-segment elevation acute coronary syndromes (NSTE ACS) has been studied in multiple randomized clinical trials. We systematically reviewed the effect of upstream ...
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Journal ArticleAm Heart J · July 2011
BACKGROUND: Mortality after ST-elevation myocardial infarction (STEMI) has reduced with reperfusion by primary percutaneous coronary intervention (PCI), which may have impacted on the adverse outcomes of cardiogenic shock (CS) and congestive heart failure ...
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Journal ArticleJ Am Coll Cardiol · May 10, 2011
OBJECTIVES: This study investigated the occurrence of intraluminal thrombus and its potential implications with facilitated percutaneous coronary interventions (fPCIs). BACKGROUND: The effect of fPCI on the presence and consequences of intraluminal thrombu ...
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Journal ArticleAm Heart J · May 2011
BACKGROUND: Traditional time-to-event analysis assigns equal weight to the first event in the composite end point. This is counterintuitive to many stakeholders. METHODS: We constructed weights for components of a composite efficacy end point and a net cli ...
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Journal ArticleAm Heart J · April 2011
BACKGROUND: The association of sustained ventricular tachycardia/fibrillation (VT/VF) with mortality in patients undergoing primary percutaneous coronary intervention (PCI) may vary with baseline patient risk and may be associated with higher mortality in ...
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Journal ArticleArch Intern Med · March 28, 2011
BACKGROUND: To understand the influence of age on treatment and outcomes, we analyzed the largest group of patients 75 years or older with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention (PPCI) in a clinic ...
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Journal ArticleContemp Clin Trials · March 2011
BACKGROUND: Independent adjudication of clinical trial events is traditionally performed by physicians on a clinical event classification (CEC) committee. OBJECTIVES: The experience of the centralized CEC group of the APEX-AMI trial is described. This grou ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · March 2011
BACKGROUND: Prior studies demonstrate a direct relationship between treatment delays to primary percutaneous intervention and mortality in patients with ST-segment elevation myocardial infarction (STEMI). This analysis compared the relationship of symptom ...
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Journal ArticleCirculation · February 22, 2011
BACKGROUND: In the Early Glycoprotein IIb/IIIa Inhibition in Patients with Non-ST-Segment Elevation Acute Coronary Syndrome (EARLY ACS) trial, routine preangiography eptifibatide use was not superior to delayed provisional use but led to more bleeding. Thi ...
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Journal ArticleArch Intern Med · February 14, 2011
BACKGROUND: Heart failure (HF) is a debilitating and chronic condition associated with significant morbidity and mortality. However, much less is known about end-of-life (EOL) costs among patients with HF. METHODS: To examine trends in resource use and cos ...
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Journal ArticleAm Heart J · February 2011
BACKGROUND: The CAPTIM trial suggested a survival benefit of prehospital fibrinolysis (FL) compared to primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI) with a presentation delay of <2 hours. We ex ...
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Journal ArticleJ Am Coll Cardiol · January 11, 2011
OBJECTIVES: The purpose of this study was to examine the association between lower socioeconomic status (SES), as ascertained by years of education, and outcomes in patients with acute ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Previou ...
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Journal ArticleCan J Cardiol · 2011
BACKGROUND: The preferred reperfusion strategy for ST-segment elevation myocardial infarction (STEMI) is percutaneous coronary intervention (PCI) provided it can be performed in a timely fashion at an expert 24/7 facility. However, many Canadians reside in ...
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Journal ArticleAm Heart J · January 2011
BACKGROUND: over the last decade, there have been major changes in the treatment of ST-elevation myocardial infarction (STEMI). Whether these have resulted in changes in sex differences in time to treatment is unknown. We examined temporal trends in time t ...
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Journal ArticleAm J Med · January 2011
BACKGROUND: studies have shown higher bleeding and mortality rates among African Americans who receive fibrinolytic therapy for ST-segment elevation myocardial infarction (STEMI) compared with whites; however, the relationship of bleeding risk to mortality ...
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Journal ArticleCirc Cardiovasc Interv · October 2010
BACKGROUND: Accurate models to predict mortality are needed for risk stratification in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). METHODS AND RESULTS: We examined 5745 patie ...
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Journal ArticleAm Heart J · October 2010
BACKGROUND: ST-elevation myocardial infarction (STEMI) patients with a prior MI history have worse outcomes. The prognostic significance of silent MI (pathologic Q waves outside the ST-elevation territory) in STEMI is unclear. METHODS: A total of 5,733 STE ...
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Journal ArticleCrit Care Med · September 2010
OBJECTIVE: Cardiogenic shock is a major cause of death in ST elevation myocardial infarction. We investigated whether determination of plasma [corrected] B-type natriuretic peptide and the N-terminal fragment of its pro-hormone in the acute phase of ST ele ...
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Journal ArticleEur Heart J · September 2010
AIMS: Multiple trials in patients with ST-segment elevation myocardial infarction (STEMI) compared early routine percutaneous coronary intervention (PCI) after successful fibrinolysis vs. standard therapy limiting PCI only to patients without evidence of r ...
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Journal ArticleAm J Cardiol · September 1, 2010
The prognostic value of myocardial infarct size estimation by QRS scoring in patients with ST-segment elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (PCI) is unclear. The standard 32-point Selvester QRS score ...
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Journal ArticleHealth Serv Manage Res · August 2010
To assess whether changes in length of wait are correlated (directly) with changes in size of list, i.e. whether census-, event- and enrolment-based estimates of the percentage that waited 0-2 months are valid measures. EyeNet Sweden supplied dates of extr ...
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Journal ArticleAm Heart J · August 2010
OBJECTIVES: The purpose of this study was to determine predictors of 90-day left ventricular function following acute ST-segment elevation myocardial infarction (STEMI) using variables from clinical presentation, biomarker testing, and cardiovascular magne ...
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Journal ArticleAm Heart J · July 2010
BACKGROUND: Primary percutaneous coronary intervention (PCI) has emerged as the preferred therapy for acute ST-elevation myocardial infarction (STEMI) provided it is performed in a timely fashion at an expert 24/7 facility. Fibrinolysis is a well-accepted ...
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Journal ArticleEur Heart J · July 2010
AIMS: To examine the incidence of and propensity for non-culprit interventions performed at the time of the primary percutaneous coronary intervention (PCI) and its association with 90-day outcomes. METHODS AND RESULTS: We examined the incidence, propensit ...
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Journal ArticleEur Heart J · July 2010
AIMS: Controversy exists regarding the early use of glycoprotein IIb/IIIa inhibitors (GPIs) in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). The Assessment of Pexelizumab in Acute Myoc ...
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Journal ArticleAm Heart J · July 2010
Practice guidelines recommend dual antiplatelet therapy with aspirin and clopidogrel for patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) regardless of in-hospital management strategy. Prasugrel-a thienopyridine adenosine diphosph ...
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Journal ArticleAm Heart J · June 2010
BACKGROUND: Despite advances in therapy, global mortality due to acute myocardial infarction remains high. The international Hirulog and Early Reperfusion or Occlusion (HERO-2) trial of 17,073 patients with ST-segment elevation myocardial infarction provid ...
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Journal ArticleAm Heart J · May 2010
BACKGROUND: ST2 is a member of the interleukin-1 receptor family that is up-regulated in conditions associated with increased myocardial strain. ST2 has been shown to be independently predictive of adverse outcome in heart failure and ST-segment elevation ...
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Journal ArticleEur Heart J · May 2010
AIMS: Experimental data point towards a favourable effect of low serum concentrations of complement mannose-binding lectin (MBL) on myocardial ischaemia/reperfusion (I/R) injury. As comparable data on the role of MBL in human I/R injury is lacking, we inve ...
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Journal ArticleAm Heart J · May 2010
BACKGROUND: Accurate estimation of coronary epicardial flow in patients with ST-elevation myocardial infarction (STEMI) is crucial to evaluating the effect of therapy and predicting outcome. Whether operator bias exists in visual estimation of TIMI flow gr ...
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Journal ArticleJACC Cardiovasc Interv · March 2010
OBJECTIVES: We sought to compare outcomes in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) with or without previous coronary artery bypass grafts (CABG). BACKGROUND: Limited informat ...
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Journal ArticleEur Heart J · March 2010
AIMS: To evaluate the prognostic impact of ST depression resolution among patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI in the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX-AMI) trial. METHODS AND ...
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Journal ArticleHealth Serv Manage Res · February 2010
To demonstrate that the incomplete waits captured at the time and by means of a census may not have the same distribution as the completed waits captured as a result of admission during a specified calendar period, cataracts added to waiting lists in Engla ...
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Journal ArticleJACC Cardiovasc Interv · February 2010
OBJECTIVES: The aim of this study was to assess the risk-benefit of enoxaparin (Sanofi-Aventis, Paris, France) in primary percutaneous coronary intervention (PCI). BACKGROUND: Randomized studies have demonstrated the superiority of enoxaparin over unfracti ...
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Journal ArticleAm J Med · February 2010
BACKGROUND: We examined warfarin use at discharge (according to Congestive heart failure, Hypertension, Age>75 years, Diabetes, Prior Stroke/transient ischemic attack score and bleeding risk) and its association with 6-month death or myocardial infarction ...
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Journal ArticleCan J Cardiol · 2010
BACKGROUND: Electrocardiograms (ECGs) are essential in identifying the type and location of acute myocardial infarction. In the setting of inferior wall myocardial infarction (IWMI), identification of the right coronary artery (RCA) as the culprit artery i ...
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Journal ArticleJ Electrocardiol · 2010
BACKGROUND: Atrial infarction reportedly occurs in 0.7% to 52% of ST-elevation myocardial infarctions (STEMIs), up to two thirds of whom develop atrial fibrillation and flutter (AF). Prospective validation of electrocardiographic atrial infarction patterns ...
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Journal ArticleAm J Cardiol · January 1, 2010
A decrease in mechanical complications after ST-elevation myocardial infarction may have contributed to improved survival rates associated with reperfusion by primary percutaneous coronary intervention (PCI). Mechanical complications occurred in 52 of 5,74 ...
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Journal ArticleAm Heart J · January 2010
BACKGROUND: We investigated the prognostic significance of plasma N-terminal fragment of the prohormone B-type natriuretic peptide (Nt-proBNP) concentrations in addition to time to reperfusion and Thrombolysis in Myocardial Infarction (TIMI) flow before an ...
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Journal ArticleJACC Cardiovasc Imaging · January 2010
OBJECTIVES: The purpose of the study was to understand determinants of infarct size in a primary percutaneous intervention (PCI) population treated with pexelizumab compared with placebo. BACKGROUND: In the multicenter APEX-AMI (Pexelizumab in Conjunction ...
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Journal ArticleJ Card Fail · December 2009
BACKGROUND: The Warfarin and Antiplatelet Therapy in Chronic Heart Failure (WATCH) trial revealed no significant differences among 1587 symptomatic heart failure patients randomized to warfarin, clopidogrel, or aspirin in time to all-cause death, nonfatal ...
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Journal ArticleAm Heart J · December 2009
BACKGROUND: Inhibition of the P2Y12 ADP-receptor with oral antiplatelet agents given to patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) is associated with improved outcomes, but this strat ...
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Journal ArticleEur Heart J · November 2009
AIMS: Red blood cell transfusion is associated with increased mortality among patients with acute coronary syndromes, but little is known about the consequences of transfusion in a contemporary setting of ST-segment elevation myocardial infarction. We desc ...
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Journal ArticleAm Heart J · November 2009
BACKGROUND: Reperfusion with primary percutaneous intervention (PCI) in ST-segment elevation myocardial infarction leads to improved clinical outcomes. The contribution angiographic vs electrocardiographic reperfusion parameters confer on prognosis is uncl ...
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Journal ArticleJACC Cardiovasc Interv · October 2009
OBJECTIVES: The aim of this report was to evaluate 12-month outcomes of facilitated percutaneous coronary intervention (PCI) in the FINESSE (Facilitated Intervention with Enhanced Reperfusion Speed to Stop Events) trial. BACKGROUND: Treatment delays remain ...
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Journal ArticleJACC Cardiovasc Interv · October 2009
OBJECTIVES: We hypothesized that patients most likely to benefit would be those at high risk with a shorter duration of acute ischemia and who required transfer for percutaneous coronary intervention (PCI). BACKGROUND: The FINESSE (Facilitated Intervention ...
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Journal ArticleJACC Cardiovasc Interv · October 2009
OBJECTIVES: We have performed a retrospective analysis of the data stratified by time to treatment and by enrollment site: percutaneous coronary intervention hospitals (PCIH), nonpercutaneous coronary intervention hospitals (NoPCIH), or in a pre-hospital s ...
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Journal ArticleEur Heart J · September 2009
AIMS: N-terminal pro-brain natriuretic peptide (NT-proBNP) levels predict outcomes in ST-elevation myocardial infarction patients treated with fibrinolysis or primary percutaneous coronary intervention (PCI). However, its role in facilitated PCI has not ye ...
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Journal ArticleAm Heart J · September 2009
BACKGROUND: The protease-activated receptor 1 (PAR-1), the main platelet receptor for thrombin, represents a novel target for treatment of arterial thrombosis, and SCH 530348 is an orally active, selective, competitive PAR-1 antagonist. We designed TRA*CER ...
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Journal ArticleJAMA · August 26, 2009
CONTEXT: Conflicting information exists about whether sex differences modulate short-term mortality following acute coronary syndromes (ACS). OBJECTIVES: To investigate the relationship between sex and 30-day mortality in ACS, and to determine whether this ...
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Journal ArticleCan J Cardiol · August 2009
BACKGROUND: Recent research and contemporary ST elevation myocardial infarction guidelines emphasize the importance of prompt reperfusion and have redefined the traditional time to treatment metric to include prehospital paramedical staff as the point of f ...
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Journal ArticleEur Heart J · August 2009
AIMS: To assess the incidence and timing of atrial fibrillation (AF), describe antithrombotic therapy use, and evaluate the association of AF with 90 day mortality and other secondary clinical outcomes. METHODS AND RESULTS: We studied 5745 ST-segment eleva ...
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Journal ArticleHeart · August 2009
BACKGROUND: Spontaneous reperfusion (SR) in ST elevation myocardial infarction (STEMI) improves clinical outcome, yet its incidence and impact among diabetic patients is unclear. OBJECTIVE: To carry out a systematic analysis of SR in the diabetic cohort of ...
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Journal ArticleCan J Cardiol · July 2009
BACKGROUND: Despite its widespread use, limited data on the validity of the Canadian Cardiovascular Society angina (CCSA) classification relative to other measures of functional status have been reported. OBJECTIVE: To assess the validity of the CCSA class ...
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Journal ArticleAnn Intern Med · June 2, 2009
BACKGROUND: Guidelines recommend that patients with heart failure receive beta-blockers in doses used in the trials that have proven their efficacy. Although the adverse effects of beta-blockade are dose-related, it is unclear whether the benefits are. PUR ...
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Journal ArticleEur J Heart Fail · June 2009
AIMS: Self-care of heart failure (HF) is a process that is important, complex, and challenging. Little is understood of the contextual factors influencing self-care. We aimed to examine the individual and contextual factors perceived by patients and their ...
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Journal ArticleN Engl J Med · May 21, 2009
BACKGROUND: Glycoprotein IIb/IIIa inhibitors are indicated in patients with acute coronary syndromes who are undergoing an invasive procedure. The optimal timing of the initiation of such therapy is unknown. METHODS: We compared a strategy of early, routin ...
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Journal ArticleJAMA · May 6, 2009
CONTEXT: The incidence and timing of sustained ventricular tachycardia or fibrillation (VT/VF) and its impact on outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) are poorly und ...
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Journal ArticleJ Am Coll Cardiol · April 28, 2009
OBJECTIVES: We assessed the incremental value of baseline Q waves over time from symptom onset as a marker of clinical outcome in ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Time from symptom onset is a central focus in STEMI patients. ...
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Journal ArticleAm Heart J · April 2009
BACKGROUND: Because acute occlusion of coronary arteries supplying the inferolateral myocardium frequently eludes standard 12-lead electrocardiogram (ECG) diagnosis, these patients may present as non-ST-segment elevation acute coronary syndromes (NSTE-ACS) ...
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Journal ArticleCirculation · March 31, 2009
BACKGROUND: Chronic heart failure remains a major cause of mortality and morbidity. The role of antithrombotic therapy in patients with chronic heart failure has long been debated. The objective of this study was to determine the optimal antithrombotic age ...
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Journal ArticleHealth Serv Manage Res · February 2009
Health service researchers, policy analysts and other commentators have overlooked the limitations of existing approaches to the estimation of waiting times. If urgent cases are given priority, there are no instances when census-based data can supply accur ...
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Journal ArticleAm Heart J · February 2009
BACKGROUND: Acute decompensated heart failure (ADHF) is a major public health burden with significant mortality and morbidity. Nesiritide is a recombinantly produced intravenous formulation of human B-type natriuretic peptide that promotes vasodilation and ...
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Journal ArticleAm J Cardiol · January 15, 2009
Acute ST-segment elevation myocardial infarction requires prompt restoration of myocardial perfusion to salvage myocardium at risk of ischemic necrosis and improve clinical outcome. Early resolution of ST-segment elevation during the time after reperfusion ...
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Journal ArticleAm J Cardiol · January 15, 2009
We evaluated the use and outcomes of drug-eluting stents (DESs) and bare metal stents (BMSs) in a large primary percutaneous coronary intervention (PCI) acute ST-elevation myocardial infarction (MI) trial. Recently concerns have been raised with "off-label ...
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Journal ArticleJ Am Coll Cardiol · January 6, 2009
OBJECTIVES: The purpose of this study was to examine the long-term incidence of heart failure (HF) in elderly patients with myocardial infarction (MI). BACKGROUND: In-hospital HF is common after MI and is associated with poor short-term prognosis. Limited ...
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Journal ArticleAm Heart J · December 2008
BACKGROUND: Patients with acute coronary syndromes (ACS) may experience nonspecific prodromal symptoms before their cardiac event. We used population-level data to determine the rate at which such patients seek medical attention for these symptoms, whether ...
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Journal ArticleContemp Clin Trials · November 2008
The APEX library was a coordinated and integrated set of ancillary analyses and substudies that were a part of the large APEX-AMI trial. The library included electrocardiogram, angiographic, blood biomarker, genetics, and MRI components. Operationally, the ...
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Journal ArticleCirculation · September 23, 2008
BACKGROUND: Primary percutaneous coronary angioplasty is an effective and widely adopted treatment for acute myocardial infarction. A simple method of determining prognosis after primary percutaneous coronary intervention (PCI) would facilitate appropriate ...
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Journal ArticleAm Heart J · August 2008
INTRODUCTION: Spontaneous reperfusion (SR) in ST-elevation myocardial infarction has traditionally been assessed by coronary angiography. The frequency of SR varies widely in prior studies, and the clinical implications in the modern reperfusion era are un ...
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Journal ArticleCan J Cardiol · July 2008
Congestive heart failure comprises a major public health problem destined to grow enormously over the next decade. Paradoxically, and in contrast to acute coronary disease, acute heart failure has been relatively understudied. Current standards of care inv ...
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Journal ArticleHeart · July 2008
OBJECTIVE: To assess variables associated with the occurrence of atrial fibrillation (AF) and the relation of AF with short- and long-term outcomes and with other in-hospital complications in patients with acute coronary syndromes (ACS) with and without ST ...
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Journal ArticleN Engl J Med · May 22, 2008
BACKGROUND: We hypothesized that percutaneous coronary intervention (PCI) preceded by early treatment with abciximab plus half-dose reteplase (combination-facilitated PCI) or with abciximab alone (abciximab-facilitated PCI) would improve outcomes in patien ...
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Journal ArticleEur Heart J · May 2008
AIMS: We studied the clinical, demographic, and angiographic factors associated with successful reperfusion and the relationship between angiographic indices and clinical outcomes in a subset of the APEX-AMI trial, which tested the efficacy of pexelizumab ...
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Journal ArticleEur Heart J · April 2008
AIMS: Non-invasive risk stratification of low- and intermediate-risk non-ST-elevation acute coronary syndromes (NSTE ACS) patients has been recommended, but limited data exist about the variation in clinical practice of stress testing in these patients and ...
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Journal ArticleEur Heart J · April 2008
AIMS: Patients in ASSENT-4 PCI undergoing tenecteplase-facilitated percutaneous coronary intervention (PCI) had more adverse events than those undergoing primary PCI. We analysed this to gain further insights. METHODS AND RESULTS: A total of 549 patients w ...
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Journal ArticleArch Intern Med · March 24, 2008
BACKGROUND: Barriers to institutions participating in clinical trials include concerns about harms and costs. However, we hypothesized that patients treated at hospitals participating in trials would have better outcomes than patients treated at nonpartici ...
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Journal ArticleEur J Heart Fail · March 2008
AIMS: Previous epidemiologic studies of acute heart failure (AHF) have involved patients admitted to hospital and fail to account for that unknown proportion discharged directly from the emergency department (ED). We examined discharge rates, and whether o ...
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Journal ArticleAm Heart J · March 2008
Despite emphasis on the use of invasive management strategies for patients with non-ST-elevation acute coronary syndromes (NSTE ACS) in recent practice guidelines, 27% to 56% of NSTE ACS patients do not undergo diagnostic angiography, and a further 45% to ...
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Journal ArticleHeart · March 2008
BACKGROUND: The baseline sum of ST deviation (SigmaSTD) and ST segment resolution after fibrinolysis for ST-elevation myocardial infarction are prognostically useful. OBJECTIVES: To examine the prognostic impact of ST resolution after fibrinolysis and infl ...
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Journal ArticleAm Heart J · February 2008
BACKGROUND: Bleeding and blood transfusion are associated with increased morbidity and mortality among patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS); however, the economic consequences of these complications are not well define ...
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Journal ArticleCirculation · January 29, 2008
BACKGROUND: Substantial evidence suggests that anemia is an independent risk factor for worse outcomes in patients with heart failure (HF). The Study of Anemia in Heart Failure Trial (STAMINA-HeFT) is the largest multicenter, randomized, double-blind, plac ...
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Journal ArticleCirculation · January 15, 2008
BACKGROUND: Although treatment with immediate aspirin reduces morbidity and mortality in ST-elevation myocardial infarction, the optimal dose is unclear. We therefore compared the acute mortality and bleeding risks associated with the initial use of 162 ve ...
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Journal ArticleAm Heart J · January 2008
BACKGROUND: Rescue percutaneous coronary intervention (PCI) is efficacious after clinical failure of fibrinolytic therapy and is recommended for those with persistent ischemia, hemodynamic, or electrical instability. We sought to describe the frequency of ...
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Journal ArticleEur Heart J · December 2007
AIMS: To examine the extent and impact on clinical outcomes of adherence to electrocardiogram (ECG) entry criteria in ST-elevation myocardial infarction patients in the assessment of pexelizumab in acute myocardial infarction (APEX-AMI) trial. METHODS AND ...
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Journal ArticleCMAJ · November 6, 2007
BACKGROUND: Previous studies examining sex-related differences in the treatment of coronary artery disease have focused on patients in hospital. We sought to examine sex-related differences at an earlier point in care--presentation to the emergency departm ...
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Journal ArticleEur Heart J · November 2007
During the 2006 World Congress of Cardiology meeting in Barcelona, the Virtual Coordinating Centre for Global Collaborative Cardiovascular Research (VIGOUR) group held a symposium examining potential approaches to understanding and controlling the explosiv ...
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Journal ArticleJ Interv Cardiol · October 2007
BACKGROUND: Adverse events occur following non-ST elevation acute coronary syndromes (NSTE ACS). However, the timing of these events in relation to index event is less clear. METHODS: Accordingly, we evaluated 26,466 NSTE ACS patients from the Global Use o ...
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Journal ArticleCatheter Cardiovasc Interv · September 2007
OBJECTIVE: To evaluate the anticoagulation effect of subcutaneous (SQ) and intravenous (IV) enoxaparin through systematic anti-Xa sampling during primary PCI for acute STEMI. BACKGROUND: Although appropriate anticoagulation is essential to maximize the eff ...
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Journal ArticleEur Heart J · September 2007
AIM: To examine the association of left ventricular hypertrophy (LVH) on admission electrocardiography with adverse outcomes in acute coronary syndrome (ACS) patients. METHODS AND RESULTS: A total of 7443 non-ST-elevation ACS patients in Global Utilization ...
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Journal ArticleAm Heart J · August 2007
BACKGROUND: Although relationships between chronic Chlamydia pneumoniae (Cpn) infection and the risk of coronary events in stable coronary artery disease patients have been reported, a similar link in acute coronary syndrome (ACS) patients has not been con ...
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Journal ArticleAm Heart J · August 2007
BACKGROUND: Evidence-based medications (EBM) are underused in older patients despite potentially larger absolute benefits. Little is known about factors influencing prescribing in the elderly with acute coronary syndromes. METHODS: Among the 15,904 patient ...
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Journal ArticleCirculation · May 15, 2007
BACKGROUND: Age is an important determinant of outcomes for patients with acute coronary syndromes. However, community practice reveals a disproportionately lower use of cardiovascular medications and invasive treatment even among elderly patients who woul ...
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Journal ArticleCirculation · May 15, 2007
BACKGROUND: Age is an important determinant of outcomes for patients with acute coronary syndromes (ACS); however, community practice reveals a disproportionately lower use of cardiovascular medications and invasive treatment even among elderly patients wi ...
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Journal ArticleHeart · April 2007
OBJECTIVE: To investigate whether the beneficial and harmful effects of platelet glycoprotein IIb/IIIa receptor blockers in non-ST elevation acute coronary syndromes (NSTE-ACS) depend on age. METHODS: A meta-analysis of six trials of platelet glycoprotein ...
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Journal ArticleCirculation · February 27, 2007
BACKGROUND: Growth-differentiation factor-15 (GDF-15) is a member of the transforming growth factor-beta cytokine superfamily that is induced in the heart after ischemia-and-reperfusion injury. Circulating levels of GDF-15 may provide prognostic informatio ...
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Journal ArticleEur Heart J · February 2007
AIMS: Multiple studies have focused on the relationship of body anthropometric measures with clinical events in ST-elevation myocardial infarction (STEMI) patients, highlighting the 'obesity paradox'. However, the relative prognostic importance of these me ...
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Journal ArticleAm J Cardiol · January 15, 2007
Electrocardiographic (ECG) estimates of myocardial infarct size based on the Selvester ECG score have been shown to predict mortality and left ventricular function after acute myocardial infarction (AMI). This score has also been used to identify not clini ...
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Journal ArticleJAMA · January 3, 2007
CONTEXT: Reperfusion with percutaneous transluminal coronary intervention (PCI) is effective at improving outcomes in patients with acute ST-elevation myocardial infarction (STEMI). However, in patients without prompt reestablishment of brisk coronary flow ...
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Journal ArticleCan J Physiol Pharmacol · January 2007
While baseline N-terminal brain natriuretic peptide (NT-proBNP) is useful in the prognosis of acute ST-elevation myocardial infarction (STEMI), it is unclear whether a relationship exists between serial NT-proBNP, reperfusion success, and prognosis. We pro ...
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ConferenceClin Invest Med · 2007
Academic medicine, in its broadest sense, has made major contributions to human health in the past quarter century. This has been achieved in large part because it has attracted an outstanding cadre of--largely altruistic--professionals. These pioneering e ...
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Journal ArticleAm J Med · January 2007
PURPOSE: To assess the effects of socioeconomic status on mortality in patients with acute myocardial infarction. MATERIAL AND METHODS: We studied a retrospective cohort of 5622 patients who presented to a hospital emergency department with an initial epis ...
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Journal ArticleAm Heart J · December 2006
BACKGROUND: Although considered the highest level of evidence and critical-to-test novel therapies, clinical trials are unrepresentative of the "real world" as they lack a true patient denominator, which limits general applicability of results. Accordingly ...
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Journal ArticleEur Heart J · December 2006
AIMS: Stroke is an uncommon but serious complication after non-ST-segment elevation acute coronary syndrome (NSTE-ACS). We aimed to identify predictors of stroke within 30 days in patients who suffered NSTE-ACS. METHODS AND RESULTS: We pooled data from six ...
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Journal ArticleAm Heart J · October 2006
BACKGROUND: Elderly patients with acute myocardial infarction are at particularly high risk for death and bleeding complications. The efficacy and safety of antithrombotic strategies in these patients remain unclear. METHODS: To provide more insight into t ...
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Journal ArticleJ Am Coll Cardiol · September 19, 2006
OBJECTIVES: This study was designed to evaluate biomarkers for selection of patients with non-ST-segment elevation acute coronary syndromes (ACS) that derive mortality benefit from revascularization. BACKGROUND: Biomarkers are essential for identification ...
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Journal ArticleJ Am Coll Cardiol · September 5, 2006
OBJECTIVES: The purpose of this study was to develop 30-day and 1-year risk stratification models for non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients that incorporate quantitative ST-segment depression and novel biomarkers. BACKGROUND: ...
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Journal ArticleAm Heart J · August 2006
BACKGROUND: Prior research suggests that patients may be entered into clinical trials with different electrocardiographic (ECG) findings than specified by study protocol criteria; the extent and impact of this variability in a large-scale trial have not be ...
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Journal ArticleAm Heart J · August 2006
BACKGROUND: Recent trials evaluating the C5 complement inhibitor, pexelizumab, have shown that modulation of inflammation during ischemia/reperfusion in patients with acute myocardial infarction (MI) or undergoing coronary artery bypass graft (CABG) surger ...
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Journal ArticleJ Am Coll Cardiol · July 4, 2006
OBJECTIVES: We sought to determine whether matrix metalloproteinase (MMP) inhibitor, PG-116800, reduced left ventricular (LV) remodeling after myocardial infarction (MI). BACKGROUND: PG-116800 is an oral MMP inhibitor with significant antiremodeling effect ...
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Journal ArticleGeriatrics and Aging · July 1, 2006
The burden of cardiovascular disease increases significantly with age. One of the most complex decisions facing clinicians is whether or not to perform coronary revascularization in an older patient. Our review of recent evidence on revascularization thera ...
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Journal ArticleEur Heart J · July 2006
AIMS: Uncertainty exists as to which reperfusion strategy for ST-elevation myocardial infarction (MI) is optimal. We evaluated whether optimal pharmacologic therapy at the earliest point of care, emphasizing pre-hospital randomization and treatment was non ...
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Journal ArticleEur Heart J · July 2006
AIMS: To explore variations in invasive care of the elderly with acute coronary syndromes across international practice. METHODS AND RESULTS: Using combined populations from the SYMPHONY and 2nd SYMPHONY trials, we describe 30-day cardiac catheterization i ...
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Journal ArticleCirculation · June 6, 2006
BACKGROUND: The safety of aspirin in heart failure (HF) has been called into question, particularly in those patients (1) without coronary disease, (2) with renal dysfunction, or (3) treated with low-dose angiotensin-converting enzyme (ACE) inhibitors and ...
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Journal ArticleEur Heart J · June 2006
AIMS: In acute myocardial infarction (AMI), baseline hyperglycaemia predicts adverse outcomes, but the relation between subsequent change in glucose levels and outcomes is unclear. We evaluated the prognostic significance of baseline glucose and the change ...
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Journal ArticleCMAJ · May 9, 2006
BACKGROUND: The optimal antithrombotic therapy to accompany tenecteplase in cases of acute ST-segment elevation myocardial infarction (STEMI) remains unclear. We undertook a prespecified pooled analysis of data from the ASSENT-3 and ASSENT-3 PLUS trials. M ...
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Journal ArticleCan J Cardiol · May 1, 2006
BACKGROUND: Subcutaneous enoxaparin is increasingly employed as the antithrombin of choice in non-ST elevation myocardial infarction and in conjunction with various fibrinolytic regimens in acute ST elevation myocardial infarction (STEMI). Few data exist d ...
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Journal ArticleEur Heart J · May 2006
AIMS: To examine the relationship between revascularization within 7 days and 1-year mortality among ST-elevation myocardial infarction patients enrolled in GUSTO-V trial (n=13 451). To examine the relative contribution of system and patient level factors ...
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Journal ArticleEur Heart J · April 2006
AIMS: Although outcomes after acute myocardial infarction (AMI) seemed to be superior with primary percutaneous coronary intervention (PPCI) relative to fibrinolysis (FL), the extent to which treatment delay modulates this treatment effect is unclear. METH ...
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Journal ArticleAm Heart J · April 2006
BACKGROUND: The COMplement inhibition in Myocardial infarction treated with Angioplasty (COMMA) trial previously demonstrated an unexpected dose-dependent reduction in 90-day mortality after bolus/infusion of pexelizumab despite no reduction in the primary ...
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Journal ArticleCan J Cardiol · April 2006
AIMS: While natriuretic peptides have demonstrated diagnostic and prognostic potential in cardiac disorders, little is known about their relationship with the onset and quantification of myocardial infarction. The relationship of serial N-terminal pro-brai ...
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Journal ArticleEur Heart J · April 2006
Reperfusion therapy for ST-elevation acute coronary syndromes aims at early and complete recanalization of the infarct-related artery in order to salvage myocardium and improve both early and late clinical outcomes. Myocardial necrosis is usually confirmed ...
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Journal ArticleJAMA · March 15, 2006
CONTEXT: Not all research presented at scientific meetings is subsequently published and, even when it is, there may be inconsistencies between these results and what is ultimately printed. Although late-breaking trials sessions are now integrated into sev ...
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Journal ArticleAm J Cardiol · March 15, 2006
Numerous trials have demonstrated survival benefits using implantable cardioverter defibrillators (ICDs) for primary prevention in selected patients with left ventricular (LV) systolic dysfunction. However, eligibility criteria differed across these trials ...
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Journal ArticleCan J Cardiol · March 1, 2006
The present report describes an unusual case of pulmonary edema after adenosine cardioversion of a supraventricular tachycardia. Despite a structurally normal heart, a 52-year-old woman presented with pulmonary edema on two separate occasions, having had h ...
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Journal ArticleAm Heart J · March 2006
BACKGROUND: Observational data suggest that the diffuse inflammatory nature of coronary disease may be expressed by the presence of unstable coronary lesions in multiple vessels in patients with acute myocardial infarction. The aim of our study was to inve ...
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Journal ArticleEur Heart J · March 2006
AIMS: To evaluate whether there is an association between 30-day mortality in patients with ST-segment elevation myocardial infarction (STEMI) included in clinical trials and country gross national income (GNI). METHODS AND RESULTS: A retrospective analysi ...
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Journal ArticleJ Am Coll Cardiol · February 21, 2006
OBJECTIVES: The goal of this study was to determine the association between Thrombolysis In Myocardial Infarction (TIMI) and Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) bleeding and clinical outcomes. BACKGROUND: There are limited d ...
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Journal ArticleAm Heart J · February 2006
BACKGROUND: Patients with high-risk non-ST-segment elevation acute coronary syndromes (NSTE ACS) benefit from the early administration of aspirin, a small molecule glycoprotein IIb/IIIa inhibitor such as eptifibatide, and heparin. The INTERACT trial demons ...
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Journal ArticleEur Heart J · February 2006
AIMS: To determine what proportion of patients with heart failure are eligible for cardiac resynchronization therapy (CRT). METHODS AND RESULTS: Eligibility criteria from the trials establishing the efficacy of CRT were applied to two prospective cohorts: ...
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Journal ArticleEur Heart J · February 2006
AIMS: To demonstrate the feasibility and clinical utility of developing dynamic risk assessment models for ST-segment elevation myocardial infarction (STEMI) patients. METHODS AND RESULTS: In 6066 STEMI patients enrolled in the Assessment of the Safety and ...
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Journal ArticleAm J Cardiol · January 15, 2006
The present study evaluated whether biomarkers of ischemia, inflammation, myocardial damage, and dysfunction are equally useful in patients who have diabetes mellitus (DM) for prediction of cardiac events in non-ST-elevation acute coronary syndrome (ACS). ...
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Journal ArticleAm Heart J · January 2006
BACKGROUND: The degree to which elevated creatine kinase (CK)-MB in the presence of normal CK is predictive of outcome is not well understood despite having been studied for decades. This analysis examined whether normal CK with elevated CK-MB in patients ...
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Journal ArticleAm Heart J · January 2006
BACKGROUND: Left bundle branch block (LBBB) complicates the diagnosis of acute myocardial infarction (AMI). The Sgarbossa criteria were developed from GUSTO I to surmount this diagnostic challenge but have not been prospectively validated in a large popula ...
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Journal ArticleCan J Cardiol · December 2005
BACKGROUND: The effect that supervised or unsupervised exercise training has on aerobic capacity (peak oxygen consumption [VO2peak]), muscle strength and quality of life in older women with heart failure remains unknown. OBJECTIVE: To examine the effect of ...
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Journal ArticleAm Heart J · December 2005
BACKGROUND: Hypertension affects 1 billion individuals worldwide and is an independent risk factor for death after acute coronary syndromes (ACS). METHODS: We examined the prevalence and medical treatment of hypertension among 15,904 ACS patients randomize ...
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Journal ArticleTetrahedron Letters · November 21, 2005
Catalytic hydrogenation of dihydroindolizidinone occurred preferentially from the endo-face giving rapid entry to (8R,8aS)-8-methylhexahydroindolizin-5- one, a key intermediate in the synthesis of 5,8-disubstituted indolizidines and deoxypumiliotoxin 251H. ...
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Journal ArticleHeart · November 2005
OBJECTIVES: To assess the impact of variation in prehospital care across distinct health care environments in ASSENT (assessment of the safety and efficacy of a new thrombolytic) -3 PLUS, a large (n = 1639) contemporary multicentred international trial of ...
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Journal ArticleExpert Opin Investig Drugs · November 2005
Despite the overall efficacy of mechanical reperfusion therapies, such as percutaneous coronary intervention and coronary artery bypass graft surgery, in reducing the morbidity and mortality that is associated with acute ischaemic syndromes, many of the tr ...
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Journal ArticleAm J Cardiol · October 15, 2005
There is conflicting evidence with regard to the value of electrocardiographic left ventricular hypertrophy (LVH) in myocardial infarction. Of 5,951 patients in the ASSENT-3 trial, 273 (5%) had LVH on baseline electrocardiograms and had significantly highe ...
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Journal ArticleEur Heart J · October 2005
AIMS: Pexelizumab, a monoclonal antibody inhibiting C5, reduced 90 day mortality and shock in the COMplement inhibition in Myocardial infarction treated with Angioplasty (COMMA) trial without apparent reductions in infarct size. Inflammation is a critical ...
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Journal ArticleEur Heart J · September 2005
AIMS: Serial forecasts of final myocardial infarct (MI) size during fibrinolytic treatment (Rx) of ST-elevation MI would allow the identification of high-risk patients with a predicted major loss of viable myocardium, at a point when treatment may still be ...
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Journal ArticleEur Heart J · August 2005
AIMS: To evaluate the relationship between activated partial thromboplastin time (aPTT) and clinical outcomes in the Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO-V) trial comparing standard-dose reteplase to half-dose reteplase and ab ...
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Journal ArticleJ Am Coll Cardiol · July 5, 2005
OBJECTIVES: The purpose of this research was to examine the prognostic value of ST-segment changes (concordant ST-segment elevation and/or precordial V1 to V3 ST-segment depression) during presumed-new left bundle branch block (LBBB) in patients receiving ...
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Journal ArticleJ Electrocardiol · July 2005
BACKGROUND: The relevance of the atrial coronary anatomy in the pathogenesis of atrial arrhythmias and atrioventricular (AV) block complicating acute myocardial infarction (AMI) remains unclear. OBJECTIVES: We evaluated the location of the infarct-related ...
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Journal ArticleAm Heart J · July 2005
BACKGROUND: We studied the potential interaction between baseline risk of death and treatment with either standard fibrinolytic monotherapy or combination fibrin and platelet lysis with respect to outcome of patients with ST-elevation myocardial infarction ...
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Journal ArticleHeart · July 2005
OBJECTIVES: To examine the interaction between ST segment depression on the baseline ECG and subsequent in-hospital revascularisation on six month mortality among patients with non-ST elevation acute coronary syndromes. To examine whether ST segment depres ...
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Journal ArticleAm Heart J · June 2005
BACKGROUND: The recent North American and European practice guidelines in patients with non-ST-segment elevation acute coronary syndrome (nSTE ACS) recommend glycoprotein IIb/IIIa (GpIIb-IIIa) inhibition in patients undergoing an early invasive treatment s ...
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Journal ArticleJ Epidemiol Community Health · May 2005
STUDY OBJECTIVE: International variation in the outcomes of patients with acute coronary syndromes (ACS) has been well reported. The relative contributions of patient, hospital, and country level factors on clinical outcomes, however, remain unclear, and t ...
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Journal ArticleJAMA · April 13, 2005
CONTEXT: Incorrect dosing of alteplase has been associated with worse clinical outcomes in patients. However, patients at high risk of adverse events are more prone to dosing errors, thus confounding this relationship. OBJECTIVE: To determine if the associ ...
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Journal ArticleHealth Econ · April 2005
The growing number of multinational clinical trials in which patient-level health care resource data are collected have raised the issue of which is the best approach for making inference for individual countries with respect to the between-treatment diffe ...
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Journal ArticleAm Heart J · April 2005
BACKGROUND: The ASSENT-3 study examined the safety and efficacy of 3 alternative regimens for ST-elevation acute myocardial infarction: full-dose tenecteplase (TNK-tPA) plus enoxaparin; half-dose TNK-tPA plus unfractionated heparin plus abciximab; and full ...
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Journal ArticleJ Thromb Haemost · March 2005
BACKGROUND: Unfractionated heparin is widely used in patients with non-ST-elevation acute coronary syndromes but has important limitations. Anticoagulants with predictable kinetics and anticoagulant effects, better efficacy, and greater safety are needed. ...
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Journal ArticleAm J Cardiol · March 1, 2005
White blood cell (WBC) count and temperature are 2 global measures of inflammation that are systematically gathered and easily identifiable in a clinical setting, unlike many other markers of inflammation being investigated in patients with coronary artery ...
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Journal ArticleCan J Cardiol · February 2005
PURPOSE: Although anemia has recently been demonstrated to be a marker for poor outcomes in patients with congestive heart failure (CHF), the impact of sex on the prevalence and prognostic impact of anemia has not been adequately explored. Accordingly, the ...
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Journal ArticleCMAJ · January 18, 2005
BACKGROUND: There is uncertainty about whether physician specialty influences the outcomes of outpatients with congestive heart failure after adjustment for differences in case mix. Our objective was to determine the impact of physician specialty on outcom ...
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Journal ArticleDrug Information Journal · 2005
Maximal utility of accessible data is attractive to all partners in clinical research, whether it directly improves patient care or more accurately allows identification of the safety and efficacy of a new drug or procedure. The Food and Drug Administratio ...
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Journal ArticleEur Heart J · January 2005
AIMS: We sought to characterize the outcomes of patients with a prior percutaneous coronary intervention (PCI) who presented with a non-ST-segment elevation acute coronary syndrome (ACS). METHODS AND RESULTS: We analysed the 30 and 180 day outcomes of 3012 ...
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Journal ArticleThromb Haemost · December 2004
Pharmacologic reperfusion of patients with acute ST segment elevation myocardial infarction is designed to achieve prompt high-quality reperfusion, prevent recurrent ischemia and reinfarction, maintain long-term patency, and to enhance patient survival and ...
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Journal ArticleAm Heart J · November 2004
BACKGROUND: Current methods for risk stratification after acute myocardial infarction (MI) include several noninvasive studies. In this cost-containment era, the development of low-cost means should be encouraged. We assessed the ability of an electrocardi ...
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Journal ArticleEur Heart J · November 2004
AIMS: We analysed the contemporary incidence, outcomes, and predictors of heart failure (HF) and/or left ventricular systolic dysfunction (LVSD) before discharge in patients with acute myocardial infarction (MI). The baseline presence of HF or LVSD, or its ...
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Journal ArticleJAMA · October 6, 2004
CONTEXT: It is unclear if blood transfusion in anemic patients with acute coronary syndromes is associated with improved survival. OBJECTIVE: To determine the association between blood transfusion and mortality among patients with acute coronary syndromes ...
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Journal ArticleCirculation · September 28, 2004
BACKGROUND: In a previous substudy of the GUSTO-I trial, we observed better functional and quality-of-life outcomes among patients in the United States (US patients) compared with patients in Canada. Rates of invasive therapy were significantly higher in t ...
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Journal ArticleCan J Cardiol · September 2004
Major changes in acute ST elevation myocardial infarction (STEMI) management prompted a comprehensive rewriting of the American College of Cardiology/American Heart Association Guidelines. The Canadian Cardiovascular Society (CCS) participated in both the ...
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Journal ArticleEur Heart J · September 2004
BACKGROUND: Immediate, as well as early, revascularisation is of benefit in patients with acute coronary syndromes (ACS) presenting with ST elevation. However, trials comparing invasive versus medical treatment in patients with an acute coronary syndrome w ...
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Journal ArticleAm J Cardiol · August 15, 2004
Several case series published after the Randomized Aldactone Evaluation Study (RALES) have focused on the adverse effects of spironolactone when prescribed to participants not in a trial and the appropriateness of these prescribing practices; however, ther ...
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Journal ArticleAm J Cardiol · August 1, 2004
We investigated the effect of smaller dose, weight-adjusted heparin with earlier monitoring of activated partial thromboplastin time on the incidence of ischemic and hemorrhagic complications in patients with ST-elevation myocardial infarction treated with ...
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Journal ArticleJAMA · July 7, 2004
CONTEXT: Enoxaparin has demonstrated advantages over unfractionated heparin in low- to moderate-risk patients with non-ST-segment elevation acute coronary syndromes (ACS) treated with a conservative strategy. OBJECTIVES: To compare the outcomes of patients ...
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Journal ArticleJ Am Coll Cardiol · July 7, 2004
OBJECTIVES: The investigators undertook a systematic, comprehensive analysis of the therapeutic response and clinical outcomes of reperfusion therapy for acute ST-segment elevation myocardial infarction (STEMI) in 5,470 patients from the Assessment of the ...
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Journal ArticleAm Heart J · July 2004
BACKGROUND: Risk assessment in patients with non-ST-elevation acute coronary syndromes (NSTE-ACS) traditionally focuses on and is limited to admission findings. The objective of the current study was to develop an approach to predicting outcome in NSTE-ACS ...
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Journal ArticleEur J Emerg Med · June 2004
The Assessment of the Safety and Efficacy of a New Thrombolytic 3 (ASSENT 3 PLUS) Plus trial (n=1639) was an international trial of pre-hospital fibrinolysis with tenecteplase randomly assigned to enoxaparin or unfractionated heparin, involving 106 sites i ...
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Journal ArticleCan J Cardiol · June 2004
BACKGROUND: Potent inhibition of the platelet glycoprotein IIb/IIIa receptor has improved the acute outcome of patients presenting with acute coronary syndromes (ACS). For patients with ACS undergoing percutaneous balloon angioplasty without coronary stent ...
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Journal ArticleAm Heart J · June 2004
BACKGROUND: In the ASsessment of the Safety of a New Thrombolytic 3 (ASSENT-3) study, full-dose tenecteplase plus enoxaparin or half-dose tenecteplase plus abciximab reduced the frequency of ischemic complications of acute myocardial infarction, when compa ...
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Journal ArticleCan J Cardiol · June 2004
BACKGROUND: Comparing American and Canadian practice patterns and outcomes offers a natural experiment to examine the relative benefits of aggressive versus conservative management of coronary artery disease. In a prospective substudy of the Global Use of ...
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Journal ArticleJ Org Chem · May 28, 2004
Epoxidation and dihydroxylation of 8-methyl-2,3,6,8a-tetrahydro-1H-indolizin-5-one proceeded from the concave face with good selectivity and gave advanced precursors for pumiliotoxin and allopumiliotoxin synthesis, respectively. The origin of the selectivi ...
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Journal ArticleClin Ther · May 2004
BACKGROUND: In patients with congestive heart failure (CHF), use of submaximal doses of angiotensin-converting enzyme (ACE) inhibitors (ie, low-dose ACE inhibitors) represents usual care in routine clinical practice, whereas high-dose ACE inhibitors, beta- ...
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Journal ArticleAm Heart J · May 2004
BACKGROUND: The glycoprotein IIb/IIIa receptor antagonist abciximab reduces the risk of thrombotic complications with percutaneous coronary intervention, but also has been associated with higher bleeding rates. METHODS: In the Global Use of Strategies to O ...
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Journal ArticleArch Intern Med · April 12, 2004
BACKGROUND: Little is known about the dosing, tolerability, and impact of beta-blockers in nontrial participants. This study was conducted to evaluate the use and outcomes of beta-blockers in a tertiary care heart failure clinic. METHODS: Analysis of prosp ...
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Journal ArticleJ Card Fail · April 2004
BACKGROUND: A cardinal feature of heart failure (HF) is the reduced peak aerobic power (VO(2peak)) secondary to alterations in cardiovascular and musculoskeletal function. Methods and results During the last decade, a number of randomized trials have exami ...
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Journal ArticleAm Heart J · April 2004
BACKGROUND: Percutaneous coronary intervention (PCI) has emerged as the strategy of choice in reestablishing effective flow in occluded infarct-related arteries in patients with acute myocardial infarction (MI) if it can be administered in a timely fashion ...
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Journal ArticleCardiology Review · April 1, 2004
We examined the prevalence of ST-segment depression and Q-waves on admission and discharge electrocardiograms (ECGs) and their prognostic impact on 6-month death and recurrent myocardial infarction rates among patients with non-ST-segment elevation acute c ...
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Journal ArticleAm Heart J · April 2004
BACKGROUND: Clinical descriptors and ST-segment recovery variables hold prognostic information for clinical outcome after thrombolysis for acute myocardial infarction (MI). We sought to define the incremental prognostic value of continuous 12-lead ST-segme ...
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Journal ArticleJ Card Fail · April 2004
BACKGROUND: The role of anticoagulation in patients with chronic heart failure has long been an area of interest and controversy. Traditionally the goal of anticoagulation has been to prevent embolic events, but recent trials also demonstrated that oral an ...
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Journal ArticleCan J Cardiol · March 15, 2004
BACKGROUND: Several clinical trials have established abciximab as an efficacious agent for use in conjunction with percutaneous coronary intervention; however, there is little documented about its use in routine clinical practice in Canada. OBJECTIVES: To ...
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Journal ArticleCirculation · March 2, 2004
BACKGROUND: The prevalence, prognostic import, and impact of renal insufficiency on the benefits of ACE inhibitors and beta-blockers in community-dwelling patients with heart failure are uncertain. METHODS AND RESULTS: We analyzed data from a prospective c ...
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Journal ArticleJ Am Coll Cardiol · February 18, 2004
OBJECTIVES: We studied the outcome of diabetics enrolled in the Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) V trial to assess whether the combination of half-dose reteplase and abciximab provides any propitious benefits over standar ...
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Journal ArticleTetrahedron Letters · February 16, 2004
A novel approach to diene based quinolizidines, using an intramolecular Heck reaction in which the vinyl bromide double bond undergoes inversion of configuration, is reported. These quinolizidines have previously been proposed as tentative structures for h ...
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Journal ArticleLancet · February 14, 2004
BACKGROUND: Early discharge of low-risk patients with acute myocardial infarction is feasible and can be achieved at no additional risk of adverse events. We aimed to identify the extent to which countries have taken advantage of the opportunity for early ...
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Journal ArticleCirculation · February 10, 2004
BACKGROUND: Although many believe that platelet glycoprotein IIb/IIIa inhibitors should be used only in acute coronary syndrome patients undergoing percutaneous coronary intervention, supporting data from randomized clinical trials are tenuous. The assumpt ...
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Journal ArticleClin Invest Med · February 2004
Cardiovascular research training is experiential, and "skills" are traditionally acquired through a master-apprentice paradigm. The complexity of contemporary clinical research requires a new model for research training. Facilitated through a Strategic Tra ...
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Journal ArticleEur Heart J · February 2004
AIM: To study the relationship between outcomes and peak creatine kinase (CK)-MB levels after percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS). METHODS AND RESULTS: Peak CK-MB ratios (pe ...
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Journal ArticleJ Thromb Haemost · February 2004
BACKGROUND: Direct factor (F)Xa inhibition is an attractive method to limit thrombotic complications during percutaneous coronary intervention (PCI). OBJECTIVES: To investigate drug levels achieved, effect on coagulation markers, and preliminary efficacy a ...
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Journal ArticleInt J Cardiol · February 2004
BACKGROUND: Troponin is a specific marker of myocardial damage. For early prediction of coronary events in patients with suspicion of acute coronary syndromes the assay also needs to be highly sensitive. METHODS AND RESULTS: A rapid troponin I assay was pe ...
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Journal ArticleAm Heart J · February 2004
BACKGROUND: In acute coronary syndromes, the inflammation and the coagulation systems are activated, implying an impaired outcome. In addition to platelet inhibition, recent evidence suggests that the glycoprotein IIb/IIIa receptor inhibitor abciximab atte ...
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Journal ArticleEur Heart J · December 2003
AIMS: We sought to evaluate international patterns of use and factors influencing use of evidence-based medications early after ACS. METHODS AND RESULTS: Using a database of 15904 ACS patients enrolled in the SYMPHONY and 2nd SYMPHONY trials in 37 countrie ...
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Journal ArticleJ Thromb Thrombolysis · December 2003
BACKGROUND: While aspirin's secondary prevention benefit is clear, prior reports indicate that 19-83% of eligible patients may not use aspirin chronically. METHODS: We investigated intolerance and bleeding while on aspirin and aspirin discontinuation using ...
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Journal ArticleArch Intern Med · November 10, 2003
BACKGROUND: Patient sex has been shown to differentially affect mortality from unstable angina (UA) and acute myocardial infarction (AMI). However, to our knowledge, no prior population-based studies have examined both cohorts simultaneously to explain thi ...
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Journal ArticleJ Am Coll Cardiol · November 5, 2003
OBJECTIVES: We sought to examine trends in the use and outcomes of transmyocardial revascularization (TMR) in community practice. We also identified important risk factors for TMR and compared outcomes of TMR combined with coronary artery bypass graft surg ...
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Journal ArticleEur Heart J · October 2003
BACKGROUND: Intracranial haemorrhage is an important limitation to pharmacologic reperfusion therapy for acute myocardial infarction. The combination of a glycoprotein IIb/IIIa inhibitor, half-dose plasminogen activator and reduced-dose heparin has been ev ...
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Journal ArticleAm Heart J · October 2003
BACKGROUND: Both ST resolution and Q-wave development postfibrinolysis provide important prognostic insights in patients with acute myocardial infarction (MI). However, the relative contributions of these 2 factors to risk assessment have not been examined ...
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Journal ArticleJ Am Coll Cardiol · October 1, 2003
OBJECTIVES: The aim of this study was to evaluate percutaneous coronary intervention (PCI) in the Assessment of the Safety and Efficacy of New Thrombolytic Regimens (ASSENT-3) trial. BACKGROUND: In the ASSENT-3 trial, co-therapy with abciximab (ABC) or eno ...
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Journal ArticleCirculation · September 9, 2003
BACKGROUND: Complement activation mediates myocardial damage that occurs during ischemia and reperfusion through multiple pathways. We performed 2 separate, parallel, double-blind, placebo-controlled trials to determine the effects of pexelizumab (a novel ...
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Journal ArticleCirculation · September 9, 2003
BACKGROUND: Complement, activated during myocardial ischemia and reperfusion, causes myocardial damage through multiple processes. The COMplement inhibition in Myocardial infarction treated with Angioplasty (COMMA) trial was performed to determine the effe ...
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Journal ArticleAm Heart J · September 2003
AIMS: A fibrinolytic agent more effective than streptokinase available for bolus injection with reasonable cost-effectiveness is a desirable goal. Pilot studies with bolus pegulated staphylokinase (PEG-Sak) have revealed excellent Thrombolysis In Myocardia ...
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Journal ArticleEur Heart J · September 2003
BACKGROUND: Revascularization rates vary substantially between countries in patients with acute ST-elevation myocardial infarction (STEMI). The impact of early revascularization on clinical outcomes in such patients remains uncertain. The ASSENT-2 fibrinol ...
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Journal ArticleAm J Med · August 15, 2003
BACKGROUND: A third-generation troponin T assay with improved precision and a lower detection limit has been developed. However, the appropriate cutoff for identifying patients with the acute coronary syndrome who are at low risk of subsequent mortality ha ...
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Journal ArticleEur Heart J · August 2003
AIMS: ASSENT 3 (Assessment of the Safety and Efficacy of a New Thrombolytic) demonstrated that the bolus fibrinolytic tenecteplase (TNK), combined with enoxaparin (ENOX) or abciximab (ABCX), substantially reduced ischemic complications of acute myocardial ...
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Journal ArticleCirculation · July 22, 2003
BACKGROUND: Biochemical markers are useful for prediction of cardiac events in patients with non-ST-segment-elevation acute coronary syndrome (ACS). The associations between N-terminal pro-brain natriuretic peptide (NT-proBNP) and other biochemical and cli ...
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Journal ArticleCirculation · July 15, 2003
BACKGROUND: The combination of a single-bolus fibrinolytic and a low-molecular-weight heparin may facilitate prehospital reperfusion and further improve clinical outcome in patients with ST-elevation myocardial infarction. METHODS AND RESULTS: In the preho ...
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Journal ArticleCan J Cardiol · July 2003
BACKGROUND: The diagnosis of myocardial necrosis in patients with chronic renal failure is often difficult because biochemical markers of cardiac damage such as creatine kinase MB (CKMB) and cardiac troponin T (cTnT) may be spuriously elevated. Recent smal ...
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Journal ArticleAm Heart J · July 2003
BACKGROUND: Single-bolus tenecteplase and accelerated alteplase were shown to be equivalent for 30-day mortality rates in the double-blind Assessment of the Safety of a New Thrombolytic (ASSENT-2) study. The aim of this study is to assess mortality rates a ...
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Journal ArticleEur Heart J · June 2003
AIMS: To assess gender differences in patients with early reinfarction after fibrinolysis for acute myocardial infarction (AMI) and the impact of these differences on treatment and outcomes. METHODS AND RESULTS: We studied 3.7% of men (n=481) and 4.8% of w ...
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Journal ArticleAm J Cardiol · April 15, 2003
The risk of death or recurrent myocardial infarction (MI) in patients with chest pain and baseline isolated troponin elevation is unclear. To determine the early and short-term risk of death or MI associated with isolated troponin elevation across a spectr ...
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Journal ArticleJ Am Coll Cardiol · March 19, 2003
OBJECTIVES: We sought to evaluate C-reactive protein (CRP) and troponin T (TnT) as predictors of risk of the individual end points of mortality and myocardial infarction (MI) in a large cohort of patients with acute coronary syndrome (ACS). BACKGROUND: Bot ...
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Journal ArticleAnn Intern Med · March 18, 2003
BACKGROUND: Sudden cardiac death is common in persons with cardiovascular disease. PURPOSE: To assess the efficacy of implantable cardioverter defibrillators (ICDs) in persons at increased risk for sudden cardiac death. DATA SOURCES: MEDLINE (1980-2002), E ...
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Journal ArticleCan J Cardiol · March 15, 2003
OBJECTIVES: To investigate the impact of on-site cardiac interventional facilities on the management and outcome of patients with versus those without ST elevation acute coronary syndromes (ACS) in the Canadian-American Global Use of Strategies to Open Occ ...
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Journal ArticleEur Heart J · March 2003
BACKGROUND: Although the prognostic value of admission ST changes in patients with non-ST elevation acute coronary syndrome (ACS) is established, the utility of the discharge ECG is unknown. Accordingly, using the PARAGON-B Troponin substudy, we assessed t ...
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Journal ArticleAm Heart J · March 2003
BACKGROUND: In many patients, ventricular arrhythmias will develop early after acute myocardial infarction. We studied the incidence, timing, and outcomes of such arrhythmias in the international Global Utilization of Streptokinase and TPA (alteplase) for ...
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Journal ArticleJ Am Coll Cardiol · February 5, 2003
OBJECTIVES: Our primary objective was to examine the prognostic relationship between baseline quantitative ST-segment depression (ST) and cardiac troponin T (cTnT) elevation. The secondary objectives were to: 1) examine whether ST provided additional insig ...
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Journal ArticleCan J Cardiol · February 2003
OBJECTIVE: To evaluate the cost effectiveness of eptifibatide, a new glycoprotein IIb/IIIa receptor inhibitor, for the treatment of acute coronary syndromes (ACS) in Canada. DESIGN: A model was created to analyze the cost effectiveness of eptifibatide usin ...
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Journal ArticleAm Heart J · February 2003
BACKGROUND: Improved patient selection may optimize the efficiency of cardiac catheterization in both high- and low-rate regions. The purpose of this study was to develop and validate a clinical model for predicting high-risk coronary artery disease (CAD) ...
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Journal ArticleCirculation · January 28, 2003
BACKGROUND: This study was designed to investigate long-term effects of the glycoprotein IIb/IIIa inhibitor abciximab in patients with acute coronary syndrome without ST elevation who were not scheduled for coronary intervention. METHODS AND RESULTS: A tot ...
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Journal ArticleCirculation · January 21, 2003
BACKGROUND: Current pharmacotherapeutic options for high-risk non-ST-segment elevation acute coronary syndrome patients include aspirin, clopidogrel, heparin, and platelet glycoprotein IIb/IIIa inhibition. A key issue of uncertainty is the safety and effic ...
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Journal ArticleCirculation · January 21, 2003
BACKGROUND: Although previous work has suggested that anemia is associated with an increased mortality in selected patients with congestive heart failure (CHF), little is known about the prevalence and predictors of anemia, or whether anemia is an independ ...
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Journal ArticleAm Heart J · January 2003
Although the medical and technologic revolution in the last 3 decades has improved clinical outcome in patients sustaining acute ST-elevation myocardial infarction (STEMI), residual morbidity and mortality remain major health concerns. The critical roles o ...
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Journal ArticleEur Heart J · January 2003
AIMS: We evaluated timing of adverse cardiac events after thrombolysis to guide length of stay after ST-segment elevation myocardial infarction. METHODS AND RESULTS: Kaplan-Meier survival curves described timing of major postinfarction complications in 410 ...
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Journal ArticleAm Heart J · December 2002
BACKGROUND: Cumulative evidence suggests a positive association between Chlamydia pneumoniae (Cpn) infection and risk of future coronary events among patients with stable coronary artery disease. However, its prognostic role in unstable coronary syndromes ...
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Journal ArticleJAMA · November 6, 2002
CONTEXT: Among patients with acute myocardial infarction, combination reperfusion therapy with a platelet glycoprotein IIb/IIIa receptor inhibitor (abciximab) and a half dose of a plasminogen activator (reteplase) did not significantly reduce mortality at ...
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Journal ArticleStat Med · October 30, 2002
The likelihood of admission is reported in England as the percentage of elective episodes occurring within a certain time, for example, within three months of the date of enrollment on the waiting list. This event-based measure is calculated from cross-sec ...
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Journal ArticleEur Heart J · October 2002
AIMS: The safety and efficacy of abciximab in addition to low-molecular-weight-heparin as the primary medical treatment of acute coronary syndromes has not previously been investigated. METHODS AND RESULTS: The GUSTO IV-ACS trial included 7800 patients wit ...
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Journal ArticleAm J Med · August 1, 2002
PURPOSE: The earliest awareness of new evidence should beat the trial sites that first generated the evidence. We hypothesized that sites that had taken part in the Survival and Ventricular Enlargement (SAVE) trial, which demonstrated that angiotensin-conv ...
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Journal ArticleAm Heart J · August 2002
BACKGROUND: Data on non-Q myocardial infarctions (MI) are derived primarily from prethrombolytic era studies. Previous trials demonstrated different development rates and none reported on clinical outcomes. METHODS: Our goal was to determine the incidence ...
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Journal ArticleCirculation · July 16, 2002
BACKGROUND: The prognosis of ventricular arrhythmias among patients with non-ST-elevation acute coronary syndromes is unknown. We studied the incidence, predictors, and outcomes of sustained ventricular arrhythmias in 4 large randomized trials of such pati ...
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Journal ArticleEur Heart J · July 2002
AIMS: To evaluate the differential effects of eptifibatide therapy on unstable angina vs non-ST elevation myocardial infarction at enrollment, since the separate impact on these two major diagnostic subsets of acute coronary syndrome patients has not been ...
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Journal ArticleAm Heart J · July 2002
BACKGROUND: Resolution of ST-segment elevation after thrombolysis for acute myocardial infarction has been shown to have prognostic significance 3 hours (180 minutes) after the initiation of therapy. Whether prognostically useful information can be achieve ...
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Journal ArticleJ Am Coll Cardiol · June 5, 2002
OBJECTIVES: We sought to assess the incidence and clinical significance of elevated cardiac troponin I (cTnI) after percutaneous coronary intervention (PCI). BACKGROUND: Elevated creatine kinase-MB (CK-MB) is prognostically important after PCI, but the pro ...
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Journal ArticleAm J Med · June 1, 2002
PURPOSE: Despite the success of intravenous glycoprotein IIb/IIIa antagonists, oral formulations have failed to show benefit and have been associated with increased mortality. To understand these findings, we performed a meta-analysis of results from four ...
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Journal ArticleCirculation · May 21, 2002
BACKGROUND: Thrombin generation is critical to the formation of an arterial thrombus after rupture of an atherosclerotic plaque. In patients with stable coronary disease receiving standard medical therapy, we evaluated the pharmacokinetics, pharmacodynamic ...
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Journal ArticleAm Heart J · February 2002
BACKGROUND: Myocardial (re)infarction (MI), a common trial end point, can be difficult to identify because of inconclusive signs and symptoms. We examined disagreement between investigator and clinical events committee (CEC) reporting of MIs in an internat ...
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Journal ArticleAnn Emerg Med · February 2002
STUDY OBJECTIVE: Early treatment with fibrinolytic therapy substantially decreases mortality in acute myocardial infarction (AMI). We examined delays to hospital arrival and treatment in 2 large, multinational, randomized trials of fibrinolytic therapy: Gl ...
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Journal ArticleCirculation · January 22, 2002
BACKGROUND: Patients with prior CABG with a subsequent non-ST-segment elevation acute coronary syndrome (ACS) pose an increasingly important clinical problem. Although GP IIb/IIIa inhibitors have improved the outcome of patients with ACS, their efficacy in ...
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Journal ArticleLancet · January 19, 2002
BACKGROUND: Platelet glycoprotein IIb/IIIa inhibitors have been shown to reduce cardiac complications in patients undergoing percutaneous coronary intervention. The clinical efficacy of these drugs in acute coronary syndromes, however, is still unclear. We ...
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Journal ArticleJ Am Coll Cardiol · January 2, 2002
OBJECTIVES: The study investigated the relationship among creatine kinase (CK) elevations, clinical characteristics and cardiac events across the whole spectrum of acute coronary syndromes (ACS). BACKGROUND: Elevated serum levels of cardiac enzymes have be ...
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Journal ArticleEur Heart J · December 2001
BACKGROUND: Fibrinolytic therapy increases the risk of bleeding events. TNK-tPA (tenecteplase) is a variant of rt-PA with greater fibrin specificity and reduced plasma clearance that can be given as a single bolus. We compared the incidence and predictors ...
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Journal ArticleAm J Cardiol · December 1, 2001
The results of the ASsessment of Safety and Efficacy of a New Thrombolytic agent (ASSENT-2) trial revealed that tenecteplase (TNK) is equivalent to tissue plasminogen activator (t-PA) for treating myocardial infarction. Because careful consideration of saf ...
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Journal ArticleLancet · December 1, 2001
BACKGROUND: The combination of fibrinolytic therapy and heparin for acute myocardial infarction fails to achieve reperfusion in 40-70% of patients, and early reocclusion occurs in a substantial number. We did a randomised, open-label trial to compare the t ...
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Journal ArticleCirculation · November 27, 2001
BACKGROUND: Early ST resolution after reperfusion is a prognostic indicator in acute myocardial infarction. Little information exists regarding the prognostic utility of ST resolution beyond 4 hours after fibrinolysis. Furthermore, the relation between tim ...
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Journal ArticleBMJ · October 27, 2001
OBJECTIVE: To determine whether multidisciplinary disease management programmes for patients with coronary heart disease improve processes of care and reduce morbidity and mortality. DATA SOURCES: Randomised clinical trials of disease management programmes ...
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Journal ArticleCirculation · September 11, 2001
BACKGROUND: Trials report a 2% to 6% incidence of reinfarction after fibrinolysis for acute myocardial infarction (MI). We combined the Global Utilization of Streptokinase and Tissue plasminogen activator (alteplase) for Occluded coronary arteries (GUSTO I ...
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Journal ArticleEur Heart J · September 2001
AIMS: To determine the sequence of critical cardiovascular events in the progression of heart failure, and whether aetiology or high-dose vs low-dose lisinopril affected these pathways. METHODS AND RESULTS: This was a post-hoc investigation of the ATLAS da ...
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Journal ArticleLancet · August 25, 2001
BACKGROUND: Current fibrinolytic therapies fail to achieve optimum reperfusion in many patients. Low-molecular-weight heparins and platelet glycoprotein IIb/IIIa inhibitors have shown the potential to improve pharmacological reperfusion therapy. We did a r ...
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Journal ArticleJ Am Coll Cardiol · July 2001
OBJECTIVES: Our objectives were to develop a risk-stratification model addressing the importance of the magnitude and distribution of ST segment depression in predicting long-term outcomes and to validate the model in an analogous patient population. BACKG ...
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Journal ArticleCirculation · June 19, 2001
BACKGROUND: Troponin T (TnT) is valuable for short- and long-term risk stratification of patients with acute coronary syndromes (ACS). It also may predict which ACS patients will benefit from glycoprotein (GP) IIb/IIIa blockade. METHODS AND RESULTS: We pro ...
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Journal ArticleLancet · April 7, 2001
BACKGROUND: Lipid-lowering agents are known to reduce long-term mortality in patients with stable coronary disease or significant risk factors. However, the effect of lipid-lowering therapy on short-term mortality immediately after an acute coronary syndro ...
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Journal ArticleAm J Med · April 1, 2001
PURPOSE: Disease management programs are often advocated for the care of patients with chronic disease. This systematic review was conducted to determine whether these programs improve outcomes for patients with heart failure. METHODS: Randomized clinical ...
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Journal ArticleJ Am Coll Cardiol · March 15, 2001
OBJECTIVES: We sought to determine the incidence of and risk factors for thrombotic events early after discontinuing antithrombin therapy in patients with acute coronary syndromes. BACKGROUND: Discontinuation of treatment with heparin and other thrombin in ...
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ConferenceJ Pharm Biomed Anal · March 2001
Although angiotensin II (ANG II) has been the focal regulatory peptide of the renin-angiotensin system, its proteolytic fragments have recently been demonstrated to have biological effects. Conventional measurement of angiotensins involves radioimmunoassay ...
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Journal ArticleArch Intern Med · January 22, 2001
BACKGROUND: Treatment with angiotensin-converting enzyme (ACE) inhibitors reduces mortality and morbidity in patients with chronic heart failure (CHF), but most affected patients are not receiving these agents or are being treated with doses lower than tho ...
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Journal ArticleCanadian Journal of Cardiology · December 12, 2000
Background: Temporal changes in baseline characteristics, treatment and clinical outcomes of patients presenting with acute ST elevation myocardial infarction in Canada and the United States have not been examined comprehensively over time. Objectives: To ...
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Journal ArticleCongestive Heart Failure · December 1, 2000
Background. Angiotensin-converting enzyme (ACE) inhibitors are generally prescribed by physicians in doses lower than the large doses that have been shown to reduce morbidity and mortality in patients with heart failure. It is unclear, however, if low dose ...
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Journal ArticleEur Heart J · December 2000
AIMS: An analysis was designed to determine whether chronic heart failure patients at high cardiovascular risk benefited to the same extent from high-dose lisinopril as the whole ATLAS population. METHODS AND RESULTS: A retrospective analysis was performed ...
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Journal ArticleEur J Heart Fail · December 2000
OBJECTIVE: A cost-effectiveness analysis of high and low doses of the angiotensin-converting enzyme (ACE) inhibitor lisinopril in the treatment of chronic heart failure. METHODS: A cost-effectiveness analysis using data from a randomized controlled trial, ...
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Journal ArticleCirculation · October 10, 2000
BACKGROUND: New recombinant plasminogen activators have been developed to simulate the fibrinolytic action of the physiological serine protease tissue plasminogen activator (alteplase, t-PA), and have prolonged half-life features permitting bolus administr ...
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Journal ArticleCirculation · September 19, 2000
BACKGROUND: Little information exists concerning practice patterns between Canada and the United States in the management of myocardial infarction (MI) patients without ST-segment elevation and unstable angina. METHODS AND RESULTS: We examined the practice ...
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Journal ArticleJ Am Coll Cardiol · September 2000
Definition of MI. Criteria for acute, evolving or recent MI. Either one of the following criteria satisfies the diagnosis for an acute, evolving or recent MI: 1) Typical rise and gradual fall (troponin) or more rapid rise and fall (CK-MB) of biochemical ma ...
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Journal ArticleEur Heart J · September 2000
This document was developed by a consensus conference initiated by Kristian Thygesen, MD, and Joseph S. Alpert, MD, after formal approval by Lars Rydén, MD, President of the European Society of Cardiology (ESC), and Arthur Garson, MD, President of the Amer ...
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Journal ArticleStat Med · August 15, 2000
The aim of this paper is to demonstrate the effect of excluding incomplete observations and competing events when calculating cross-sectional measures of NHS waiting times, and to obtain a more accurate estimate of the 'time-to-admission' of those listed o ...
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Journal ArticleCirculation · August 15, 2000
BACKGROUND: Antiplatelet therapy is the mainstay of the treatment and secondary prevention of cardiovascular and cerebrovascular ischemic events. We assessed the safety, tolerability, and pharmacodynamics of lotrafiban, an oral platelet glycoprotein IIb/II ...
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Journal ArticleCirculation · August 8, 2000
BACKGROUND: Sudden unexpected death frequently occurs in chronic heart failure. The importance of acute coronary events in triggering sudden death (SD) is unclear. METHODS AND RESULTS: We evaluated at autopsy the prevalence of acute coronary findings (coro ...
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Journal ArticleAm J Cardiol · July 1, 2000
Previous reports indicate that patients who do not develop Q waves after thrombolytic therapy are a different population with a better long-term survival than those who do develop Q waves. However, the use of resources, quality of life, and health status o ...
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Journal ArticleCirculation · June 6, 2000
BACKGROUND: Appropriate treatment policies should include an accurate estimate of a patient's baseline risk. Risk modeling to date has been underutilized in patients with acute coronary syndromes without persistent ST-segment elevation. METHODS AND RESULTS ...
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Journal ArticleCirculation · May 16, 2000
BACKGROUND: When a patient survives thrombolysis for acute myocardial infarction, little information from large studies exists from which to estimate prognosis during follow-up visits. METHODS AND RESULTS: Baseline, in-hospital, and later survival data wer ...
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Journal ArticleAm Heart J · May 2000
BACKGROUND: We undertook an angiographic, dose-finding study of staphylokinase (SAK42D variant) to evaluate its efficacy and safety in patients with acute ST-segment myocardial infarction. METHODS AND RESULTS: Patients were studied within 6 hours of sympto ...
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Journal ArticleCan J Cardiol · April 2000
OBJECTIVE: To review the potential adverse effects of glucocorticoid therapy on the cardiovascular system and to provide insight into the mechanisms of these effects. DATA SOURCES: Case reports and studies demonstrating adverse effects of glucocorticoid th ...
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Journal ArticleN Engl J Med · March 16, 2000
BACKGROUND: Reducing the length of hospitalizations can reduce short-term costs, but there are few data on the long-term clinical and economic consequences of early discharge. METHODS: Using data from the Global Utilization of Streptokinase and Tissue Plas ...
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Journal ArticleJ Epidemiol Biostat · 2000
THESIS: The UK Government Statistical Service reports the percentage of elective 'admissions' that took place in England within 3 months of a patient being added to NHS waiting lists. This percentage is calculated from cross-sectional data using the total ...
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Journal ArticleJ Am Coll Cardiol · January 2000
OBJECTIVES: This study characterized clinical factors predictive of cardiogenic shock developing after thrombolytic therapy for acute myocardial infarction (AMI). BACKGROUND: Cardiogenic shock remains a common and ominous complication of AMI. By identifyin ...
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Journal ArticleCirculation · December 7, 1999
BACKGROUND: Angiotensin-converting enzyme (ACE) inhibitors are generally prescribed by physicians in doses lower than the large doses that have been shown to reduce morbidity and mortality in patients with heart failure. It is unclear, however, if low dose ...
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Journal ArticleAm J Cardiol · December 1, 1999
Troponin T has been used successfully to risk stratify patients with acute coronary syndromes, but the utility of this approach using a rapid bedside assay in patients undergoing thrombolysis for ST-segment elevation acute myocardial infarction has not bee ...
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Journal ArticleLancet · August 28, 1999
BACKGROUND: Bolus fibrinolytic therapy facilitates early efficient institution of reperfusion therapy. Tenecteplase is a genetically engineered variant of alteplase with slower plasma clearance, better fibrin specificity, and high resistance to plasminogen ...
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Journal ArticleAm Heart J · July 1999
OBJECTIVES: To evaluate the epidemiology, prognosis, and patterns of practice in patients with chronic congestive heart failure (CHF) treated and followed at a specialized clinic. METHODS: Prospective cohort study of consecutive patients referred to and fo ...
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Journal ArticleJ Am Coll Cardiol · July 1999
OBJECTIVES: We sought to compare U.S. and Canada's post-myocardial infarction (MI) cardiac catheterization practices in the detection of severe coronary artery disease (CAD). BACKGROUND: Little is known about the efficiency with which the aggressive post-M ...
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Journal ArticleCardiol Clin · May 1999
The goal of anticoagulant therapy in unstable angina is to prevent progression of a subocclusive coronary thrombus to complete occlusion of the coronary artery, thereby preventing myocardial infarction and death. Although these have been many advances in t ...
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Journal ArticleAm J Cardiol · April 15, 1999
Aspirin is beneficial in the prevention and treatment of cardiovascular events, but patients who have events while taking aspirin may have worse outcomes than those not on aspirin. We investigated the association between prior aspirin use and clinical outc ...
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Journal ArticleEur J Heart Fail · March 1999
BACKGROUND: The beneficial effect of ACE inhibitors on mortality has been established in a series of trials. However, in clinical practice, ACE inhibitors are commonly administered in doses much lower than those shown to be effective in the landmark trials ...
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Journal ArticlePacing Clin Electrophysiol · February 1999
Supraventricular tachycardia requires atrial or AV junctional tissue for its initiation and maintenance. Acute management of supraventricular tachycardias include vagal maneuvers, pharmacological treatment, and electrical cardioversion. We describe a case ...
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Journal ArticleAm Heart J · January 1999
BACKGROUND: A large proportion of deaths among patients with myocardial infarction occurs within the first 24 hours after presentation. It is not clear whether this phenomenon is also true of patients without ST-segment elevation who may or may not have in ...
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Journal ArticleEur Heart J · January 1999
AIMS: Reteplase has been reported to achieve better patency of the infarct artery than alteplase. As infarct artery patency is strongly associated with survival among patients with cardiogenic shock, we postulated that treatment with reteplase would improv ...
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Journal ArticleAmerican Journal of Physiology - Heart and Circulatory Physiology · December 1, 1998
In congestive heart failure (CHF) the alterations in cardiac NO synthase (NOS) isoforms activity and expression are incompletely documented and the chamber specificity of these changes is unknown. We studied plasma nitrate- nitrite (NO(x)/-), atrial, and v ...
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Journal ArticleAm J Physiol · December 1998
In congestive heart failure (CHF) the alterations in cardiac NO synthase (NOS) isoforms activity and expression are incompletely documented and the chamber specificity of these changes is unknown. We studied plasma nitrate-nitrite (NO-x), atrial, and ventr ...
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Journal ArticleJ Am Coll Cardiol · December 1998
OBJECTIVES: The purpose of this study to determine whether use of cardiac medications reflects evidence-based recommendations for patients with non-ST elevation acute coronary syndromes. BACKGROUND: Agency for Health Care Policy and Research practice guide ...
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Journal ArticleJ Am Coll Cardiol · December 1998
OBJECTIVES: The trial was designed to assess the safety, pharmacodynamics and effects on reperfusion of the platelet glycoprotein (GP) IIb/IIIa inhibitor lamifiban when given with thrombolysis to patients with ST segment elevation acute myocardial infarcti ...
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Journal ArticleCirculation · November 3, 1998
BACKGROUND: The baseline cardiac troponin T (cTnT) level strongly predicts short-term mortality in acute coronary syndromes, but the added value of later measures to predict short- and long-term outcome and in the context of baseline clinical characteristi ...
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Journal ArticleCirculation · November 3, 1998
BACKGROUND: Recurrent ischemia after an acute coronary syndrome portends an unfavorable outcome and has major resource-use implications. This issue has not been studied systematically among the spectrum of patients with acute coronary presentations, encomp ...
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Journal ArticleJ Am Coll Cardiol · September 1998
OBJECTIVES: We assessed the use and effects of acute intravenous and later oral atenolol treatment in a prospectively planned post hoc analysis of the GUSTO-I dataset. BACKGROUND: Early intravenous beta blockade is generally recommended after myocardial in ...
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Journal ArticleCirculation · June 23, 1998
BACKGROUND: Unstable angina and non-Q-wave myocardial infarction involve coronary arterial plaque rupture, platelet activation, and thrombus formation. This study tested the benefit of different doses of lamifiban (a platelet IIb/IIIa antagonist) alone and ...
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Journal ArticleJ Am Coll Cardiol · June 1998
OBJECTIVES: We sought to show that hirudin might interact differently with streptokinase (SK) and tissue-type plasminogen activator (t-PA), which could reduce the incidence of death or reinfarction at 30 days. BACKGROUND: In a large-scale trial of patients ...
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Journal ArticleAm J Cardiol · May 1, 1998
Increased T-wave amplitude is one of the earliest electrocardiographic (ECG) changes following coronary artery occlusion. Therefore, higher T waves in the presenting electrocardiogram should represent earlier time to treatment and thus be associated with l ...
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Journal ArticleAm Heart J · April 1998
Platelet glycoprotein (GP) IIb/IIIa blockade has the potential to advance treatment of acute coronary syndromes, both as a primary pharmacologic approach and an adjunct to interventional treatment strategies. The benefits of GP IIb/IIIa inhibition with the ...
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Journal ArticleEur Heart J · April 1998
Platelet glycoprotein (GP) IIb/IIIa blockade has the potential to advance treatment of acute coronary syndromes, both as a primary pharmacologic approach and an adjunct to interventional treatment strategies. The benefits of GP IIb/IIIa inhibition with the ...
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Journal ArticleJ Am Coll Cardiol · March 15, 1998
OBJECTIVES: We sought to study the relation between recurrent ST segment shift within 6 to 24 h of initial resolution of ST elevation after thrombolytic therapy and 30-day and 1-year mortality. BACKGROUND: Rapid and stable resolution of ST segment elevatio ...
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Journal ArticleJ Card Fail · March 1998
AIMS: This study was designed to determine regional differences in patient characteristics and medication use among patients entered into an international heart failure trial. METHODS AND RESULTS: Data for this analysis were derived from the Assessment of ...
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Journal ArticleClin Chem · March 1998
We compared cardiac troponins T (cTnT) and I (cTnI) collected within 3.5 h of ischemic symptoms for predicting clinical outcomes in 770 patients. cTnT (cutoff > 0.1 microgram/L) and cTnI (cutoff > 1.5 micrograms/L) were concordant (both positive or negativ ...
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Journal ArticleCirculation · February 10, 1998
BACKGROUND: Although the stratification of patients with myocardial infarction into ECG subsets based on the presence or absence of new Q waves has important clinical and prognostic utility, systematic evaluation of the impact of thrombolytic therapy on th ...
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Journal ArticleACC Current Journal Review · January 1, 1998
Early stratification of patients by prognostic features of the clinical presentation and early clinical course allows the physician to choose a pace and intensity of therapy that is likely to appropriately balance the risk of adverse effects of the treatme ...
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Journal ArticleCardiology Review · December 1, 1997
Heart rate variability during the first 48 hours after acute myocardial infarction was assessed in a group of 178 infarction patients among 288 who received thrombolytic therapy. From day one to day two, a significant decrease in all heart rate variability ...
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Journal ArticleClin Lab Med · December 1997
An exciting era exists as a result of the introduction of novel markers of myocardial damage. The prognostic implications of troponins, even in the setting of "minor myocardial damage," are potentially of immense value to patient care. We need to take the ...
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Journal ArticleN Engl J Med · October 16, 1997
BACKGROUND: Reteplase (recombinant plasminogen activator), a mutant of alteplase tissue plasminogen activator, has a longer half-life than its parent molecule and produced superior angiographic results in pilot studies of acute myocardial infarction. In th ...
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Journal ArticleCan J Cardiol · October 1997
Ticlopidine is an antiplatelet agent that has been proven efficacious in preventing vascular events in patients with a history of vasculopathy. Neutropenia is a significant adverse effect and pancytopenia is rarely reported. A fatal case of pancytopenia as ...
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Journal ArticleAm J Physiol · September 1997
Alterations in nitric oxide (NO) biosynthesis in the heart have been implicated in the pathophysiology of heart failure. We compared changes in cardiac nitric oxide synthase (NOS) activity and expression in genetically heart failure-prone (SHHF) rats at 6, ...
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Journal ArticleN Engl J Med · June 5, 1997
BACKGROUND: Among physicians who treat patients with acute myocardial infarction, there is controversy about the magnitude of the clinical benefit of primary (i.e., immediate) coronary angioplasty as compared with thrombolytic therapy. METHODS: As part of ...
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Journal ArticleCirculation · June 3, 1997
BACKGROUND: Although the benefit of thrombolytic therapy in reducing mortality in acute myocardial infarction is well established, the types of bleeding and risk factors for bleeding are less well described in large trials. METHODS AND RESULTS: We analyzed ...
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Journal ArticleCan J Cardiol · May 1997
OBJECTIVE: To compare the research productivity, and its impact, of individuals awarded research scholarships from the Heart and Stroke Foundation of Canada (HSFC) with that of a parallel group of unsuccessful applicants during the funding years 1980/81 to ...
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Journal ArticleAm J Cardiol · May 1, 1997
We evaluated allergic reactions in 20,201 patients randomized to the streptokinase arms of The Global Utilization of Streptokinase and t-PA (Tissue Plasminogen Activator) in Occluded Coronary Arteries (GUSTO-I) trial, and tested the hypothesis that patient ...
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Journal ArticleCMAJ · February 15, 1997
OBJECTIVES: To characterize the extent of delay in administration of thrombolytic therapy to patients with acute myocardial infarction (AMI) in Canada, to examine patient-specific predictors of such delay and to measure the effect of delay on short-term no ...
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Journal ArticleCan J Cardiol · February 1997
BACKGROUND: Left ventricular (LV) shape is a major determinant of cardiac physiology with important prognostic implications. Current techniques are limited in their ability to characterize shape. Regional curvature analysis is a recently developed method t ...
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Journal ArticleCardiovasc Res · January 1997
OBJECTIVE: We examined the response to hypertonic saline challenge (SC) as a potential predictor of fluid retention during heart failure induced by rapid ventricular pacing. METHODS: Twelve dogs (22 +/- 4 kg) were given an intra-arterial bolus of 30 ml of ...
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Journal ArticleCan J Cardiol · December 1996
Unstable angina is generally considered to encompass a spectrum of symptomatic manifestations of ischemic heart disease, intermediate between stable angina and acute myocardial infarction. Approximately 75,000 Canadians are hospitalized yearly with unstabl ...
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Journal ArticleN Engl J Med · October 31, 1996
BACKGROUND: The prognosis of patients hospitalized with acute myocardial ischemia is quite variable. We examined the value of serum levels of cardiac troponin T, serum creatine kinase MB (CK-MB) levels, and electrocardiographic abnormalities for risk strat ...
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Journal ArticleCan J Cardiol · October 1996
OBJECTIVE: To trace the evolution of coronary care and the management of acute coronary syndromes. STUDY SELECTION: Landmark articles and selected personal experiences. DATA SYNTHESIS: The evolution of coronary care falls into four major categories and dec ...
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Journal ArticleCirculation · September 15, 1996
BACKGROUND: In the randomized Global Utilization of t-PA and Streptokinase for Occluded Coronary Arteries (GUSTO-I) trial, 41021 patients received one of four thrombolytic regimens. Patients treated with accelerated tissue plasminogen activator (TPA) had a ...
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Journal ArticleN Engl J Med · September 12, 1996
BACKGROUND: Thrombin has a pivotal role in the pathogenesis of acute coronary thrombosis. We compared the clinical efficacy of a potent, direct thrombin inhibitor, recombinant hirudin, with that of heparin (an indirect antithrombin agent) in patients with ...
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ConferenceEur Heart J · September 1996
Four thrombolytic comparative trials without a placebo arm have each been conducted in populations of more than 1000 patients: GISSI-2 International, ISIS-3, GUSTO, and INJECT. The treatment strategy associated with use of intravenous heparin and the accel ...
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Journal ArticleJ Card Fail · June 1996
BACKGROUND: The canine model of pacing-induced heart failure is characterized by an absence of ventricular hypertrophy despite severe hemodynamic stress and neurohormonal activation. Given the mode of ventricular pacing, hypertrophy might occur in the atri ...
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Journal ArticleJ Am Coll Cardiol · June 1996
OBJECTIVES: This study sought to examine the relations among patient characteristics, time to thrombolysis and outcomes in the international GUSTO-I trial. BACKGROUND: Studies have shown better left ventricular function and decreased infarct size as well a ...
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Journal ArticleJ Am Coll Cardiol · May 1996
OBJECTIVES: We examined the impact of thrombolytic therapy and the prognosis of patients with non-Q wave myocardial infarction in a randomized placebo-controlled trial known as the Late Assessment of Thrombolytic Efficacy (LATE) study. BACKGROUND: Patients ...
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Journal ArticleCirculation · April 1, 1996
BACKGROUND: Diminished heart rate variability is associated with less favorable prognosis after myocardial infarction. However, the prognostic value of early (first 48 hours) measurement and the influence of thrombolytic strategies, myocardial infarction l ...
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Journal ArticleJ Am Coll Cardiol · March 1, 1996
OBJECTIVES: This study evaluated the role of changes in heart rate, cardiac filling pressures and cardiac tissue atrial and brain natriuretic peptides in the modulation of their plasma levels in a model of heart failure. BACKGROUND: Atrial and brain natriu ...
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ConferenceEur Heart J · November 1995
Assessment of the risks of new antithrombotic therapies is best undertaken by evaluating risk factors for bleeding in individual patients, and risks associated with specific antithrombotic agents. This forms the basis for the development of a management st ...
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Journal ArticleJ Am Coll Cardiol · November 1, 1995
OBJECTIVES: Our purpose was to evaluate the relation between smoking and the outcomes of patients receiving thrombolysis for acute myocardial infarction. BACKGROUND: A paradoxic beneficial effect has been observed in smokers with a myocardial infarction. W ...
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Journal ArticleHum Reprod · September 1995
Fetal antigen 2 (FA-2) is a human protein, first identified in amniotic fluid, and shown to be identical to the aminopropeptide of the alpha 1 chain of collagen type I. It exists in several different size and charge forms. In the present study, FA-2 was me ...
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Journal ArticleN Engl J Med · August 31, 1995
BACKGROUND: Differences in the management of acute myocardial infarction have been reported among countries, but few studies have investigated this issue in regions of the United States. METHODS: We compared the management of acute myocardial infarction am ...
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Journal ArticleJ Card Fail · June 1995
Rapid ventricular pacing is widely accepted as a useful model to produce heart failure. The heart failure is associated with reduced myocardial energy stores and absence of cardiac hypertrophy. In this study, it was hypothesized that a modification of the ...
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Journal ArticleJ Am Coll Cardiol · June 1995
OBJECTIVES: The ST segment monitoring substudy of the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO-I) trial compared the speed and stability of ST segment recovery among four thrombolytic strate ...
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Journal ArticleMed Care · June 1995
Treatment of acute myocardial infarction differs between the United States and Canada, but the reasons for these practice pattern differences remain elusive. To investigate whether physician beliefs and access to procedures account for these differences in ...
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Journal ArticleN Engl J Med · May 25, 1995
BACKGROUND: Patients with acute myocardial infarction who were treated with accelerated tissue plasminogen activator (t-PA) (given over a period of 1 1/2 hours rather than the conventional 3 hours, and with two thirds of the dose given in the first 30 minu ...
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Journal ArticleJAMA · May 24, 1995
OBJECTIVE: To examine differences in outcomes and patient management between patients in the United States and outside the United States undergoing thrombolysis for acute myocardial infarction. DESIGN, SETTING, AND PATIENTS: Patients in the United States ( ...
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Journal ArticleClin Chim Acta · May 15, 1995
Fetal antigen 2 (FA-2) has been identified in amniotic fluid and shown to be of fetal origin. In this study we have extended previous observations on FA-2 heterogeneity with respect to both size and charge using gel filtration, ion-exchange chromatography, ...
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Journal ArticleAm J Cardiol · May 15, 1995
To evaluate the relation of mental stress-induced ischemia to silent ischemia on ambulatory monitoring, 46 patients with stable coronary artery disease underwent standardized laboratory mental stress and exercise treadmill testing according to National Ins ...
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Journal ArticleCMAJ · March 15, 1995
Thrombolytic therapy is a huge advance in the management of acute myocardial infarction (AMI). The results of large clinical trials over the past 9 years have unequivocally demonstrated its benefit: of every 1000 patients treated 30 will be saved, at a cos ...
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Journal ArticleBr Heart J · March 1995
OBJECTIVE: To define the prevalence and pathophysiology of myocardial ischaemia induced by mental stress in patients with coronary artery disease and exercise inducible ischaemia, and to determine the correlation between the severity of coronary artery dis ...
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Journal ArticleJ Am Coll Cardiol · March 1, 1995
OBJECTIVES: This study in patients with diabetes mellitus was undertaken 1) to evaluate cardiac sympathetic innervation in diabetic patients using metaiodobenzylguanidine (MIBG) imaging; 2) to study the relation between autonomic function assessed by clini ...
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Journal ArticleCan J Cardiol · March 1995
OBJECTIVE: To assess the temporal behaviour of plasma lipoprotein(a) [Lp(a)]--a low density lipoprotein-like particle whose plasma levels are associated with atherosclerosis risk--and apolipoproteins (apo) B and A-I (the major protein components of low and ...
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Journal ArticleCan J Cardiol · February 1995
BACKGROUND: Patients with unstable angina are at increased risk of unfavourable outcomes such as myocardial infarction, death and urgent revascularization. Early risk stratification may improve subsequent outcome. Recently the presence and duration (at lea ...
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Journal ArticleTopics in Emergency Medicine · January 1, 1995
The degree of pulmonary injury experienced by the burn patient is extremely variable. A working knowledge of the burning environment and the individual's condition on the scene can provide vital information for successful management of these injuries. Carb ...
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Journal ArticleCan J Cardiol · November 1994
OBJECTIVES: To determine the influence of timing, infarct location and thrombolytic therapy on the electrocardiographic (ECG) response to exercise testing following acute myocardial infarction. DESIGN: Maximal treadmill exercise testing was performed on po ...
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Journal ArticleCan J Cardiol · November 1994
False aneurysms of the left ventricle are a rare complication of myocardial infarction. They pose a high risk of cardiac rupture and death in the immediate stages following infarction. The long term fate of these aneurysms is less clear. Based on early rep ...
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Journal ArticleN Engl J Med · October 27, 1994
BACKGROUND: Much attention has been directed to the use of medical resources and to patients' outcomes in Canada as compared with the United States. We compared U.S. and Canadian patients with respect to their use of medical resources and their quality of ...
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Journal ArticleCirc Res · October 1994
Remodeling of the vessel wall after balloon angioplasty injury is incompletely understood, and in particular, the role of extracellular matrix synthesis in restenosis has received little attention. The objective of the present study was to determine the se ...
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Journal ArticleCan J Physiol Pharmacol · October 1994
In vitro coronary artery responsiveness to noradrenaline, phenylephrine, and BHT-920 together with functional relaxation to acetylcholine was assessed in dogs at the early onset of pacing-induced heart failure (1 week) and in dogs recovered from heart fail ...
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Journal ArticleJAMA · September 28, 1994
OBJECTIVE: To compare the appropriateness of coronary angiography and coronary artery bypass graft (CABG) use between the United States and Canada. DESIGN: Retrospective randomized medical record review. SETTING: All hospitals performing coronary angiograp ...
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Journal ArticleAm J Cardiol · September 1, 1994
Ventricular premature complexes (VPCs) after acute myocardial infarction (AMI) remain important determinants of survival in the post-thrombolytic era. The role of thrombolysis, left ventricular function, and Holter ST-segment depression in modulating VPC f ...
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Journal ArticleCan J Physiol Pharmacol · September 1994
The contraction-relaxation cycle of the heart is dependent on a cycle of ATP production and utilization and a cycle of Ca uptake and Ca release by the sarcoplasmic reticulum (SR). Heart failure (HF) is associated with abnormalities of myocardial Ca and ATP ...
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Journal ArticleCirculation · August 1994
BACKGROUND: Thrombolytic therapy reduces mortality after acute myocardial infarction, even when treatment is initiated relatively late after onset of symptoms. The mechanism underlying this survival benefit is incompletely understood. METHODS AND RESULTS: ...
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Journal ArticleAm J Cardiol · July 15, 1994
To determine the prevalence of decreases in left ventricular (LV) ejection fraction (EF) at rest in patients with coronary artery disease (CAD), including those with stable angina (n = 21), unstable angina (n = 13), and recent myocardial infarction (n = 11 ...
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Journal ArticleCMAJ · July 15, 1994
OBJECTIVE: To develop a predictive index for length of stay in the intensive care unit (ICU) following cardiac surgery. DESIGN: Univariate and multivariate logistic regression analysis of a cohort of 1404 patients divided into a derivation set of 713 patie ...
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Journal ArticleCirculation · June 1994
BACKGROUND: Increased activity of the sympathetic nervous system contributes significantly to the pathophysiology of heart failure. However, cardiac efferent sympathetic function has not been well characterized in this disorder. In this study, we evaluated ...
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Journal ArticleAm J Cardiol · April 15, 1994
The role of ambulatory myocardial ischemia detection, in addition to exercise testing and myocardial perfusion scintigraphy, in the prediction of the angiographic severity of coronary artery disease in patients with stable angina was examined. Ninety-seven ...
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Journal ArticleCan J Cardiol · March 1994
OBJECTIVE: Rapid ventricular pacing in the dog produces severe congestive cardiac failure in association with neurohumoral activation and marked depression of cardiac function. This syndrome is associated with left ventricular dilation, significant wall th ...
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Journal ArticleCardiovasc Res · March 1994
OBJECTIVE: Rapid ventricular pacing reliably induces severe congestive heart failure in dogs, with an associated attenuation of baroreflex sensitivity. Unique to this model is the capacity for rapid recovery of haemodynamics and plasma noradrenaline follow ...
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Journal ArticlePeptides · 1994
We investigated the use of two HPLC injectors, one reserved for standards and the other for blanks or biological samples, to minimize shadowing in the measurement of angiotensin II (ANGII). HPLC carryover of standard ANGII to blank with a one-injector and ...
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Journal ArticleCan J Physiol Pharmacol · January 1994
We have modified an assay utilizing ion-pair high-performance liquid chromatography with electrochemical detection to measure dihydroxyphenylalanine and dyhydroxyphenylglycol simultaneously with noradrenaline. We measured these agents at control, 1 and 3 w ...
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Journal ArticleCan J Physiol Pharmacol · January 1994
The mechanism whereby chronic rapid ventricular pacing induces severe heart failure is unclear, but the phenomenon is associated with a reduction in left ventricular ATP levels. Accordingly, the current study was undertaken to evaluate the acute effects of ...
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Journal ArticleCardiovasc Res · January 1994
OBJECTIVES: Canine pacing induced heart failure is characterised by impaired left ventricular contractility and relaxation, and clinical recovery after cessation of pacing. It is unclear whether the impairment is responsive to adrenergic stimulation. The a ...
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Journal ArticleCirculation · December 1993
The increased incidence and prevalence of congestive heart failure place a high priority on novel treatment strategies. Left ventricular ejection fraction remains the single most valuable measurement providing both diagnostic and prognostic insights. The m ...
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Journal ArticleN Engl J Med · November 25, 1993
BACKGROUND: Although it is known that thrombolytic therapy improves survival after acute myocardial infarction, it has been debated whether the speed with which coronary-artery patency is restored after the initiation of therapy further affects outcome. ME ...
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Journal ArticleN Engl J Med · September 2, 1993
BACKGROUND: The relative efficacy of streptokinase and tissue plasminogen activator and the roles of intravenous as compared with subcutaneous heparin as adjunctive therapy in acute myocardial infarction are unresolved questions. The current trial was desi ...
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Journal ArticleJ Am Coll Cardiol · September 1993
OBJECTIVES: The objectives of this study were 1) to define in an experimental model of heart failure the time course of changes in plasma brain natriuretic peptide concentrations during the development of and recovery from heart failure, and 2) to relate t ...
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Journal ArticleAm J Cardiol · August 15, 1993
The influence of tissue plasminogen activator (t-PA) and heparin versus heparin alone on anatomic characteristics of patent infarct-related coronary arteries and the development of these angiographic descriptors in coronary arteries that remain patent duri ...
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Journal ArticleCardiovasc Res · March 1993
OBJECTIVE: The role of myocardial beta receptors in pacing induced congestive heart failure is uncertain. The aims of the study were therefore (1) to examine total beta adrenoceptor density in canine left ventricle during pacing induced heart failure; and ...
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Journal ArticleJ Lab Clin Med · February 1993
Left ventricular myocardial blood flow and metabolic parameters were studied in dogs with severe heart failure induced by rapid ventricular pacing. The impact of early administration of enalapril was also evaluated. Seventeen dogs were randomly assigned in ...
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Journal ArticleJ Am Coll Cardiol · November 15, 1992
OBJECTIVES: We performed Holter monitoring on days 4 and 7 after acute myocardial infarction in 109 patients to assess whether ST segment shift would identify those with more severe coronary artery disease, left ventricular dysfunction and unfavorable prog ...
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Journal ArticleAm Heart J · November 1992
The frequency, clinical pattern, and timing of recurrent angina following successful single-lesion percutaneous transluminal coronary angioplasty (PTCA) was assessed in a consecutive group of 104 patients with stable angina and in 85 with unstable angina. ...
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Journal ArticleCan J Physiol Pharmacol · October 1992
In vitro coronary artery responsiveness to angiotensin I, angiotensin II, noradrenaline, phenylephrine, BHT 920, and potassium chloride together with functional relaxation to acetylcholine was investigated in dogs with pacing-induced heart failure treated ...
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Journal ArticleCan J Cardiol · September 1992
OBJECTIVE: To define prevalence, pathophysiology and relation to thrombolytic therapy of reverse redistribution (appearance of a new, or worsening of an existing, scintigraphic defect on 4 h delayed images compared with the stress thallium image). DESIGN: ...
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Journal ArticleJ Cardiovasc Pharmacol · August 1992
The responsiveness of both the in vitro dorsal pedal artery and in vitro saphenous vein to alpha-adrenergic agents and prostaglandin F2 alpha was evaluated at baseline (prior to the onset of rapid ventricular pacing), at 1 week of pacing (mild heart failur ...
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Journal ArticleJ Am Coll Cardiol · July 1992
Growth or altered metabolism of nonmyocyte cells (cardiac fibroblasts, vascular smooth muscle and endothelial cells) alters myocardial and vascular structure (remodeling) and function. However, the precise roles of circulating and locally generated factors ...
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Journal ArticleJ Mol Cell Cardiol · July 1992
Myoglobin is known to protect the mechanical function of the heart from hypoxia by acting as a sarcoplasmic oxygen reservoir and shuttle. We postulated a role for myoglobin in the pathogenesis of congestive heart failure. Several models of congestive heart ...
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Journal ArticleCan J Psychiatry · June 1992
We evaluated the association of psychiatric morbidity during the early phase of admission to a coronary care unit with cardiac diagnosis and subsequent morbidity. Ninety-two patients admitted for the first time for presumed myocardial infarction were evalu ...
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Journal ArticleCirculation · June 1992
BACKGROUND: Lipoprotein(a) [Lp(a)] is a low density lipoprotein-like particle whose apolipoprotein B (apo B) moiety is disulfide-linked to apo(a), a plasminogen-like inhibitor of fibrinolysis in vitro. We hypothesized that plasma concentrations of Lp(a) ar ...
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Journal ArticleJ Cardiovasc Pharmacol · May 1992
The pharmacokinetics of synthetic atrial natriuretic factor (ANF) and its effects on cyclic GMP, urinary sodium excretion, and hemodynamics were compared in 18 control subjects with normal hemodynamics and 12 patients with severe heart failure. Human 99-12 ...
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Journal ArticleAm J Cardiol · May 1, 1992
The hypothesis that an infusion of recombinant tissue-type plasminogen activator (rt-PA) maintained for up to 24 hours could prevent reocclusion after early coronary patency had been established was evaluated in patients with acute myocardial infarction. T ...
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Journal ArticleJournal of the American College of Cardiology · May 1, 1992
The Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) trial is a large scale international trial of new myocardial reperfusion strategies. The primary hypothesis is that early and sustained coronary ...
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Journal ArticleCardiovasc Res · April 1992
OBJECTIVE: The aim was to evaluate changes in indices of left ventricular contractility and relaxation in relation to changes in loading conditions in dogs with rapid pacing induced heart failure. METHODS: 14 conscious male mongrel dogs were paced at 250 b ...
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Journal ArticleCirculation · January 1992
BACKGROUND: Because coronary thrombosis is important in the pathogenesis of unstable angina and correlates with in-hospital cardiac events, we hypothesized that thrombolytic therapy would decrease cardiac events. METHODS AND RESULTS: We randomized 70 patie ...
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Journal ArticleCathet Cardiovasc Diagn · November 1991
To assess the hemodynamic factors affecting left-to-right shunting following balloon mitral valvuloplasty we studied 10 patients at 3 points during the procedure: pre-septal dilation, post-septal dilation pre-valvuloplasty, and post-valvuloplasty. Hemodyna ...
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Journal ArticleEur J Pharmacol · August 6, 1991
Isoprenaline produced concentration-dependent contractions of the in vitro canine saphenous vein which were attenuated by phentolamine (10(-6) M) and pacing-induced heart failure. Both at control and peak heart failure, a biphasic response was seen in the ...
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Journal ArticleAm J Cardiol · June 15, 1991
The effect of autologous blood perfusion, delivered through an angiographic power injector, on alleviating left ventricular (LV) hemodynamic deterioration during percutaneous transluminal coronary angioplasty (PTCA) was examined. LV systolic and diastolic ...
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Journal ArticleCardiovasc Res · June 1991
STUDY OBJECTIVE: The aim was to study the nature, magnitude, and time course of left ventricular structural adaptations to evolving heart failure. DESIGN: 17 male mongrel dogs, weight 24.9(SD 3.7) kg, underwent rapid ventricular pacing (250 beats.min-1) un ...
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Journal ArticleJ Am Coll Cardiol · June 1991
Infarct size, left ventricular function and infarct-related coronary artery patency were examined in 108 patients who took part in a previously reported placebo-controlled trial of recombinant tissue-type plasminogen activator (rt-PA) in acute myocardial i ...
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Journal ArticleJ Lab Clin Med · June 1991
The effects of volume loading on atrial pressures and dimensions, plasma levels of atrial natriuretic factor (ANF), and other neurohormonal variables were studied in 11 patients with normal hemodynamics with the patients in a supine -15 degree left decubit ...
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Journal ArticleAm J Cardiol · May 15, 1991
The prevalence of silent myocardial ischemia and its relation to autonomic dysfunction and pain threshold was studied in 58 men with diabetes mellitus and without cardiac symptoms. All patients underwent 48-hour ambulatory electrocardiographic monitoring a ...
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Journal ArticleCirculation · May 1991
BACKGROUND: This study evaluated the role of changes in heart rate, atrial pressure, volume, and cardiac tissue atrial natriuretic factor (ANF) concentration in the modulation of plasma ANF concentration in a model of pacing-induced heart failure. METHODS ...
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Journal ArticleCMAJ · April 15, 1991
In October 1989, the Canadian Cardiovascular Society announced a program to achieve consensus on important issues in the care of patients with cardiovascular disease. This report on the management of the postmyocardial infarction patient represents the fir ...
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Journal ArticleCirc Res · April 1991
The role of the endothelium in regulating coronary alpha-adrenergic tone was evaluated in isolated coronary arterial rings from dogs with and without pacing-induced congestive heart failure (CHF). The maximal contractile response to methoxamine was attenua ...
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Journal ArticleCan J Cardiol · April 1991
This study was undertaken to clarify the relationships among dose, plasma concentration time course, therapeutic efficacy, electrocardiographic effects, and toxicity of amiodarone during the initiation and maintenance of oral therapy. A standardized dosing ...
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Journal ArticleCan J Physiol Pharmacol · February 1991
The development of muscle fatigue due to exhaustive exercise is associated with impaired sarcoplasmic reticulum (SR) Ca-transport activity. This study tested the hypothesis that SR failure is a consistent feature of cardiac and skeletal muscle fatigue owin ...
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Journal ArticleMod Pathol · January 1991
Nineteen patients with refractory unstable angina who were undergoing aortocoronary bypass were studied to assess the extent of platelet aggregation present in the microvasculature. Ultrastructural findings on the morphology of cardiac muscle and microvasc ...
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Journal ArticleAmerican Journal of Cardiac Imaging · December 1, 1990
Quantitative analysis of thallium tomograms were compared with coronary arteriography and left ventriculography in 111 patients who had stabilized after presentation with unstable angina. Visual and quantitative analysis of thallium tomograms had similar s ...
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Journal ArticleJ Cardiovasc Pharmacol · November 1990
Postjunctional alpha-adrenoceptor characteristics were evaluated in canine dorsal pedal arterial and saphenous vein rings studied before and after development of severe pacing-induced heart failure (CHF). Before CHF, all agonists produced concentration-dep ...
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Journal ArticleAnn Intern Med · October 15, 1990
OBJECTIVE: To assess the relative value of invasive and noninvasive predictors of outcome in patients after unstable angina. DESIGN: Cohort of 54 patients with unstable angina who had 6-month follow-up after stabilization on medical therapy. SETTING: Unive ...
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Journal ArticleBiochem J · October 15, 1990
A novel inhibitor of receptor-mediated calcium entry (RMCE) is described. SK&F 96365 (1-(beta-[3-(4-methoxy-phenyl)propoxy]-4-methoxyphenethyl)-1H- imidazole hydrochloride) is structurally distinct from the known 'calcium antagonists' and shows selectivity ...
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Journal ArticleCirculation · October 1990
To test the hypothesis that in the failing volume-overloaded ventricle, the extracellular matrix and fibrillar collagen in particular are major determinants of the architectural remodeling of the myocardium, this histopathological study of the dilated, pos ...
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Journal ArticleJ Am Coll Cardiol · September 1990
The response of atrial natriuretic factor to an acute increase in atrial pressures produced by changing from a 45 degrees upright to a -15 degrees Trendelenburg tilt was examined in 21 patients with heart failure and 8 control subjects with normal hemodyna ...
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Journal ArticleBr J Pharmacol · September 1990
1. The relaxant actions of nitroglycerin (previously considered to be an endothelium-independent relaxing agent) and acetylcholine (an endothelium-dependent relaxing agent) were compared on 4 vascular preparations (dorsal pedal artery, saphenous vein, left ...
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Journal ArticleCardiovasc Res · July 1990
STUDY OBJECTIVE: The aim was to study the interactions between pulmonary capillary wedge pressure (an estimate of left atrial pressure), left atrial dimension, and atrial natriuretic factor during evolving heart failure. DESIGN: Sequential simultaneous mea ...
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Journal ArticleClin Invest Med · June 1990
The hemodynamic, renal, neurohormonal effects and pharmacokinetics of synthetic atrial natriuretic factor (ANF) were studied in six conscious dogs with severe heart failure induced by right ventricular pacing at 250 beats/min for 5.0 +/- 0.6 weeks. Severe ...
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Journal ArticleClin Invest Med · February 1990
A method allowing assessment of cardiac structure and function in the conscious dog using readily available instrumentation is desirable and should provide physiologic advantages when compared to anaesthesia. Accordingly, we studied 19 dogs (22 +/- 2.5 kg) ...
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Journal ArticleJ Gen Intern Med · 1990
STUDY OBJECTIVE: To determine the optimal strategy for the timing of aortic valve replacement in patients with chronic, severe aortic regurgitation with left ventricular dysfunction. DESIGN: Decision analysis comparing early surgery (timed at the onset of ...
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Journal ArticleDrug Metab Dispos · 1990
A comparative study of the plasma disposition and tissue distribution of amiodarone and its proximate metabolite, desethylamiodarone, for a single oral dose and short-term oral dosage regimens was conducted in the dog. Four groups of male mongrel dogs (six ...
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Journal ArticleEuropean Journal of Medicinal Chemistry · January 1, 1990
Receptor mediated calcium entry (RMCE) is a now recognised mechanism by which the influx of Ca2+ into cells can occur. Agents which antagonise or block this mechanism are expected to possess anti-platelet aggregation and anti-inflammatory activities. The f ...
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Journal ArticleCan J Physiol Pharmacol · January 1990
Chronic, rapid ventricular pacing produces congestive heart failure in dogs. The objectives of this study were to determine whether or not (i) in vitro myocardial biochemical alterations reported for heart failure by volume or pressure overload also occurr ...
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Journal ArticleCMAJ · October 15, 1989
A simple model was developed to project the potential effect of intravenous thrombolytic therapy on the caseloads of revascularization early after acute myocardial infarction. Published data were used to estimate the proportion of infarct patients eligible ...
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Journal ArticleCirculation · July 1989
In 78 consecutive patients with unstable angina, we performed coronary angiography randomized to either the first day of presentation or later during the hospital admission to assess the frequency of intracoronary thrombus and complex coronary morphology r ...
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Journal ArticleJ Am Coll Cardiol · June 1989
The efficacy and safety of recombinant tissue plasminogen activator (rt-PA) administered on a dosing per weight basis was evaluated in a randomized, placebo-controlled, double-blind trial in 115 patients with acute myocardial infarction. The principal outc ...
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Journal ArticleCardiovasc Res · June 1989
Adrenergic vascular responsiveness was assessed in the dorsal pedal artery and the saphenous vein in dogs before and after the development of congestive heart failure (CHF). Following development of severe CHF, both noradrenaline and phenylephrine could pr ...
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Journal ArticleCMAJ · June 1, 1989
A consensus group convened under the auspices of the Ontario Medical Association produced guidelines for the use of intravenous thrombolytic agents in acute myocardial infarction. The guidelines, updated to December 1988, include the following points. 1) A ...
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Journal ArticleJ Am Coll Cardiol · June 1989
The significance of ST segment shift with respect to coronary anatomy and hospital outcome was evaluated in 135 patients with unstable angina. ST shift was evident in 44% of patients on admission electrocardiogram (ECG) and in 66% on Holter monitor ECG. Du ...
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Journal ArticleCan J Physiol Pharmacol · February 1989
The interactions between yohimbine (selective alpha 2-antagonist) with noradrenaline (mixed agonist) and phenylephrine (selective alpha 1-agonist) were studied in the canine dorsal pedal artery in an attempt to characterize the peripheral vascular response ...
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Journal ArticleAm Heart J · February 1989
We performed quantitative thallium scintigraphy in 66 unstable angina patients, 5.6 +/- 5.1 hours after rest pain, to predict coronary anatomy, left ventricular wall motion, and hospital outcome. Thallium defects and/or washout abnormalities were present i ...
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Journal ArticleJ Am Coll Cardiol · January 1989
The pathophysiologic role of atrial natriuretic factor and other neuroendocrine variables in relation to serum sodium and renal function was evaluated in 15 conscious dogs with severe chronic ventricular pacing-induced heart failure (250 beats/min for 5.1 ...
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Journal ArticleAm J Physiol Imaging · 1989
To develop a technique for quantitative analysis of resting thallium scintigrams, an understanding of thallium kinetics at rest is required. This study evaluates in normal man the thallium distribution and washout rates of thallium at rest and compares the ...
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Journal ArticleCan J Physiol Pharmacol · December 1988
Chronic, rapid ventricular pacing produces congestive heart failure in the dog. Using echocardiography, the features of developing heart failure were analysed and the capacity of this model for recovery was assessed once pacing had been discontinued. Fifte ...
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Journal ArticleAm J Cardiol · December 1, 1988
The safety and efficacy of exercise electrocardiography and thallium scintigraphy early in the course of unstable angina pectoris were assessed 4.6 +/- 1.6 days after admission in 67 patients with unstable angina that stabilized after medical therapy. Coro ...
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Journal ArticleClin Invest Med · December 1988
The objective of this study was to examine the integrative physiologic effects of atrial natriuretic factor (ANF). Synthetic 99-126 ANF was administered to 6 normal conscious dogs as two consecutive infusions (0.02 and 0.1 microgram/kg/min respectively) ea ...
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Journal ArticleAm J Cardiol · November 15, 1988
Complex morphology occurs frequently in unstable angina; however, its relation to symptomatic presentation, timing of angiography and hospital outcome has not been investigated. Accordingly, coronary angiography was performed 5 +/- 2 days after qualifying ...
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Journal ArticleJ Lab Clin Med · October 1988
Chronic rapid ventricular pacing (250 beats/min) induces severe heart failure in a canine model. To assess the potential for recovery after cessation of pacing, simultaneous hemodynamic and two-dimensional echocardiographic studies were conducted in nine c ...
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Journal ArticleJ Cardiovasc Pharmacol · August 1988
The acute hemodynamic effects of intravenous nisoldipine were studied in 10 patients with severe congestive heart failure. Nisoldipine was administered in three consecutive doses (1.5, 3.0, and 6.0 micrograms/kg) at least 150 min apart. Following the first ...
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Journal ArticleCMAJ · April 15, 1988
Congestive heart failure (CHF) is a condition that is increasing in incidence and is associated with significant morbidity and mortality rates. The main abnormality that underlies CHF is depressed myocardial function. The resulting decrease in cardiac outp ...
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Journal ArticleJournal of Obstetrics and Gynaecology · January 1, 1988
Urine samples, negative for protein on 'dipstick' testing (< 300 mg/l), were collected from women at 28-41 weeks of pregnancy and analysed for albumin and creatinine. Compared with a non-pregnant control group, there was no significant difference in the ur ...
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Journal ArticleJ Cardiovasc Pharmacol · April 1987
The mechanism whereby nitroglycerin initiates relaxation in vascular smooth muscle remains unclear. One hypothesis states that nitroglycerin oxidizes critical sulfhydryl groups in smooth muscle to initiate relaxation, and that repeated exposure to nitrogly ...
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Journal ArticleArch Intern Med · March 1987
Over a 13-month period, serum potassium and magnesium levels were measured in 590 patients admitted to a coronary care unit. Hypokalemia, often in the absence of diuretic use, occurred in 17% of the 211 patients with acute myocardial infarction. Patients w ...
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Journal ArticleJ Am Coll Cardiol · February 1987
Ten patients with chronic congestive heart failure were studied to assess the hemodynamic effects and bioavailability of a transdermal nitroglycerin delivery system. Nitrate sensitivity was defined by a prior 20 minute infusion of nitroglycerin, 21 microgr ...
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Journal ArticleAm J Cardiol · January 30, 1987
Nitroglycerin and nifedipine have been suggested as useful agents in the therapy of congestive heart failure. Because of the rapid action and feasability for sublingual administration of both drugs, their comparative hemodynamic and neurohumoral effects we ...
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Journal ArticleJournal of the Chemical Society, Chemical Communications · January 1, 1987
Oximes react with Michael acceptors and dipolarophiles, usually regio- and stereo-specifically, via a tandem Michael addition-1,3-dipolar cycloaddition process, to give isoxazolidines in good yield; analysis of the tandem process identifies four broad synt ...
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Journal ArticleJournal of the Chemical Society, Chemical Communications · January 1, 1987
Oximes undergo intramolecular Michael addition to proximate electronegative alkenes, generating cyclic nitrones which can be trapped inter- and intra-molecularly in 1,3-dipolar cycloaddition reactions taking place either separately or in tandem. ...
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Journal ArticleCanadian Journal of Physiology and Pharmacology · January 1, 1987
The distribution of the antiarrhythmic drug amiodarone and its principal lipophilic metabolite, desethylamiodarone, was determined in postmortem tissues of six patients who received amiodarone therapy (treatment period, 6-189 days; total dose, 4.8-127.0 g) ...
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Journal ArticleCirculation · November 1986
We examined rapid ventricular cardiac pacing as a means of inducing heart failure in the dog to establish the sequence and nature of physiologic compensation in this preparation. Seven animals paced at 250 beats/min for 3 weeks (VP1 group) showed an increa ...
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Journal ArticleAm J Med · November 1986
Nitroglycerin ointment (12.5 to 50 mg) was administered in randomized fashion to three skin sites, arm, chest, or thigh, to compare the hemodynamic effects and bioavailability in nine patients with severe congestive heart failure. Hemodynamic parameters an ...
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Journal ArticleBr J Hosp Med · November 1986
Hypertension is the single commonest cause of maternal mortality, but prompt and effective treatment with a variety of drugs, some more familiar than others, can reduce the risk of both maternal and fetal death. ...
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Journal ArticleCan Med Assoc J · June 1, 1985
Swallowing is considered a rare cause of syncope. The five patients described in this report had a spectrum of gastrointestinal tract or cardiovascular disease. For each patient there was a clear association between swallowing and the onset of syncope. Pro ...
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Journal ArticleJ Cardiovasc Pharmacol · 1985
We examined the hemodynamic effect of ethacrynic acid (EA), a diuretic, and sulfhydryl binding reagent in the dog to determine whether EA attenuated the response to nitroglycerin (GTN) in vivo or in vitro in rings of dorsal pedal artery (DPA). Six dogs (gr ...
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Journal ArticleTetrahedron · January 1, 1985
Azomethine ylides are readily generated from imines of α-amino acid esters by a formal 1,2-H shift. A suitably positioned unactivated double or triple bond in either of the two precursors of the imines (aldehyde or α-amino ester) leads to an intramolecular ...
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Journal ArticleCan Med Assoc J · December 15, 1984
Hemolytic anemia is a relatively common complication after the replacement of cardiac valves with mechanical prostheses; the prevalence rate varies from 38% to 85%, depending on the prosthesis implanted. However, cardiac valves fabricated from biologic mat ...
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Journal ArticleCrit Care Med · November 1984
We compared cuff to simultaneous direct intra-arterial pressure in 26 seriously ill patients, in order to: test the accuracy of oscillometric and auscultatory estimates of direct systolic pressure; test muffling and disappearance of sound as indices of dir ...
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Journal ArticleJ Pharmacol Methods · March 1984
We studied six dogs to determine the hemodynamic response to and pharmacokinetics of intravenous nitroglycerin (i.v. GTN) before and after a five-day treatment with placebo ointment. On the first study day, the major hemodynamic response to 21 micrograms/m ...
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Journal ArticleJ Cardiovasc Pharmacol · 1984
The hemodynamic effects and pharmacokinetics of two doses of disopyramide (DP) given as a two-stage intravenous load and maintenance infusion were studied in anesthetized dogs. One group (n = 4) received 4 mg/kg for 30 min and 1 mg/kg/h for 30 min (low-dos ...
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Journal ArticleBiochem Pharmacol · December 15, 1983
Isosorbide dinitrate (ISDN) (at a concentration of 100 ng/ml) was incubated aerobically at 37 degrees in whole blood from five male and five female normal volunteers. Following incubation of the blood samples for 0, 30, 60, 120, 240 and 360 min, the sample ...
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Journal ArticleAm J Med · June 27, 1983
The initial efficacy of long-acting nitrate preparations in the management of angina pectoris and congestive heart failure is well established. A high priority has been placed on determining whether tolerance to the early beneficial effects develops after ...
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Journal ArticleJ Pharmacol Methods · June 1983
A rapid, reliable assay is described for the quantitation of disopyramide (DP) and its metabolite, mono-N-desisopropyl-disopyramide (MNDP), in serum using p-chloro-disopyramide as the internal standard and aqueous standards for calibration. The procedure i ...
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Journal ArticleCan J Physiol Pharmacol · June 1983
The effect of inhibition of prostaglandin synthesis on nitroglycerin-induced relaxation was examined in isolated rabbit mesenteric and celiac arterial rings. An indomethacin dose of 5 microM was selected as adequate to inhibit prostaglandin synthesis as th ...
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Journal ArticleCan J Physiol Pharmacol · March 1983
A rapid and reliable high-performance liquid chromatographic (HPLC) assay has been developed for the measurement of the antiarrhythmic drug, amiodarone (A), and its metabolite, N-desethyl-amiodarone (NDA), in serum. The procedure involves addition of absol ...
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Journal ArticleCirculation · December 1982
We assessed the concentration of nitroglycerin (GTN) measured in plasma at different sampling sites in the circulation during a constant i.v. infusion. Twenty patients with chronic congestive cardiac failure underwent hemodynamic monitoring during i.v. GTN ...
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Journal ArticleCan J Physiol Pharmacol · October 1982
The mechanism by which nitroglycerin (GTN) initiates relaxation in vascular smooth muscle is not known. According to one hypothesis a specific nitrate receptor exists with a key sulfhydryl (SH) group in the active site. The current study was performed with ...
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Journal ArticleAm J Cardiol · June 1982
A prospective study of 199 patients with unstable angina pectoris was undertaken to assess whether frequent serial sampling of serum creatine kinase (CK) was useful in predicting prognosis. Nineteen percent of the patients had transient CK elevations sugge ...
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Journal ArticleJ Electrocardiol · 1982
An inexpensive system was developed for automated on-line analysis of ST segment heights, Q, R, and S heights and areas under these peaks, using an LSI-11 microcomputer. System accuracy was evaluated using a computer graphics technique which enabled magnif ...
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Journal ArticleBiomedicine · September 1981
Conventional blind randomized trials involve obtaining consent for treatment prior to randomization into control or treatment groups. When the trial is of necessity an open one, obtaining consent to treatment and then assigning the patient to a control gro ...
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Journal ArticleAm J Med · June 1980
The hemodynamic effects of disopyramide phosphate were studied in nine patients with left ventricular dysfunction. After control measurements, administration of a 2 mg/kg bolus of disopyramide phosphate over 5 or 15 minutes was followed by a 20 minute 0.4 ...
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Journal ArticleCan J Physiol Pharmacol · May 1980
Nitroglycerin (GTN) (at a concentration of 50 ng/mL) was incubated aerobically at 37 degrees C with whole blood, resuspended cells, and plasma from five normal volunteers. At several time periods following the initiation of the incubation (0, 1.5, 3, 5, 10 ...
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Journal ArticleCan Med Assoc J · October 6, 1979
Optimal therapy for congestive cardiac failure requires identification of correctable factors that aggravate it as well as an understanding of its etiology. Increased sympathetic nervous system activity, reduced renal blood flow, and cardiac hypertrophy an ...
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Journal ArticleCirculation · March 1979
Pharmacokinetic analysis of nitroglycerin (GTN) has been hampered by the lack of a sensitive and specific method for measuring GTN in blood. Therefore, we examined the appearance of GTN in blood after administering 0.6 mg sublingually in 10 studies of norm ...
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Journal ArticleCan Med Assoc J · July 22, 1978
In a 53-year-old man with ventricular pre-excitation (normal PR interval, QRS interval of 0.12 seconds and delta-waves) acute inferior wall myocardial infarction was complicated by, successively, first-degree atrioventricular block, second-degree atriovent ...
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Journal ArticleCan Med Assoc J · July 8, 1978
A woman with Prinzmetal's variant angina had spontaneous attacks of myocardial ischemia characterized by severe chest pain, hypotension, inferior ST-segment elevation, transient complete heart block and selective right ventricular dysfunction. Despite init ...
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Journal ArticleAm J Cardiol · July 1977
The hemodynamic, coronary sinus blood flow and myocardial metabolic effects of 0.15 mg/kg body weight of intravenously administered propranolol were studied in 19 patients with coronary artery disease and 6 normal patients. Atrial pacing was performed in a ...
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Journal ArticleAm J Cardiol · October 1976
The hemodynamic effects of nitroglycerin ointment were studied in 22 patients with acute myocardial infarction. Control measurements were obtained and observations were made over the ensuing 240 minutes. There was no change in heart rate, cardiac index or ...
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Journal ArticleAm J Med · August 1976
Controversy exists regarding the relative safety of intravenously administered lidocaine and procainamide to patients with acutely impaired hemodynamics. Accordingly, their effects were studied in 15 such patients, 14 with acute myocardial infarction and o ...
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Journal ArticleThe American Journal of Cardiology · January 1, 1976
The effects of nitroglycerin ointment (15 mg nitroglycerin) on hemodynamics at rest and during exercise were studied in 12 patients with coronary artery disease and exertional angina (angina group) and in 8 patients with normal coronary arteriograms or wit ...
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Journal ArticleCirculation · December 1975
Twenty-six patients with complicated acute myocardial infarction were studied in order to compare the hemodynamic effects of sodium nitroprusside (NP) and nitroglycerin (GTN). All patients received NP and 18 of the 26 also received GTN to evaluate both dru ...
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Journal ArticleJ Clin Invest · June 1974
Recovery from hypoxia has been shown to prolong cardiac muscle contraction, particularly the relaxation phase. The present studies were designed to examine whether incomplete relaxation between beats can result from this prolongation of contraction and rel ...
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