Skip to main content

Paul Wayne Armstrong

Adjunct Professor in the Department of Medicine
Medicine, Cardiology

Selected Publications


Recurrent Hospitalizations and Response to Vericiguat in Heart Failure and Reduced Ejection Fraction.

Journal Article JACC 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 ... Full text Link to item Cite

Diuretic use and outcomes in patients with heart failure with reduced ejection fraction: Insights from the VICTORIA trial.

Journal Article Eur J Heart Fail · March 7, 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 ... Full text Link to item Cite

Accelerometer vs. other activity measures in heart failure with preserved ejection fraction: the VITALITY-HFpEF trial.

Journal Article ESC 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 = ... Full text Link to item Cite

Cost-Effectiveness of Vericiguat in Patients With Heart Failure With Reduced Ejection Fraction: The VICTORIA Randomized Clinical Trial.

Conference Circulation · 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 ... Full text Link to item Cite

Evolution of NT-proBNP During Prerandomization Screening in VICTORIA: Implications for Clinical Outcomes and Efficacy of Vericiguat.

Journal Article Circ 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 ... Full text Link to item Cite

Relationship between baseline electrocardiographic measurements and outcomes in patients with high-risk heart failure: Insights from the VerICiguaT Global Study in Subjects with Heart Failure with Reduced Ejection Fraction (VICTORIA) trial.

Journal Article Eur 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 ... Full text Link to item Cite

Mitochondrial metabolites predict adverse cardiovascular events in individuals with diabetes.

Journal Article JCI 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 ... Full text Link to item Cite

Background Medical Therapy and Clinical Outcomes From the VICTORIA Trial.

Journal Article Circ 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 ... Full text Link to item Cite

Age, Sex, and Outcomes in Heart Failure With Reduced EF: Insights From the VICTORIA Trial.

Journal Article JACC 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 ... Full text Link to item Cite

STREAM-2: Half-Dose Tenecteplase or Primary Percutaneous Coronary Intervention in Older Patients With ST-Segment-Elevation Myocardial Infarction: A Randomized, Open-Label Trial.

Journal Article Circulation · 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 ... Full text Link to item Cite

Classification of Heart Failure Events by Severity: Insights From the VICTORIA Trial.

Journal Article J 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 ... Full text Link to item Cite

Effect of vericiguat on left ventricular structure and function in patients with heart failure with reduced ejection fraction: The VICTORIA echocardiographic substudy.

Journal Article Eur J Heart Fail · July 2023 AIM: Vericiguat 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 with v ... Full text Link to item Cite

Ejection Fraction, Biomarkers, and Outcomes and Impact of Vericiguat on Outcomes Across EF in VICTORIA.

Journal Article JACC 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 ... Full text Link to item Cite

Patient-Reported Frailty and Functional Status in Heart Failure With Preserved Ejection Fraction: Insights From VITALITY-HFpEF.

Journal Article JACC. Heart failure · April 2023 BackgroundThe association between frailty and health status in patients with heart failure with preserved ejection fraction (HFpEF) is not well known.ObjectivesThe authors examined the association between: 1) patient-reported frailty, mea ... Full text Cite

Left main coronary disease: evolving management concepts.

Journal Article Eur 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 ... Full text Link to item Cite

Population Pharmacokinetics of Vericiguat in Patients With Heart Failure With Reduced Ejection Fraction: An Integrated Analysis.

Journal Article Clin 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 ... Full text Link to item Cite

Recurrent Hospitalizations and Response to Vericiguat in Heart Failure and Reduced Ejection Fraction.

Journal Article JACC 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 ... Full text Link to item Cite

Diuretic use and outcomes in patients with heart failure with reduced ejection fraction: Insights from the VICTORIA trial.

Journal Article Eur J Heart Fail · March 7, 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 ... Full text Link to item Cite

Accelerometer vs. other activity measures in heart failure with preserved ejection fraction: the VITALITY-HFpEF trial.

Journal Article ESC 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 = ... Full text Link to item Cite

Cost-Effectiveness of Vericiguat in Patients With Heart Failure With Reduced Ejection Fraction: The VICTORIA Randomized Clinical Trial.

Conference Circulation · 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 ... Full text Link to item Cite

Evolution of NT-proBNP During Prerandomization Screening in VICTORIA: Implications for Clinical Outcomes and Efficacy of Vericiguat.

Journal Article Circ 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 ... Full text Link to item Cite

Relationship between baseline electrocardiographic measurements and outcomes in patients with high-risk heart failure: Insights from the VerICiguaT Global Study in Subjects with Heart Failure with Reduced Ejection Fraction (VICTORIA) trial.

Journal Article Eur 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 ... Full text Link to item Cite

Mitochondrial metabolites predict adverse cardiovascular events in individuals with diabetes.

Journal Article JCI 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 ... Full text Link to item Cite

Background Medical Therapy and Clinical Outcomes From the VICTORIA Trial.

Journal Article Circ 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 ... Full text Link to item Cite

Age, Sex, and Outcomes in Heart Failure With Reduced EF: Insights From the VICTORIA Trial.

Journal Article JACC 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 ... Full text Link to item Cite

STREAM-2: Half-Dose Tenecteplase or Primary Percutaneous Coronary Intervention in Older Patients With ST-Segment-Elevation Myocardial Infarction: A Randomized, Open-Label Trial.

Journal Article Circulation · 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 ... Full text Link to item Cite

Classification of Heart Failure Events by Severity: Insights From the VICTORIA Trial.

Journal Article J 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 ... Full text Link to item Cite

Effect of vericiguat on left ventricular structure and function in patients with heart failure with reduced ejection fraction: The VICTORIA echocardiographic substudy.

Journal Article Eur J Heart Fail · July 2023 AIM: Vericiguat 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 with v ... Full text Link to item Cite

Ejection Fraction, Biomarkers, and Outcomes and Impact of Vericiguat on Outcomes Across EF in VICTORIA.

Journal Article JACC 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 ... Full text Link to item Cite

Patient-Reported Frailty and Functional Status in Heart Failure With Preserved Ejection Fraction: Insights From VITALITY-HFpEF.

Journal Article JACC. Heart failure · April 2023 BackgroundThe association between frailty and health status in patients with heart failure with preserved ejection fraction (HFpEF) is not well known.ObjectivesThe authors examined the association between: 1) patient-reported frailty, mea ... Full text Cite

Left main coronary disease: evolving management concepts.

Journal Article Eur 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 ... Full text Link to item Cite

Population Pharmacokinetics of Vericiguat in Patients With Heart Failure With Reduced Ejection Fraction: An Integrated Analysis.

Journal Article Clin 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 ... Full text Link to item Cite

Efficacy and safety of vericiguat in patients with heart failure with reduced ejection fraction treated with sacubitril/valsartan: insights from the VICTORIA trial.

Journal Article Eur 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 ... Full text Link to item Cite

Sequential Evaluation of NT-proBNP in Heart Failure: Insights Into Clinical Outcomes and Efficacy of Vericiguat.

Journal Article JACC 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 ... Full text Link to item Cite

Medical Therapy During Hospitalization for Heart Failure With Reduced Ejection Fraction: The VICTORIA Registry.

Journal Article J 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 ... Full text Link to item Cite

Vericiguat and Health-Related Quality of Life in Patients With Heart Failure With Reduced Ejection Fraction: Insights From the VICTORIA Trial.

Journal Article Circ 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 ... Full text Link to item Cite

Novel multi-marker proteomics in phenotypically matched patients with ST-segment myocardial infarction: association with clinical outcomes.

Journal Article J 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 ... Full text Link to item Cite

Vericiguat in patients with coronary artery disease and heart failure with reduced ejection fraction.

Journal Article Eur 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 ... Full text Link to item Cite

Blood Pressure and Safety Events With Vericiguat in the VICTORIA Trial.

Journal Article J 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 ... Full text Link to item Cite

Hemoglobin and Clinical Outcomes in the Vericiguat Global Study in Patients With Heart Failure and Reduced Ejection Fraction (VICTORIA).

Journal Article Circulation · 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 ... Full text Link to item Cite

Participation in a Heart Failure Clinical Trial: Perspectives and Opportunities From the VICTORIA Trial and VICTORIA Simultaneous Registry.

Journal Article Circ 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 ... Full text Link to item Cite

Renal function and the effects of vericiguat in patients with worsening heart failure with reduced ejection fraction: insights from the VICTORIA (Vericiguat Global Study in Subjects with HFrEF) trial.

Journal Article European journal of heart failure · August 2021 AimsVericiguat 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 r ... Full text Cite

Vericiguat in patients with atrial fibrillation and heart failure with reduced ejection fraction: insights from the VICTORIA trial.

Journal Article Eur 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 ... Full text Link to item Cite

Clinical Outcome Predictions for the VerICiguaT Global Study in Subjects With Heart Failure With Reduced Ejection Fraction (VICTORIA) Trial.

Journal Article J 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 ... Full text Link to item Cite

Clinical Outcomes and Response to Vericiguat According to Index Heart Failure Event: Insights From the VICTORIA Trial.

Journal Article JAMA 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 ... Full text Link to item Cite

Learning whether to subtract beta-blockers: it's about time.

Journal Article Eur 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 ... Full text Link to item Cite

National trends in coronary intensive care unit admissions, resource utilization, and outcomes.

Journal Article Eur 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 ... Full text Link to item Cite

In Memoriam: James T. Willerson, 1939 to 2020

Journal Article Journal of the American College of Cardiology · November 3, 2020 Full text Cite

Association between glycated haemoglobin levels and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease: a secondary analysis of the TECOS randomized clinical trial.

Journal Article Eur 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 ... Full text Link to item Cite

Influence of Clinical Trials of Acute Coronary Syndrome Beyond the Primary Hypothesis: A Systematic Review.

Journal Article JAMA 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 ... Full text Link to item Cite

N-Terminal Pro-B-Type Natriuretic Peptide and Clinical Outcomes: Vericiguat Heart Failure With Reduced Ejection Fraction Study.

Journal Article JACC 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 ... Full text Link to item Cite

Effect of Vericiguat vs Placebo on Quality of Life in Patients With Heart Failure and Preserved Ejection Fraction: The VITALITY-HFpEF Randomized Clinical Trial.

Journal Article JAMA · 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 ... Full text Link to item Cite

Long-Term Bleeding Risk Prediction with Dual Antiplatelet Therapy After Acute Coronary Syndromes Treated Without Revascularization.

Journal Article Circ 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 ... Full text Link to item Cite

The Second Strategic Reperfusion Early After Myocardial Infarction (STREAM-2) study optimizing pharmacoinvasive reperfusion strategy in older ST-elevation myocardial infarction patients.

Journal Article Am 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 ... Full text Link to item Cite

Post-Discharge Bleeding and Mortality Following Acute Coronary Syndromes With or Without PCI.

Journal Article J 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 ... Full text Link to item Cite

Long-Term Outcomes of Complete Revascularization With Percutaneous Coronary Intervention in Acute Coronary Syndromes.

Journal Article JACC 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 ... Full text Link to item Cite

Novel Biomarkers, ST-Elevation Resolution, and Clinical Outcomes Following Primary Percutaneous Coronary Intervention.

Journal Article J 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 ... Full text Link to item Cite

The burden of non-cardiac comorbidities and association with clinical outcomes in an acute heart failure trial - insights from ASCEND-HF.

Journal Article Eur 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 ... Full text Link to item Cite

Vericiguat in Patients with Heart Failure and Reduced Ejection Fraction.

Journal Article N 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 ... Full text Link to item Cite

The hospital frailty risk score in patients with heart failure is strongly associated with outcomes but less so with pharmacotherapy.

Journal Article J 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 ... Full text Link to item Cite

Ambulance use, distance and outcomes in patients with suspected cardiovascular disease: a registry-based geographic information system study.

Journal Article Eur 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 ... Full text Link to item Cite

High-throughput targeted proteomics discovery approach and spontaneous reperfusion in ST-segment elevation myocardial infarction.

Journal Article Am 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- ... Full text Link to item Cite

Low-density lipoprotein cholesterol treatment and outcomes in patients with type 2 diabetes and established cardiovascular disease: Insights from TECOS.

Journal Article Am 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 ... Full text Link to item Cite

Associations between β-blocker therapy and cardiovascular outcomes in patients with diabetes and established cardiovascular disease.

Journal Article Am 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 ... Full text Link to item Cite

Baseline features of the VICTORIA (Vericiguat Global Study in Subjects with Heart Failure with Reduced Ejection Fraction) trial.

Journal Article Eur 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 ... Full text Link to item Cite

Associations of osteopontin and NT-proBNP with circulating miRNA levels in acute coronary syndrome.

Journal Article Physiol 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 ... Full text Link to item Cite

Pharmacoinvasive Strategy Versus Primary Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction in Clinical Practice: Insights From the Vital Heart Response Registry.

Journal Article Circ 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 ... Full text Link to item Cite

Prognostic Implications of Changes in Amino-Terminal Pro-B-Type Natriuretic Peptide in Acute Decompensated Heart Failure: Insights From ASCEND-HF.

Journal Article J 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 ... Full text Link to item Cite

Outcomes of medically managed patients with myocardial infarction.

Journal Article Eur 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. ... Full text Link to item Cite

The continuous heart failure spectrum: moving beyond an ejection fraction classification.

Journal Article Eur 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 ... Full text Link to item Cite

Rationale and Design of the VITALITY-HFpEF Trial.

Journal Article Circ 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 ... Full text Link to item Cite

Cardiovascular and Lifestyle Risk Factors and Cognitive Function in Patients With Stable Coronary Heart Disease.

Journal Article J 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 ... Full text Link to item Cite

Sex And Prognostic Significance of Self-Reported Frailty in Non-ST-Segment Elevation Acute Coronary Syndromes: Insights From the TRILOGY ACS Trial.

Journal Article Can 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 ... Full text Link to item Cite

2019 Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology Guidelines on the Acute Management of ST-Elevation Myocardial Infarction: Focused Update on Regionalization and Reperfusion.

Journal Article Can 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 ... Full text Link to item Cite

Stroke Outcomes With Vorapaxar Versus Placebo in Patients With Acute Coronary Syndromes: Insights From the TRACER Trial.

Journal Article J 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 ... Full text Link to item Cite

Days Alive and Out of Hospital: Exploring a Patient-Centered, Pragmatic Outcome in a Clinical Trial of Patients With Acute Coronary Syndromes.

Journal Article Circ 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 ... Full text Link to item Cite

Relation of Volume Overload to Clinical Outcomes in Acute Heart Failure (From ASCEND-HF).

Journal Article Am 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 ... Full text Link to item Cite

Sex differences in management and outcomes of patients with type 2 diabetes and cardiovascular disease: A report from TECOS.

Journal Article Diabetes 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 ... Full text Link to item Cite

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

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

Early discontinuation of prasugrel or clopidogrel in acute coronary syndromes: insights from the TRILOGY ACS trial.

Journal Article Coron 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, ... Full text Link to item Cite

Effects of genetic variation in protease activated receptor 4 after an acute coronary syndrome: Analysis from the TRACER trial.

Journal Article Blood 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 ... Full text Link to item Cite

Relationship between community hospital versus pre-hospital location of randomisation and clinical outcomes in ST-elevation myocardial infarction patients: insights from the Stream study.

Journal Article Eur 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 ... Full text Link to item Cite

Population-level incidence and outcomes of myocardial infarction with non-obstructive coronary arteries (MINOCA): Insights from the Alberta contemporary acute coronary syndrome patients invasive treatment strategies (COAPT) study.

Journal Article Int 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 ... Full text Link to item Cite

Safety of ticagrelor in patients with baseline conduction abnormalities: A PLATO (Study of Platelet Inhibition and Patient Outcomes) analysis.

Journal Article Am 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 ... Full text Link to item Cite

Circulating Cardiac Troponin I Levels Measured by a Novel Highly Sensitive Assay in Acute Decompensated Heart Failure: Insights From the ASCEND-HF Trial.

Journal Article J 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 ... Full text Link to item Cite

Circulation Global Rounds.

Journal Article Circulation · July 3, 2018 Full text Link to item Cite

Discharge timing and outcomes after uncomplicated non-ST-segment elevation acute myocardial infarction.

Journal Article Am 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 ... Full text Link to item Cite

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

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

Traveling the Interstices of Data Sharing.

Journal Article JACC Heart Fail · June 2018 Full text Link to item Cite

Prognostic and Practical Validation of Current Definitions of Myocardial Infarction Associated With Percutaneous Coronary Intervention.

Journal Article JACC 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 ... Full text Link to item Cite

Is Time of the Essence? The Impact of Time of Hospital Presentation in Acute Heart Failure: Insights From ASCEND-HF Trial.

Journal Article JACC 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 ... Full text Link to item Cite

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

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

Increased Risk of Severe Hypoglycemic Events Before and After Cardiovascular Outcomes in TECOS Suggests an At-Risk Type 2 Diabetes Frail Patient Phenotype.

Journal Article Diabetes 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 ... Full text Link to item Cite

2018 Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology Focused Update of the Guidelines for the Use of Antiplatelet Therapy.

Journal Article Can 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 ... Full text Link to item Cite

Interaction of Body Mass Index on the Association Between N-Terminal-Pro-b-Type Natriuretic Peptide and Morbidity and Mortality in Patients With Acute Heart Failure: Findings From ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure).

Journal Article J 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 ... Full text Link to item Cite

A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial of the Efficacy and Safety of the Oral Soluble Guanylate Cyclase Stimulator: The VICTORIA Trial.

Journal Article JACC 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 ... Full text Link to item Cite

Aetiology, timing and clinical predictors of early vs. late readmission following index hospitalization for acute heart failure: insights from ASCEND-HF.

Journal Article Eur 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 ... Full text Link to item Cite

Clinical features and outcomes of patients with type 2 myocardial infarction: Insights from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) trial.

Journal Article Am 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 ... Full text Link to item Cite

Psychosocial stress and major cardiovascular events in patients with stable coronary heart disease.

Journal Article J 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 ... Full text Link to item Cite

Causes of Death in a Contemporary Cohort of Patients With Type 2 Diabetes and Atherosclerotic Cardiovascular Disease: Insights From the TECOS Trial.

Journal Article Diabetes 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 ... Full text Link to item Cite

Hypertension Control in Adults With Diabetes Mellitus and Recurrent Cardiovascular Events: Global Results From the Trial Evaluating Cardiovascular Outcomes With Sitagliptin.

Journal Article Hypertension · 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 ... Full text Link to item Cite

Does renal function affect the efficacy or safety of a pharmacoinvasive strategy in patients with ST-elevation myocardial infarction? A meta-analysis.

Journal Article Am 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 ... Full text Link to item Cite

Relationships Between Baseline Q Waves, Time From Symptom Onset, and Clinical Outcomes in ST-Segment-Elevation Myocardial Infarction Patients: Insights From the Vital Heart Response Registry.

Journal Article Circ 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 ... Full text Link to item Cite

Recalibrating Reperfusion Waypoints.

Journal Article Circulation · October 17, 2017 Full text Link to item Cite

Physical Activity and Mortality in Patients With Stable Coronary Heart Disease.

Journal Article J 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. ... Full text Link to item Cite

Secondary Prevention of Cardiovascular Disease in Patients With Type 2 Diabetes Mellitus: International Insights From the TECOS Trial (Trial Evaluating Cardiovascular Outcomes With Sitagliptin).

Journal Article Circulation · 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 ... Full text Link to item Cite

Outcomes after planned invasive or conservative treatment strategy in patients with non-ST-elevation acute coronary syndrome and a normal value of high sensitivity troponin at randomisation: A Platelet Inhibition and Patient Outcomes (PLATO) trial biomarker substudy.

Journal Article Eur 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 ... Full text Link to item Cite

Self-Reported Health and Outcomes in Patients With Stable Coronary Heart Disease.

Journal Article J 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 ... Full text Link to item Cite

Hospital variation in treatment and outcomes in acute coronary syndromes: Insights from the Alberta Contemporary Acute Coronary Syndrome Patients Invasive Treatment Strategies (COAPT) study.

Journal Article Int 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 ... Full text Link to item Cite

Biomarker-Based Risk Model to Predict Cardiovascular Mortality in Patients With Stable Coronary Disease.

Journal Article J 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 ... Full text Link to item Cite

Predicting the risk of bleeding during dual antiplatelet therapy after acute coronary syndromes.

Journal Article Heart · 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 ... Full text Link to item Cite

Temporal Biomarker Profiling Reveals Longitudinal Changes in Risk of Death or Myocardial Infarction in Non-ST-Segment Elevation Acute Coronary Syndrome.

Journal Article Clin 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 ... Full text Link to item Cite

Hospitalization for Recently Diagnosed Versus Worsening Chronic Heart Failure: From the ASCEND-HF Trial.

Journal Article J 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 ... Full text Link to item Cite

Composite End Points in Clinical Research: A Time for Reappraisal.

Journal Article Circulation · 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 ... Full text Link to item Cite

Dual antiplatelet therapy in patients with diabetes and acute coronary syndromes managed without revascularization.

Journal Article Am 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 ... Full text Link to item Cite

Characterization of hemodynamically stable acute heart failure patients requiring a critical care unit admission: Derivation, validation, and refinement of a risk score.

Journal Article Am 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 ... Full text Link to item Cite

Whole blood sequencing reveals circulating microRNA associations with high-risk traits in non-ST-segment elevation acute coronary syndrome.

Journal Article Atherosclerosis · 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 ... Full text Link to item Cite

Identifying Low-risk Patients for Early Discharge From Emergency Department Without Using Subjective Descriptions of Chest Pain: Insights From Providing Rapid Out of Hospital Acute Cardiovascular Treatment (PROACT) 3 and 4 Trials.

Journal Article Acad 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 ... Full text Link to item Cite

STREAM characterisation correction.

Journal Article Lancet · May 27, 2017 Full text Link to item Cite

Navigating Choices Among a Sea of Comorbidities.

Journal Article J Am Coll Cardiol · May 16, 2017 Full text Link to item Cite

Differential occurrence, profile, and impact of first recurrent cardiovascular events after an acute coronary syndrome.

Journal Article Am 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 ... Full text Link to item Cite

Trade-off of myocardial infarction vs. bleeding types on mortality after acute coronary syndrome: lessons from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) randomized trial.

Journal Article Eur 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 ... Full text Link to item Cite

Use of thienopyridine prior to presentation with non-ST-segment elevation acute coronary syndrome and association with safety and efficacy of vorapaxar: insights from the TRACER trial.

Journal Article Eur 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 ... Full text Link to item Cite

Insufficient reduction in heart rate during hospitalization despite beta-blocker treatment in acute decompensated heart failure: insights from the ASCEND-HF trial.

Journal Article Eur 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 ... Full text Link to item Cite

Sitagliptin and risk of fractures in type 2 diabetes: Results from the TECOS trial.

Journal Article Diabetes 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 ... Full text Link to item Cite

Interprovincial Differences in Canadian Coronary Care Unit Resource Use and Outcomes.

Journal Article Can 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 ... Full text Link to item Cite

Body Weight Change During and After Hospitalization for Acute Heart Failure: Patient Characteristics, Markers of Congestion, and Outcomes: Findings From the ASCEND-HF Trial.

Journal Article JACC 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 ... Full text Link to item Cite

Relationship of Platelet Reactivity With Bleeding Outcomes During Long-Term Treatment With Dual Antiplatelet Therapy for Medically Managed Patients With Non-ST-Segment Elevation Acute Coronary Syndromes.

Journal Article J 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 ... Full text Open Access Link to item Cite

The Choice Is Reperfusion Therapy: But Which One?

Journal Article JACC Cardiovasc Interv · October 10, 2016 Full text Link to item Cite

Impact of chronic kidney disease on long-term ischemic and bleeding outcomes in medically managed patients with acute coronary syndromes: Insights from the TRILOGY ACS Trial.

Conference Eur 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 ... Full text Link to item Cite

Temporal changes in biomarkers and their relationships to reperfusion and to clinical outcomes among patients with ST segment elevation myocardial infarction.

Journal Article J 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 ... Full text Link to item Cite

Dual Antiplatelet Therapy and Outcomes in Patients With Atrial Fibrillation and Acute Coronary Syndromes Managed Medically Without Revascularization: Insights From the TRILOGY ACS Trial.

Journal Article Clin 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 ... Full text Link to item Cite

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

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

Arterial access site and outcomes in patients undergoing percutaneous coronary intervention with and without vorapaxar.

Journal Article Catheter 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 ... Full text Link to item Cite

Effect of prior clopidogrel use on outcomes in medically managed acute coronary syndrome patients.

Journal Article Heart · 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 ... Full text Link to item Cite

Albuminuria and cardiovascular events in patients with acute coronary syndromes: Results from the TRACER trial.

Journal Article Am 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 ... Full text Link to item Cite

Health-related quality of life outcomes with prasugrel among medically managed non-ST-segment elevation acute coronary syndrome patients: Insights from the Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes (TRILOGY ACS) trial.

Journal Article Am 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 ... Full text Link to item Cite

Effect of age on efficacy and safety of vorapaxar in patients with non-ST-segment elevation acute coronary syndrome: Insights from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) trial.

Journal Article Am 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: ... Full text Link to item Cite

Temporal and Provincial Variation in Ambulance Use Among Patients Who Present to Acute Care Hospitals With ST-Elevation Myocardial Infarction.

Journal Article Can 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 ... Full text Link to item Cite

Lipoprotein-Associated Phospholipase A2 Activity Is a Marker of Risk But Not a Useful Target for Treatment in Patients With Stable Coronary Heart Disease.

Journal Article J 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 ... Full text Link to item Cite

Relationship Between Arterial Access and Outcomes in ST-Elevation Myocardial Infarction With a Pharmacoinvasive Versus Primary Percutaneous Coronary Intervention Strategy: Insights From the STrategic Reperfusion Early After Myocardial Infarction (STREAM) Study.

Journal Article J 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 ... Full text Link to item Cite

Frailty is associated with worse outcomes in non-ST-segment elevation acute coronary syndromes: Insights from the TaRgeted platelet Inhibition to cLarify the Optimal strateGy to medicallY manage Acute Coronary Syndromes (TRILOGY ACS) trial.

Journal Article Eur 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 ... Full text Link to item Cite

Nesiritide in patients hospitalized for acute heart failure: does timing matter? Implication for future acute heart failure trials.

Journal Article Eur 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 ... Full text Link to item Cite

Geographic Differences in Patients in a Global Acute Heart Failure Clinical Trial (from the ASCEND-HF Trial).

Journal Article Am 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 ... Full text Link to item Cite

Association Between Very Low Levels of High-Density Lipoprotein Cholesterol and Long-term Outcomes of Patients With Acute Coronary Syndrome Treated Without Revascularization: Insights From the TRILOGY ACS Trial.

Journal Article Clin 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 ... Full text Link to item Cite

Prognostic significance of anaemia in patients with heart failure with preserved and reduced ejection fraction: results from the MAGGIC individual patient data meta-analysis.

Journal Article QJM · 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 ... Full text Link to item Cite

Validation of BARC Bleeding Criteria in Patients With Acute Coronary Syndromes: The TRACER Trial.

Journal Article J 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 ... Full text Link to item Cite

Lack of Concordance Between Local Investigators, Angiographic Core Laboratory, and Clinical Event Committee in the Assessment of Stent Thrombosis: Results From the TRACER Angiographic Substudy.

Journal Article Circ 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 ... Full text Link to item Cite

Association Between Sitagliptin Use and Heart Failure Hospitalization and Related Outcomes in Type 2 Diabetes Mellitus: Secondary Analysis of a Randomized Clinical Trial.

Journal Article JAMA 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 ... Full text Link to item Cite

Author Reply.

Other Urology · May 2016 Full text Link to item Cite

Trends in Enrollment, Clinical Characteristics, Treatment, and Outcomes According to Age in Non-ST-Segment-Elevation Acute Coronary Syndromes Clinical Trials.

Journal Article Circulation · 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 ... Full text Link to item Cite

Liver function tests in patients with acute heart failure and associated outcomes: insights from ASCEND-HF.

Journal Article Eur 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 ... Full text Link to item Cite

Implications of ischaemic area at risk and mode of reperfusion in ST-elevation myocardial infarction.

Journal Article Heart · 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 ... Full text Link to item Cite

Time-Varying Effects of Prasugrel Versus Clopidogrel on the Long-Term Risks of Stroke After Acute Coronary Syndromes: Results From the TRILOGY ACS Trial.

Journal Article Stroke · 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 ... Full text Link to item Cite

Alignment of site versus adjudication committee-based diagnosis with patient outcomes: Insights from the Providing Rapid Out of Hospital Acute Cardiovascular Treatment 3 trial.

Journal Article Clin 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 ... Full text Link to item Cite

Sudden Cardiac Death After Non-ST-Segment Elevation Acute Coronary Syndrome.

Journal Article JAMA 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 ... Full text Link to item Cite

Spontaneous MI After Non-ST-Segment Elevation Acute Coronary Syndrome Managed Without Revascularization: The TRILOGY ACS Trial.

Journal Article J 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 ... Full text Link to item Cite

Arrival by ambulance in acute heart failure: insights into the mode of presentation from Acute Studies of Nesiritide in Decompensated Heart Failure (ASCEND-HF).

Journal Article BMJ 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 ... Full text Link to item Cite

The clinical course of health status and association with outcomes in patients hospitalized for heart failure: insights from ASCEND-HF.

Journal Article Eur 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 ... Full text Link to item Cite

Increased mortality with elevated plasma endothelin-1 in acute heart failure: an ASCEND-HF biomarker substudy.

Journal Article Eur 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 ... Full text Link to item Cite

Renal failure in patients with ST-segment elevation acute myocardial infarction treated with primary percutaneous coronary intervention: Predictors, clinical and angiographic features, and outcomes.

Journal Article Am 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 ... Full text Link to item Cite

Impact of CYP2C19 Metabolizer Status on Patients With ACS Treated With Prasugrel Versus Clopidogrel.

Journal Article J 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 ... Full text Link to item Cite

Torsemide Versus Furosemide in Patients With Acute Heart Failure (from the ASCEND-HF Trial).

Journal Article Am 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 ... Full text Link to item Cite

Drug Treatment of STEMI in the Elderly: Focus on Fibrinolytic Therapy and Insights from the STREAM Trial.

Journal Article Drugs 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 ... Full text Link to item Cite

Effect of the REG1 anticoagulation system versus bivalirudin on outcomes after percutaneous coronary intervention (REGULATE-PCI): a randomised clinical trial.

Journal Article Lancet · 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 ... Full text Link to item Cite

Ascertainment, classification, and impact of neoplasm detection during prolonged treatment with dual antiplatelet therapy with prasugrel vs. clopidogrel following acute coronary syndrome.

Journal Article Eur 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 ... Full text Link to item Cite

Transatlantic Comparison of ST-Segment Elevation Myocardial Infarction Guidelines: Insights From the United States and Europe.

Journal Article J 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 ... Full text Link to item Cite

Prognostic Value of Baseline and Changes in Circulating Soluble ST2 Levels and the Effects of Nesiritide in Acute Decompensated Heart Failure.

Journal Article JACC 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 ... Full text Link to item Cite

High-degree atrioventricular block, asystole, and electro-mechanical dissociation complicating non-ST-segment elevation myocardial infarction.

Journal Article Am 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 ... Full text Link to item Cite

Efficacy and Safety of Vorapaxar in Non-ST-Segment Elevation Acute Coronary Syndrome Patients Undergoing Noncardiac Surgery.

Journal Article J 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 ... Full text Link to item Cite

Impact of weighted composite compared to traditional composite endpoints for the design of randomized controlled trials.

Journal Article Stat 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 ... Full text Link to item Cite

Providing Rapid Out of Hospital Acute Cardiovascular Treatment 4 (PROACT-4).

Journal Article J 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 ... Full text Link to item Cite

Long-term outcomes for women versus men with unstable angina/non-ST-segment elevation myocardial infarction managed medically without revascularization: insights from the TaRgeted platelet Inhibition to cLarify the Optimal strateGy to medicallY manage Acute Coronary Syndromes trial.

Journal Article Am 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 ... Full text Link to item Cite

Concomitant proton-pump inhibitor use, platelet activity, and clinical outcomes in patients with acute coronary syndromes treated with prasugrel versus clopidogrel and managed without revascularization: insights from the Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes trial.

Journal Article Am 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 ... Full text Link to item Cite

Circulating Kidney Injury Molecule-1 Levels in Acute Heart Failure: Insights From the ASCEND-HF Trial (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure).

Journal Article JACC 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 ... Full text Link to item Cite

Acute Heart Failure and Atrial Fibrillation: Insights From the Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure (ASCEND-HF) Trial.

Journal Article J 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 ... Full text Link to item Cite

Infarct Size, Shock, and Heart Failure: Does Reperfusion Strategy Matter in Early Presenting Patients With ST-Segment Elevation Myocardial Infarction?

Journal Article J 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 ... Full text Link to item Cite

Worsening heart failure during hospitalization for acute heart failure: Insights from the Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure (ASCEND-HF).

Journal Article Am 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 ... Full text Link to item Cite

Predictors of clinical outcomes in acute decompensated heart failure: Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure outcome models.

Journal Article Am 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 ... Full text Link to item Cite

Baseline Q waves and time from symptom onset to ST-segment elevation myocardial infarction: insights from PLATO on the influence of sex.

Journal Article Am 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 ... Full text Link to item Cite

Effect of Sitagliptin on Cardiovascular Outcomes in Type 2 Diabetes.

Journal Article N 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 ... Full text Link to item Cite

Sex-Stratified Trends in Enrollment, Patient Characteristics, Treatment, and Outcomes Among Non-ST-Segment Elevation Acute Coronary Syndrome Patients: Insights From Clinical Trials Over 17 Years.

Journal Article Circ 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 ... Full text Link to item Cite

Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes.

Journal Article N 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 ... Full text Link to item Cite

Meta-analysis of intracranial hemorrhage in acute coronary syndromes: incidence, predictors, and clinical outcomes.

Journal Article J 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 ... Full text Link to item Cite

The future of cardiovascular clinical research in North America and beyond-addressing challenges and leveraging opportunities through unique academic and grassroots collaborations.

Journal Article Am 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 ... Full text Link to item Cite

Evaluation of Cardiac Magnetic Resonance as a Surrogate in ST-Segment Elevation Myocardial Infarction.

Journal Article Am 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 ... Full text Link to item Cite

Reduced dose tenecteplase and outcomes in elderly ST-segment elevation myocardial infarction patients: Insights from the STrategic Reperfusion Early After Myocardial infarction trial.

Journal Article Am 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 ... Full text Link to item Cite

Magnitude of troponin elevation and long-term clinical outcomes in acute coronary syndrome patients treated with and without revascularization.

Journal Article Circ 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 ... Full text Link to item Cite

Glycoprotein IIb/IIIa Receptor Inhibitors in Combination With Vorapaxar, a Platelet Thrombin Receptor Antagonist, Among Patients With Non-ST-Segment Elevation Acute Coronary Syndromes (from the TRACER Trial).

Journal Article Am 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 ... Full text Link to item Cite

Influence of Patient Goals of Care on Performance Measures in Patients Hospitalized for Heart Failure: An Analysis of the Enhanced Feedback For Effective Cardiac Treatment (EFFECT) Registry.

Journal Article Circ 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 ... Full text Link to item Cite

Impact of a pharmacoinvasive strategy when delays to primary PCI are prolonged.

Journal Article Heart · 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 ... Full text Link to item Cite

Cardiovascular drug development: is it dead or just hibernating?

Journal Article J 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 ... Full text Link to item Cite

Regional, age and sex differences in baseline characteristics of patients enrolled in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS).

Journal Article Diabetes 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 ... Full text Link to item Cite

The making of an author

Journal Article American Heart Journal · April 1, 2015 Full text Cite

Loop diuretic dose adjustments after a hospitalization for heart failure: insights from ASCEND-HF.

Conference Eur 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 ... Full text Link to item Cite

Applying novel methods to assess clinical outcomes: insights from the TRILOGY ACS trial.

Journal Article Eur 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 ... Full text Link to item Cite

Impact of Human Development Index on the profile and outcomes of patients with acute coronary syndrome.

Journal Article Heart · 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 ... Full text Link to item Cite

The long-term effects of dietary sodium restriction on clinical outcomes in patients with heart failure. The SODIUM-HF (Study of Dietary Intervention Under 100 mmol in Heart Failure): a pilot study.

Journal Article Am 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 ... Full text Link to item Cite

Comparative assessment of short-term adverse events in acute heart failure with cystatin C and other estimates of renal function: results from the ASCEND-HF trial.

Journal Article JACC 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 ... Full text Link to item Cite

The Effects of Climate Change on Cardiac Health.

Journal Article Cardiology · 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, ... Full text Link to item Cite

Incorporating patient preferences into clinical trial design: results of the opinions of patients on treatment implications of new studies (OPTIONS) project.

Journal Article Am 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. ... Full text Link to item Cite

Relationship between time to invasive assessment and clinical outcomes of patients undergoing an early invasive strategy after fibrinolysis for ST-segment elevation myocardial infarction: a patient-level analysis of the randomized early routine invasive clinical trials.

Journal Article JACC 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 ... Full text Link to item Cite

The association between meteorological events and acute heart failure: new insights from ASCEND-HF.

Journal Article Int 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 ... Full text Link to item Cite

Vorapaxar with or without clopidogrel after non-ST-segment elevation acute coronary syndromes: results from the thrombin receptor antagonist for clinical event reduction in acute coronary syndrome trial.

Journal Article Am 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 ... Full text Link to item Cite

Extent, location, and clinical significance of non-infarct-related coronary artery disease among patients with ST-elevation myocardial infarction.

Journal Article JAMA · 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, ... Full text Link to item Cite

Practice patterns and clinical outcomes among non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients presenting to primary and tertiary hospitals: insights from the EARLY glycoprotein IIb/IIIa inhibition in NSTE-ACS (EARLY-ACS) trial.

Journal Article Catheter 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 ... Full text Link to item Cite

Hypotension during hospitalization for acute heart failure is independently associated with 30-day mortality: findings from ASCEND-HF.

Journal Article Circ 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 ... Full text Link to item Cite

Routine invasive management early after fibrinolysis: relationship between baseline risk and treatment effects in a pooled patient-level analysis of 7 randomized controlled trials.

Journal Article Am 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 ... Full text Link to item Cite

Prognostic implications of creatine kinase-MB measurements in ST-segment elevation myocardial infarction patients treated with primary percutaneous coronary intervention.

Journal Article Am 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 ... Full text Link to item Cite

Vorapaxar in patients with peripheral artery disease and acute coronary syndrome: insights from Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER).

Journal Article Am 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 ... Full text Link to item Cite

Aborted myocardial infarction in ST-elevation myocardial infarction: insights from the STrategic Reperfusion Early After Myocardial infarction trial.

Journal Article Heart · 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 ... Full text Link to item Cite

Providing Rapid Out of Hospital Acute Cardiovascular Treatment 3 (PROACT-3).

Journal Article Can 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 ... Full text Link to item Cite

ST-segment-elevation myocardial infarction patients randomized to a pharmaco-invasive strategy or primary percutaneous coronary intervention: Strategic Reperfusion Early After Myocardial Infarction (STREAM) 1-year mortality follow-up.

Journal Article Circulation · 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 ... Full text Link to item Cite

Outcomes of a pharmacoinvasive strategy for successful versus failed fibrinolysis and primary percutaneous intervention in acute myocardial infarction (from the STrategic Reperfusion Early After Myocardial Infarction [STREAM] study).

Journal Article Am 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 ... Full text Link to item Cite

Vorapaxar, a platelet thrombin-receptor antagonist, in medically managed patients with non-ST-segment elevation acute coronary syndrome: results from the TRACER trial.

Journal Article Eur 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 ... Full text Link to item Cite

Usefulness and safety of vorapaxar in patients with non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention (from the TRACER Trial).

Journal Article Am 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 ... Full text Link to item Cite

Independent data monitoring committees: preparing a path for the future.

Journal Article Am 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 ... Full text Link to item Cite

Association of metabolic syndrome and its individual components with outcomes among patients with high-risk non-ST-segment elevation acute coronary syndromes.

Journal Article Am 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 ... Full text Link to item Cite

Reduction in overall occurrences of ischemic events with vorapaxar: results from TRACER.

Journal Article J 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 ... Full text Link to item Cite

Impact of smoking status on platelet function and clinical outcomes with prasugrel vs. clopidogrel in patients with acute coronary syndromes managed without revascularization: Insights from the TRILOGY ACS trial.

Conference Am 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 ... Full text Link to item Cite

The organization, function, and outcomes of ST-elevation myocardial infarction networks worldwide: current state, unmet needs and future directions.

Journal Article Eur 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 ... Full text Link to item Cite

No STEMI left behind.

Journal Article J Assoc Physicians India · June 2014 Link to item Cite

Darapladib for preventing ischemic events in stable coronary heart disease.

Journal Article N 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 ... Full text Link to item Cite

Clinical perspectives on reperfusion injury in acute myocardial infarction.

Journal Article Am 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 ... Full text Link to item Cite

Angiographic outcomes with early eptifibatide therapy in non-ST-segment elevation acute coronary syndrome (from the EARLY ACS Trial).

Journal Article Am 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 ... Full text Link to item Cite

Vorapaxar in acute coronary syndrome patients undergoing coronary artery bypass graft surgery: subgroup analysis from the TRACER trial (Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome).

Journal Article J 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 ... Full text Link to item Cite

Association of aspirin dose and vorapaxar safety and efficacy in patients with non-ST-segment elevation acute coronary syndrome (from the TRACER Trial).

Journal Article Am 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 ... Full text Link to item Cite

The relationship between left ventricular ejection fraction and mortality in patients with acute heart failure: insights from the ASCEND-HF Trial.

Journal Article Eur 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 ... Full text Link to item Cite

Use of renin-angiotensin system blockers in acute coronary syndromes: findings from Get With the Guidelines-Coronary Artery Disease Program.

Journal Article Circ 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 ... Full text Link to item Cite

Prognostic implications of quantitative evaluation of baseline Q-wave width in ST-segment elevation myocardial infarction.

Journal Article J 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 ... Full text Link to item Cite

Outcomes of a pharmacoinvasive strategy for successful versus failed fibrinolysis and primary percutaneous intervention in acute myocardial infarction (from the STrategic Reperfusion Early After Myocardial Infarction [STREAM] study).

Journal Article The 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 ... Cite

Use of electrocardiogram indices of myocardial ischemia for risk stratification and decision making of reperfusion strategies.

Conference J 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 ... Full text Link to item Cite

The prognostic relationship of qt interval and dispersion in patients with acute st elevation myocardial infarction

Journal Article Experimental 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 ... Cite

An assessment of ST-segment measurement variability between two core electrocardiogram laboratories.

Journal Article J 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 ... Full text Link to item Cite

Differences in treatment, outcomes, and quality of life among patients with heart failure in Canada and the United States.

Journal Article JACC 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 ... Full text Link to item Cite

Physical activity in patients with stable coronary heart disease: an international perspective.

Journal Article Eur 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 ... Full text Link to item Cite

Clinical and prognostic implications of circulating pentraxin 3 levels in non ST-elevation acute coronary syndrome.

Journal Article Clin 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 ... Full text Link to item Cite

Prognostic implications of left ventricular end-diastolic pressure during primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: Findings from the Assessment of Pexelizumab in Acute Myocardial Infarction study.

Journal Article Am 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 ... Full text Link to item Cite

The relationship between meteorological conditions and index acute coronary events in a global clinical trial.

Journal Article Int 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 ... Full text Link to item Cite

Prognostic relevance of baseline pro- and anti-inflammatory markers in STEMI: an APEX AMI substudy.

Journal Article Int 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 ... Full text Link to item Cite

Incidence, treatment, and outcomes of atrial fibrillation complicating non-ST-segment elevation acute coronary syndromes.

Journal Article Int 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 ... Full text Link to item Cite

Clinical outcome endpoints in heart failure trials: a European Society of Cardiology Heart Failure Association consensus document.

Journal Article Eur 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 ... Full text Link to item Cite

Association between bleeding and mortality among women and men with high-risk acute coronary syndromes: insights from the Early versus Delayed, Provisional Eptifibatide in Acute Coronary Syndromes (EARLY ACS) trial.

Journal Article Am 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 ... Full text Link to item Cite

Age, treatment, and outcomes in high-risk non-ST-segment elevation acute coronary syndrome patients: insights from the EARLY ACS trial.

Journal Article Int 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 ... Full text Link to item Cite

The systemic inflammatory response syndrome in patients with ST-segment elevation myocardial infarction.

Journal Article Crit 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 ... Full text Link to item Cite

Global variation in quality of care among patients hospitalized with acute heart failure in an international trial: findings from the acute study clinical effectiveness of nesiritide in decompensated heart failure trial (ASCEND-HF).

Journal Article Circ 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 ... Full text Link to item Cite

Routine early eptifibatide versus delayed provisional use at percutaneous coronary intervention in high-risk non-ST-segment elevation acute coronary syndromes patients: an analysis from the Early Glycoprotein IIb/IIIa Inhibition in Non-ST-Segment Elevation Acute Coronary Syndrome trial.

Journal Article Am 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 ... Full text Link to item Cite

Medical resource use, costs, and quality of life in patients with acute decompensated heart failure: findings from ASCEND-HF.

Journal Article J 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 ... Full text Link to item Cite

Duration of eptifibatide infusion after percutaneous coronary intervention and outcomes among high-risk patients with non-ST-segment elevation acute coronary syndrome: insights from EARLY ACS.

Journal Article Eur 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 ... Full text Link to item Cite

Elderly patients with acute coronary syndromes managed without revascularization: insights into the safety of long-term dual antiplatelet therapy with reduced-dose prasugrel versus standard-dose clopidogrel.

Journal Article Circulation · 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 ... Full text Link to item Cite

Prasugrel versus clopidogrel for patients with unstable angina or non-ST-segment elevation myocardial infarction with or without angiography: a secondary, prespecified analysis of the TRILOGY ACS trial.

Journal Article Lancet · 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 ... Full text Link to item Cite

Quantitative ST-depression in acute coronary syndromes: the PLATO electrocardiographic substudy.

Journal Article Am 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 ... Full text Link to item Cite

The forgotten lead: does aVR ST-deviation add insight into the outcomes of ST-elevation myocardial infarction patients?

Journal Article Am 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 ... Full text Link to item Cite

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

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

Cardiac troponin after percutaneous coronary intervention and 1-year mortality in non-ST-segment elevation acute coronary syndrome using systematic evaluation of biomarker trends.

Journal Article J 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 ... Full text Link to item Cite

Do countries or hospitals with longer hospital stays for acute heart failure have lower readmission rates?: Findings from ASCEND-HF.

Journal Article Circ 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 ... Full text Link to item Cite

Effect of vorapaxar on myocardial infarction in the thrombin receptor antagonist for clinical event reduction in acute coronary syndrome (TRA·CER) trial.

Journal Article Eur 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 ... Full text Link to item Cite

Cardiovascular clinical research in South America.

Journal Article Am 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 ... Full text Link to item Cite

Heart failure complicating non-ST-segment elevation acute coronary syndrome: timing, predictors, and clinical outcomes.

Journal Article JACC 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- ... Full text Link to item Cite

Methods of creatine kinase-MB analysis to predict mortality in patients with myocardial infarction treated with reperfusion therapy.

Journal Article Trials · 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). ... Full text Open Access Link to item Cite

Association of global weather changes with acute coronary syndromes: gaining insights from clinical trials data.

Journal Article Int 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 ... Full text Link to item Cite

Fibrinolysis or primary PCI in ST-segment elevation myocardial infarction.

Journal Article N 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 ... Full text Link to item Cite

Stroke after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction: timing, characteristics, and clinical outcomes.

Journal Article Circ 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 ... Full text Link to item Cite

Radial versus femoral access, bleeding and ischemic events in patients with non-ST-segment elevation acute coronary syndrome managed with an invasive strategy.

Journal Article Am 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 ... Full text Link to item Cite

Evaluation of early percutaneous coronary intervention vs. standard therapy after fibrinolysis for ST-segment elevation myocardial infarction: contribution of weighting the composite endpoint.

Journal Article Eur 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 ... Full text Link to item Cite

Incidence of heart failure and mortality after acute coronary syndromes.

Journal Article Am 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 ... Full text Link to item Cite

Implementation of standardized assessment and reporting of myocardial infarction in contemporary randomized controlled trials: a systematic review.

Journal Article Eur 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 ... Full text Link to item Cite

Dynamic modeling of 90-day mortality in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention.

Journal Article Am 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 ... Full text Link to item Cite

The power of more than one.

Journal Article Circulation · February 12, 2013 Full text Link to item Cite

Aborted myocardial infarction after primary percutaneous coronary intervention: magnetic resonance imaging insights from the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX-AMI) trial.

Journal Article Am 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 ... Full text Link to item Cite

Comparison of the prognosis of spontaneous and percutaneous coronary intervention-related myocardial infarction.

Journal Article J 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 ... Full text Link to item Cite

Relative prognostic value of baseline Q wave and time from symptom onset among men and women with ST-elevation myocardial infarction undergoing percutaneous coronary intervention.

Journal Article Am 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 ... Full text Link to item Cite

Platelet Function During Extended Prasugrel and Clopidogrel Therapy for Patients With ACS Treated Without Revascularization: The TRILOGY ACS Platelet Function Substudy.

Journal Article JAMA · 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 ... Full text Link to item Cite

Troponin I in acute decompensated heart failure: insights from the ASCEND-HF study.

Journal Article Eur 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. ... Full text Link to item Cite

Acute heart failure: perspectives from a randomized trial and a simultaneous registry.

Journal Article Circ 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 ... Full text Link to item Cite

Third universal definition of myocardial infarction.

Journal Article Circulation · October 16, 2012 Full text Link to item Cite

Prasugrel versus clopidogrel for acute coronary syndromes without revascularization.

Journal Article N 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, ... Full text Link to item Cite

Road mapping ATLAS ACS 2: are we there yet?

Journal Article Eur Heart J · October 2012 Full text Link to item Cite

Baseline Q waves as a prognostic modulator in patients with ST-segment elevation: insights from the PLATO trial.

Journal Article CMAJ · 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 ... Full text Link to item Cite

Anticoagulation after subcutaneous enoxaparin is time sensitive in STEMI patients treated with tenecteplase.

Journal Article J 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 ... Full text Link to item Cite

Contemporary pharmacological reperfusion in ST elevation myocardial infarction.

Journal Article Curr 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 ... Full text Link to item Cite

Serious infection after acute myocardial infarction: incidence, clinical features, and outcomes.

Journal Article JACC 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 ... Full text Link to item Cite

Transfer times and outcomes in patients with ST-segment-elevation myocardial infarction undergoing interhospital transfer for primary percutaneous coronary intervention: APEX-AMI insights.

Journal Article Circ 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 ... Full text Link to item Cite

Pexelizumab fails to inhibit assembly of the terminal complement complex in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Insight from a substudy of the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX-AMI) trial.

Journal Article Am 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 ... Full text Link to item Cite

Baseline NT-proBNP and biomarkers of inflammation and necrosis in patients with ST-segment elevation myocardial infarction: insights from the APEX-AMI trial.

Journal Article J 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 ... Full text Link to item Cite

Testosterone supplementation in heart failure: a meta-analysis.

Journal Article Circ 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 ... Full text Link to item Cite

Estimating the length of waits: a description of the period lifetable method and comparison with census and event based methods.

Journal Article Health 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 ... Full text Link to item Cite

Variations in practice and outcomes in patients undergoing primary percutaneous coronary intervention in the United States and Canada: insights from the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX AMI) trial.

Journal Article Am 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 ... Full text Link to item Cite

Assessment of dyspnea in acute decompensated heart failure: insights from ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure) on the contributions of peak expiratory flow.

Journal Article J 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 ... Full text Link to item Cite

Regional patterns of use of a medical management strategy for patients with non-ST-segment elevation acute coronary syndromes: insights from the EARLY ACS Trial.

Journal Article Circ 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 ... Full text Link to item Cite

Prediction of enzymatic infarct size in ST-segment elevation myocardial infarction.

Journal Article Coron 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 ... Full text Link to item Cite

Comparison of incidence of bleeding and mortality of men versus women with ST-elevation myocardial infarction treated with fibrinolysis.

Journal Article Am 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 ... Full text Link to item Cite

ST-elevation acute coronary syndromes in the Platelet Inhibition and Patient Outcomes (PLATO) trial: insights from the ECG substudy.

Journal Article Circulation · 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 ... Full text Link to item Cite

Thrombin-receptor antagonist vorapaxar in acute coronary syndromes.

Journal Article N 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 ... Full text Link to item Cite

International variation in and factors associated with hospital readmission after myocardial infarction.

Journal Article JAMA · 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 ... Full text Link to item Cite

Discussion

Conference · 2012 Cite

Impact of TIMI 3 patency before primary percutaneous coronary intervention for ST-elevation myocardial infarction on clinical outcome: Results from the ASSENT-4 PCI study

Journal Article European Heart Journal: Acute Cardiovascular Care · January 1, 2012 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 primary percut ... Full text Cite

Pattern of liver enzyme elevations in acute ST-elevation myocardial infarction.

Journal Article Coron 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 ... Full text Link to item Cite

Safety and efficacy of adjusted-dose eptifibatide in patients with acute coronary syndromes and reduced renal function.

Journal Article Am 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 ... Full text Link to item Cite

Reperfusion paradox in ST-segment elevation myocardial infarction.

Journal Article Ann 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 ... Full text Link to item Cite

Diagnosing acute myocardial infarction in patients with left bundle branch block.

Journal Article Am 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 ... Full text Link to item Cite

Mode of hospital presentation in patients with non-ST-elevation myocardial infarction: implications for strategic management.

Journal Article Am 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 ... Full text Link to item Cite

Highlights from the III International Symposium of Thrombosis and Anticoagulation (ISTA), October 14-16, 2010, São Paulo, Brazil.

Journal Article J 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 ... Full text Link to item Cite

Effect of nesiritide in patients with acute decompensated heart failure.

Journal Article N 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 ... Full text Link to item Cite

Upstream use of small-molecule glycoprotein iib/iiia inhibitors in patients with non-ST-segment elevation acute coronary syndromes: a systematic overview of randomized clinical trials.

Journal Article Circ 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 ... Full text Link to item Cite

Cardiogenic shock and heart failure post-percutaneous coronary intervention in ST-elevation myocardial infarction: observations from "Assessment of Pexelizumab in Acute Myocardial Infarction".

Journal Article Am 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 ... Full text Link to item Cite

Intraluminal thrombus in facilitated versus primary percutaneous coronary intervention: an angiographic substudy of the ASSENT-4 PCI (Assessment of the Safety and Efficacy of a New Treatment Strategy with Percutaneous Coronary Intervention) trial.

Journal Article J 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 ... Full text Link to item Cite

Refining clinical trial composite outcomes: an application to the Assessment of the Safety and Efficacy of a New Thrombolytic-3 (ASSENT-3) trial.

Journal Article Am 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 ... Full text Link to item Cite

Relationship of sustained ventricular tachyarrhythmias to outcomes in patients undergoing primary percutaneous coronary intervention with varying underlying baseline risk.

Journal Article Am 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 ... Full text Link to item Cite

Age and outcomes in ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention: findings from the APEX-AMI trial.

Journal Article Arch 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 ... Full text Link to item Cite

Strategic lessons from the clinical event classification process for the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX-AMI) trial.

Journal Article Contemp 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 ... Full text Link to item Cite

Mortality implications of primary percutaneous coronary intervention treatment delays: insights from the Assessment of Pexelizumab in Acute Myocardial Infarction trial.

Journal Article Circ 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 ... Full text Link to item Cite

Upstream clopidogrel use and the efficacy and safety of early eptifibatide treatment in patients with acute coronary syndrome: an analysis from the Early Glycoprotein IIb/IIIa Inhibition in Patients with Non-ST-Segment Elevation Acute Coronary Syndrome (EARLY ACS) trial.

Journal Article Circulation · 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 ... Full text Link to item Cite

Resource use in the last 6 months of life among patients with heart failure in Canada.

Journal Article Arch 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 ... Full text Link to item Cite

The influence of time from symptom onset and reperfusion strategy on 1-year survival in ST-elevation myocardial infarction: a pooled analysis of an early fibrinolytic strategy versus primary percutaneous coronary intervention from CAPTIM and WEST.

Journal Article Am 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 ... Full text Link to item Cite

Association of mortality with years of education in patients with ST-segment elevation myocardial infarction treated with fibrinolysis.

Journal Article J 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 ... Full text Link to item Cite

Aldosterone antagonists--last man standing?

Journal Article N Engl J Med · January 6, 2011 Full text Link to item Cite

Determining the cost economic "tipping point" for the addition of a regional percutaneous coronary intervention facility.

Journal Article Can 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 ... Full text Link to item Cite

Temporal trends in patient and treatment delay among men and women presenting with ST-elevation myocardial infarction.

Journal Article Am 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 ... Full text Link to item Cite

Race, Bleeding, and Outcomes in STEMI Patients Treated with Fibrinolytic Therapy.

Journal Article Am 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 ... Full text Link to item Cite

A model for predicting mortality in acute ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention: results from the Assessment of Pexelizumab in Acute Myocardial Infarction Trial.

Journal Article Circ 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 ... Full text Link to item Cite

Does silent myocardial infarction add prognostic value in ST-elevation myocardial infarction patients without a history of prior myocardial infarction? Insights from the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX-AMI) Trial.

Journal Article Am 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 ... Full text Link to item Cite

Prediction of cardiogenic shock using plasma B-type natriuretic peptide and the N-terminal fragment of its pro-hormone [corrected] concentrations in ST elevation myocardial infarction: an analysis from the ASSENT-4 Percutaneous Coronary Intervention Trial.

Journal Article Crit 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 ... Full text Link to item Cite

Early routine percutaneous coronary intervention after fibrinolysis vs. standard therapy in ST-segment elevation myocardial infarction: a meta-analysis.

Journal Article Eur 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 ... Full text Link to item Cite

Usefulness of the QRS score as a strong prognostic marker in patients discharged after undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.

Journal Article Am 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 ... Full text Link to item Cite

Spotting the pantomime villain: do the usual approaches correctly indicate when waiting times got shorter?

Journal Article Health 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 ... Full text Link to item Cite

Predicting chronic left ventricular dysfunction 90 days after ST-segment elevation myocardial infarction: An Assessment of Pexelizumab in Acute Myocardial Infarction (APEX-AMI) Substudy.

Journal Article Am 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 ... Full text Link to item Cite

The Strategic Reperfusion Early After Myocardial Infarction (STREAM) study.

Journal Article Am 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 ... Full text Link to item Cite

Non-culprit coronary artery percutaneous coronary intervention during acute ST-segment elevation myocardial infarction: insights from the APEX-AMI trial.

Journal Article Eur 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 ... Full text Link to item Cite

Use of glycoprotein IIb/IIIa inhibitors in primary percutaneous coronary intervention: insights from the APEX-AMI trial.

Journal Article Eur 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 ... Full text Link to item Cite

Study design and rationale of a comparison of prasugrel and clopidogrel in medically managed patients with unstable angina/non-ST-segment elevation myocardial infarction: the TaRgeted platelet Inhibition to cLarify the Optimal strateGy to medicallY manage Acute Coronary Syndromes (TRILOGY ACS) trial.

Journal Article Am 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 ... Full text Link to item Cite

Unexplained international differences in clinical outcomes after acute myocardial infarction and fibrinolytic therapy: lessons from the Hirulog and Early Reperfusion or Occlusion (HERO)-2 trial.

Journal Article Am 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 ... Full text Link to item Cite

ST2 and mortality in non-ST-segment elevation acute coronary syndrome.

Journal Article Am 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 ... Full text Link to item Cite

Influence of functional deficiency of complement mannose-binding lectin on outcome of patients with acute ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention.

Journal Article Eur 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 ... Full text Link to item Cite

Is visual interpretation of coronary epicardial flow reliable in patients with ST-elevation myocardial infarction undergoing primary angioplasty? Insights from the angiographic substudy of the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX-AMI) trial.

Journal Article Am 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 ... Full text Link to item Cite

Prior coronary artery bypass graft patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention.

Journal Article JACC 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 ... Full text Link to item Cite

Resolution of ST-segment depression: A new prognostic marker in ST-segment elevation myocardial infarction.

Journal Article Eur 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 ... Full text Link to item Cite

One question, two answers: do the two most commonly used methods of sampling describe the length of the prospective wait for admission to hospital?

Journal Article Health 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 ... Full text Link to item Cite

Enoxaparin in primary and facilitated percutaneous coronary intervention A formal prospective nonrandomized substudy of the FINESSE trial (Facilitated INtervention with Enhanced Reperfusion Speed to Stop Events).

Journal Article JACC 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 ... Full text Link to item Cite

Warfarin use and outcomes in patients with atrial fibrillation complicating acute coronary syndromes.

Journal Article Am 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 ... Full text Link to item Cite

Electrocardiographic identification of the culprit coronary artery in inferior wall ST elevation myocardial infarction.

Journal Article Can 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 ... Full text Link to item Cite

Do baseline atrial electrocardiographic and infarction patterns predict new-onset atrial fibrillation after ST-elevation myocardial infarction? Insights from the Assessment of Pexelizumab in Acute Myocardial Infarction Trial.

Journal Article J 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 ... Full text Link to item Cite

Mechanical complications after percutaneous coronary intervention in ST-elevation myocardial infarction (from APEX-AMI).

Journal Article Am 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 ... Full text Link to item Cite

Plasma N-terminal fragment of the prohormone B-type natriuretic peptide concentrations in relation to time to treatment and Thrombolysis in Myocardial Infarction (TIMI) flow: a substudy of the Assessment of the Safety and Efficacy of a New Treatment Strategy with Percutaneous Coronary Intervention (ASSENT IV-PCI) trial.

Journal Article Am 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 ... Full text Link to item Cite

Pexelizumab and infarct size in patients with acute myocardial infarction undergoing primary percutaneous coronary Intervention: a delayed enhancement cardiac magnetic resonance substudy from the APEX-AMI trial.

Journal Article JACC 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 ... Full text Link to item Cite

Reply

Journal Article Journal of the American College of Cardiology · December 29, 2009 Full text Cite

Resource use and costs of treatment with anticoagulation and antiplatelet agents: results of the WATCH trial economic evaluation.

Journal Article J 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 ... Full text Link to item Cite

Safety and feasibility of adjunctive antiplatelet therapy with intravenous elinogrel, a direct-acting and reversible P2Y12 ADP-receptor antagonist, before primary percutaneous intervention in patients with ST-elevation myocardial infarction: the Early Rapid ReversAl of platelet thromboSis with intravenous Elinogrel before PCI to optimize reperfusion in acute Myocardial Infarction (ERASE MI) pilot trial.

Journal Article Am 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 ... Full text Link to item Cite

Transfusion and mortality in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention.

Journal Article Eur 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 ... Full text Link to item Cite

Contribution of angiographic and electrocardiographic parameters of reperfusion to prediction of mortality and morbidity after acute ST-elevation myocardial infarction: Insights from the Assessment of Pexelizumab in Acute Myocardial Infarction trial.

Journal Article Am 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 ... Full text Link to item Cite

1-year survival in a randomized trial of facilitated reperfusion: results from the FINESSE (Facilitated Intervention with Enhanced Reperfusion Speed to Stop Events) trial.

Journal Article JACC 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 ... Full text Link to item Cite

Benefit of facilitated percutaneous coronary intervention in high-risk ST-segment elevation myocardial infarction patients presenting to nonpercutaneous coronary intervention hospitals.

Journal Article JACC 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 ... Full text Link to item Cite

The impact of place of enrollment and delay to reperfusion on 90-day post-infarction mortality in the ASSENT-4 PCI trial: assessment of the safety and efficacy of a new treatment strategy with percutaneous coronary intervention.

Journal Article JACC 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 ... Full text Link to item Cite

In reply

Journal Article JAMA · September 2, 2009 Full text Cite

Reperfusion before percutaneous coronary intervention in ST-elevation myocardial infarction patients is associated with lower N-terminal pro-brain natriuretic peptide levels during follow-up, irrespective of pre-treatment with full-dose fibrinolysis.

Journal Article Eur 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 ... Full text Link to item Cite

The Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRA*CER) trial: study design and rationale.

Journal Article Am 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 ... Full text Link to item Cite

Sex differences in mortality following acute coronary syndromes.

Journal Article JAMA · 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 ... Full text Link to item Cite

Time from first medical contact to reperfusion in ST elevation myocardial infarction: a Which Early ST Elevation Myocardial Infarction Therapy (WEST) substudy.

Journal Article Can 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 ... Full text Link to item Cite

Antithrombotic therapy and outcomes of patients with atrial fibrillation following primary percutaneous coronary intervention: results from the APEX-AMI trial.

Journal Article Eur 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 ... Full text Link to item Cite

Benefit of angiographic spontaneous reperfusion in STEMI: does it extend to diabetic patients?

Journal Article Heart · 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 ... Full text Link to item Cite

Assessment of activity status and survival according to the Canadian Cardiovascular Society angina classification.

Journal Article Can 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 ... Full text Link to item Cite

Meta-analysis: beta-blocker dose, heart rate reduction, and death in patients with heart failure.

Journal Article Ann 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 ... Full text Link to item Cite

Patient and informal caregivers' knowledge of heart failure: necessary but insufficient for effective self-care.

Journal Article Eur 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 ... Full text Link to item Cite

Early versus delayed, provisional eptifibatide in acute coronary syndromes.

Journal Article N 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 ... Full text Link to item Cite

Incidence of and outcomes associated with ventricular tachycardia or fibrillation in patients undergoing primary percutaneous coronary intervention.

Journal Article JAMA · 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 ... Full text Link to item Cite

Baseline Q-wave surpasses time from symptom onset as a prognostic marker in ST-segment elevation myocardial infarction patients treated with primary percutaneous coronary intervention.

Journal Article J 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. ... Full text Link to item Cite

Early versus delayed, provisional eptifibatide in acute coronary syndromes

Journal Article Revista Portuguesa de Cardiologia · April 1, 2009 Cite

Incidence, distribution, and prognostic impact of occluded culprit arteries among patients with non-ST-elevation acute coronary syndromes undergoing diagnostic angiography.

Journal Article Am 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) ... Full text Link to item Cite

Randomized trial of warfarin, aspirin, and clopidogrel in patients with chronic heart failure: the Warfarin and Antiplatelet Therapy in Chronic Heart Failure (WATCH) trial.

Journal Article Circulation · 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 ... Full text Link to item Cite

Response to bogaty

Journal Article Circulation · March 10, 2009 Cite

What do we know? Limitations of the two methods most commonly used to estimate the length of the prospective wait.

Journal Article Health 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 ... Full text Link to item Cite

Rationale and design of the Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure Trial (ASCEND-HF).

Journal Article Am 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 ... Full text Link to item Cite

ST resolution 1 hour after fibrinolysis for prediction of myocardial infarct size: insights from ASSENT 3.

Journal Article Am 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 ... Full text Link to item Cite

Comparison of six-month outcomes for primary percutaneous revascularization for acute myocardial infarction with drug-eluting versus bare metal stents (from the APEX-AMI study).

Journal Article Am 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 ... Full text Link to item Cite

Declining in-hospital mortality and increasing heart failure incidence in elderly patients with first myocardial infarction.

Journal Article J 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 ... Full text Link to item Cite

Sex differences in patients seeking medical attention for prodromal symptoms before an acute coronary event.

Journal Article Am 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 ... Full text Link to item Cite

Integrating ancillary studies in a large clinical trial: the design and rationale of the APEX library.

Journal Article Contemp 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 ... Full text Link to item Cite

ST-segment recovery and outcome after primary percutaneous coronary intervention for ST-elevation myocardial infarction: insights from the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX-AMI) trial.

Journal Article Circulation · 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 ... Full text Link to item Cite

Spontaneous reperfusion in ST-elevation myocardial infarction: comparison of angiographic and electrocardiographic assessments.

Journal Article Am 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 ... Full text Link to item Cite

A Canadian context for the Acute Study of Clinical Effectiveness of Nesiritide and Decompensated Heart Failure (ASCEND-HF) trial.

Journal Article Can 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 ... Full text Link to item Cite

Short- and long-term outcomes following atrial fibrillation in patients with acute coronary syndromes with or without ST-segment elevation.

Journal Article Heart · 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 ... Full text Link to item Cite

Facilitated PCI in patients with ST-elevation myocardial infarction.

Journal Article N 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 ... Full text Link to item Cite

Reperfusion after primary angioplasty for ST-elevation myocardial infarction: predictors of success and relationship to clinical outcomes in the APEX-AMI angiographic study.

Journal Article Eur 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 ... Full text Link to item Cite

Requiem for the sounds of silence.

Journal Article CMAJ · April 8, 2008 Full text Link to item Cite

Variation in the use of stress testing and outcomes in patients with non-ST-elevation acute coronary syndromes: insights from GUSTO IIb.

Journal Article Eur 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 ... Full text Link to item Cite

Adverse outcomes in fibrinolytic-based facilitated percutaneous coronary intervention: insights from the ASSENT-4 PCI electrocardiographic substudy.

Journal Article Eur 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 ... Full text Link to item Cite

Better outcomes for patients treated at hospitals that participate in clinical trials.

Journal Article Arch 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 ... Full text Link to item Cite

Acute heart failure in the emergency department: short and long-term outcomes of elderly patients with heart failure.

Journal Article Eur 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 ... Full text Link to item Cite

Noninvasive, medical management for non-ST-elevation acute coronary syndromes.

Journal Article Am 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 ... Full text Link to item Cite

Risk stratification in ST-elevation myocardial infarction is enhanced by combining baseline ST deviation and subsequent ST-segment resolution.

Journal Article Heart · 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 ... Full text Link to item Cite

PCI at non-PCI centres: immediate or rescue?

Journal Article Lancet · February 16, 2008 Full text Link to item Cite

Association between bleeding, blood transfusion, and costs among patients with non-ST-segment elevation acute coronary syndromes.

Journal Article Am 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 ... Full text Link to item Cite

Randomized double-blind trial of darbepoetin alfa in patients with symptomatic heart failure and anemia.

Journal Article Circulation · 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 ... Full text Link to item Cite

Initial aspirin dose and outcome among ST-elevation myocardial infarction patients treated with fibrinolytic therapy.

Journal Article Circulation · 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 ... Full text Link to item Cite

Guideline adjudicated fibrinolytic failure: incidence, findings, and management in a contemporary clinical trial.

Journal Article Am 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 ... Full text Link to item Cite

Failure of investigator adherence to electrocardiographic entry criteria is frequent and influences clinical outcomes: lessons from APEX-AMI.

Journal Article Eur 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 ... Full text Link to item Cite

Differences in admission rates and outcomes between men and women presenting to emergency departments with coronary syndromes.

Journal Article CMAJ · 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 ... Full text Link to item Cite

Cardiovascular disease on a global scale: defining the path forward for research and practice.

Journal Article Eur 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 ... Full text Link to item Cite

Timing of death and myocardial infarction in patients with non-ST elevation acute coronary syndromes: insights from randomized clinical trials.

Journal Article J 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 ... Full text Link to item Cite

A novel enoxaparin regime for ST elevation myocardial infarction patients undergoing primary percutaneous coronary intervention: a WEST sub-study.

Journal Article Catheter 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 ... Full text Link to item Cite

Electrocardiographic left ventricular hypertrophy in GUSTO IV ACS: an important risk marker of mortality in women.

Journal Article Eur 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 ... Full text Link to item Cite

No prognostic significance of chronic infection with Chlamydia pneumoniae in acute coronary syndromes: insights from the Global Utilization of Strategies to Open Occluded Arteries IV Acute Coronary Syndromes trial.

Journal Article Am 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 ... Full text Link to item Cite

Use of evidence-based medicine for acute coronary syndromes in the elderly and very elderly: insights from the Sibrafiban vs aspirin to Yield Maximum Protection from ischemic Heart events postacute cOroNary sYndromes trials.

Journal Article Am 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 ... Full text Link to item Cite

Acute coronary care in the elderly, part II: ST-segment-elevation myocardial infarction: a scientific statement for healthcare professionals from the American Heart Association Council on Clinical Cardiology: in collaboration with the Society of Geriatric Cardiology.

Journal Article Circulation · 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 ... Full text Link to item Cite

Acute coronary care in the elderly, part I: Non-ST-segment-elevation acute coronary syndromes: a scientific statement for healthcare professionals from the American Heart Association Council on Clinical Cardiology: in collaboration with the Society of Geriatric Cardiology.

Journal Article Circulation · 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 ... Full text Link to item Cite

Effects of platelet glycoprotein IIb/IIIa receptor blockers in non-ST segment elevation acute coronary syndromes: benefit and harm in different age subgroups.

Journal Article Heart · 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 ... Full text Link to item Cite

Ruminating on OAT: is the case closed?

Journal Article Eur Heart J · March 2007 Full text Link to item Cite

Prognostic value of growth-differentiation factor-15 in patients with non-ST-elevation acute coronary syndrome.

Journal Article Circulation · 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 ... Full text Link to item Cite

The impact of anthropomorphic indices on clinical outcomes in patients with acute ST-elevation myocardial infarction.

Journal Article Eur 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 ... Full text Link to item Cite

Comparison of effectiveness of enoxaparin versus unfractionated heparin to reduce silent and clinically apparent acute myocardial infarction in patients presenting with non-ST-segment elevation acute coronary syndrome.

Journal Article Am 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 ... Full text Link to item Cite

Pexelizumab for acute ST-elevation myocardial infarction in patients undergoing primary percutaneous coronary intervention: a randomized controlled trial.

Journal Article JAMA · 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 ... Full text Link to item Cite

Insights into the change in brain natriuretic peptide after ST-elevation myocardial infarction (STEMI): why should it be better than baseline?

Journal Article Can 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 ... Full text Link to item Cite

A time for transformative leadership in academic health sciences.

Conference Clin 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 ... Full text Link to item Cite

Effects of socioeconomic status on mortality after acute myocardial infarction.

Journal Article Am 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 ... Full text Link to item Cite

Feasibility and applicability of paramedic-based prehospital fibrinolysis in a large North American center.

Journal Article Am 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 ... Full text Link to item Cite

Predictors of stroke within 30 days in patients with non-ST-segment elevation acute coronary syndromes.

Journal Article Eur 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 ... Full text Link to item Cite

Age, outcomes, and treatment effects of fibrinolytic and antithrombotic combinations: findings from Assessment of the Safety and Efficacy of a New Thrombolytic (ASSENT)-3 and ASSENT-3 PLUS.

Journal Article Am 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 ... Full text Link to item Cite

Troponin-T and N-terminal pro-B-type natriuretic peptide predict mortality benefit from coronary revascularization in acute coronary syndromes: a GUSTO-IV substudy.

Journal Article J 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 ... Full text Link to item Cite

Short- and long-term risk stratification in acute coronary syndromes: the added value of quantitative ST-segment depression and multiple biomarkers.

Journal Article J 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: ... Full text Link to item Cite

The prognostic value of the admission and predischarge electrocardiogram in acute coronary syndromes: the GUSTO-IIb ECG Core Laboratory experience.

Journal Article Am 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 ... Full text Link to item Cite

Effect of pexelizumab on mortality in patients with acute myocardial infarction or undergoing coronary artery bypass surgery: a systematic overview.

Journal Article Am 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 ... Full text Link to item Cite

Effects of selective matrix metalloproteinase inhibitor (PG-116800) to prevent ventricular remodeling after myocardial infarction: results of the PREMIER (Prevention of Myocardial Infarction Early Remodeling) trial.

Journal Article J 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 ... Full text Link to item Cite

The role of revascularization in older patients with acute coronary syndromes

Journal Article Geriatrics 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 ... Cite

A comparison of pharmacologic therapy with/without timely coronary intervention vs. primary percutaneous intervention early after ST-elevation myocardial infarction: the WEST (Which Early ST-elevation myocardial infarction Therapy) study.

Journal Article Eur 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 ... Full text Link to item Cite

International variation in invasive care of the elderly with acute coronary syndromes.

Journal Article Eur 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 ... Full text Link to item Cite

Aspirin use and outcomes in a community-based cohort of 7352 patients discharged after first hospitalization for heart failure.

Journal Article Circulation · 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 ... Full text Link to item Cite

Prognostic significance of the change in glucose level in the first 24 h after acute myocardial infarction: results from the CARDINAL study.

Journal Article Eur 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 ... Full text Link to item Cite

Efficacy and safety of unfractionated heparin versus enoxaparin: a pooled analysis of ASSENT-3 and -3 PLUS data.

Journal Article CMAJ · 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 ... Full text Link to item Cite

Catheter thrombosis during primary percutaneous coronary intervention for acute ST elevation myocardial infarction despite subcutaneous low-molecular-weight heparin, acetylsalicylic acid, clopidogrel and abciximab pretreatment.

Journal Article Can 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 ... Full text Link to item Cite

Optimizing use of revascularization and clinical outcomes in ST-elevation myocardial infarction: insights from the GUSTO-V trial.

Journal Article Eur 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 ... Full text Link to item Cite

Does time matter? A pooled analysis of randomized clinical trials comparing primary percutaneous coronary intervention and in-hospital fibrinolysis in acute myocardial infarction patients.

Journal Article Eur 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 ... Full text Link to item Cite

Concerning the mechanism of pexelizumab's benefit in acute myocardial infarction.

Journal Article Am 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 ... Full text Link to item Cite

N-terminal pro-brain natriuretic peptide and the timing, extent and mortality in ST elevation myocardial infarction.

Journal Article Can 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 ... Full text Link to item Cite

Aborted myocardial infarction: a new target for reperfusion therapy.

Journal Article Eur 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 ... Full text Link to item Cite

Transition from meeting abstract to full-length journal article for randomized controlled trials.

Journal Article JAMA · 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 ... Full text Link to item Cite

Proportion of patients followed in a specialized heart failure clinic needing an implantable cardioverter defibrillator as determined by applying different trial eligibility criteria.

Journal Article Am 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 ... Full text Link to item Cite

Pulmonary edema post-cardioversion: a potential calcium signalling problem.

Journal Article Can 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 ... Full text Link to item Cite

What is the frequency and functional and clinical significance of complex lesions in non-infarct-related arteries after fibrinolysis for acute ST-elevation myocardial infarction?

Journal Article Am 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 ... Full text Link to item Cite

Outcomes of patients in clinical trials with ST-segment elevation myocardial infarction among countries with different gross national incomes.

Journal Article Eur 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 ... Full text Link to item Cite

A comparison of the clinical impact of bleeding measured by two different classifications among patients with acute coronary syndromes.

Journal Article J 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 ... Full text Link to item Cite

Randomized evaluation of the efficacy of enoxaparin versus unfractionated heparin in high-risk patients with non-ST-segment elevation acute coronary syndromes receiving the glycoprotein IIb/IIIa inhibitor eptifibatide. Long-term results of the Integrilin and Enoxaparin Randomized Assessment of Acute Coronary Syndrome Treatment (INTERACT) trial.

Journal Article Am 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 ... Full text Link to item Cite

How many patients with heart failure are eligible for cardiac resynchronization? Insights from two prospective cohorts.

Journal Article Eur 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: ... Full text Link to item Cite

Forecasting mortality: dynamic assessment of risk in ST-segment elevation acute myocardial infarction.

Journal Article Eur 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 ... Full text Link to item Cite

Usefulness of biomarkers for predicting long-term mortality in patients with diabetes mellitus and non-ST-elevation acute coronary syndromes (a GUSTO IV substudy).

Journal Article Am 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). ... Full text Link to item Cite

Elevated creatine kinase-MB with normal creatine kinase predicts worse outcomes in patients with acute coronary syndromes: results from 4 large clinical trials.

Journal Article Am 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 ... Full text Link to item Cite

Unraveling the spectrum of left bundle branch block in acute myocardial infarction: insights from the Assessment of the Safety and Efficacy of a New Thrombolytic (ASSENT 2 and 3) trials.

Journal Article Am 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 ... Full text Link to item Cite

Supervised exercise training improves aerobic capacity and muscle strength in older women with heart failure.

Journal Article Can 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 ... Link to item Cite

Prevalence and management of hypertension in acute coronary syndrome patients varies by sex: observations from the Sibrafiban versus aspirin to Yield Maximum Protection from ischemic Heart events postacute cOroNary sYndromes (SYMPHONY) randomized clinical trials.

Journal Article Am 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 ... Full text Link to item Cite

Stereoselective synthesis of (8R,8aS)-8-methylhexahydroindolizin-5-one

Journal Article Tetrahedron 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. ... Full text Cite

Time to treatment and the impact of a physician on prehospital management of acute ST elevation myocardial infarction: insights from the ASSENT-3 PLUS trial.

Journal Article Heart · 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 ... Full text Link to item Cite

MC-1 (pyridoxal 5'-phosphate): novel therapeutic applications to reduce ischaemic injury.

Journal Article Expert 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 ... Full text Link to item Cite

Short- and long-term outcomes of patients with electrocardiographic left ventricular hypertrophy after fibrinolysis for acute myocardial infarction.

Journal Article Am 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 ... Full text Link to item Cite

Prognostic significance of blood markers of inflammation in patients with ST-segment elevation myocardial infarction undergoing primary angioplasty and effects of pexelizumab, a C5 inhibitor: a substudy of the COMMA trial.

Journal Article Eur 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 ... Full text Link to item Cite

A dynamic model forecasting myocardial infarct size before, during, and after reperfusion therapy: an ASSENT-2 ECG/VCG substudy.

Journal Article Eur 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 ... Full text Link to item Cite

Prognostic implication of activated partial thromboplastin time after reteplase or half-dose reteplase plus abciximab: results from the GUSTO-V trial.

Journal Article Eur 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 ... Full text Link to item Cite

Patients with prolonged ischemic chest pain and presumed-new left bundle branch block have heterogeneous outcomes depending on the presence of ST-segment changes.

Journal Article J 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 ... Full text Link to item Cite

Compromised atrial coronary anatomy is associated with atrial arrhythmias and atrioventricular block complicating acute myocardial infarction.

Journal Article J 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 ... Full text Link to item Cite

The relationship between baseline risk and mortality in ST-elevation acute myocardial infarction treated with pharmacological reperfusion: insights from the Global Utilization of Strategies To open Occluded arteries (GUSTO) V trial.

Journal Article Am 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 ... Full text Link to item Cite

Relation between baseline risk and treatment decisions in non-ST elevation acute coronary syndromes: an examination of international practice patterns.

Journal Article Heart · 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 ... Full text Link to item Cite

The early glycoprotein IIb/IIIa inhibition in non-ST-segment elevation acute coronary syndrome (EARLY ACS) trial: a randomized placebo-controlled trial evaluating the clinical benefits of early front-loaded eptifibatide in the treatment of patients with non-ST-segment elevation acute coronary syndrome--study design and rationale.

Journal Article Am 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 ... Full text Link to item Cite

Guidelines for STEMI.

Journal Article CMAJ · May 24, 2005 Full text Link to item Cite

Omega-3 fatty acids for secondary prevention.

Journal Article J Am Coll Cardiol · May 3, 2005 Full text Link to item Cite

Are international differences in the outcomes of acute coronary syndromes apparent or real? A multilevel analysis.

Journal Article J 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 ... Full text Link to item Cite

Relationship of incorrect dosing of fibrinolytic therapy and clinical outcomes.

Journal Article JAMA · 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 ... Full text Link to item Cite

Country specific cost comparisons from multinational clinical trials using empirical Bayesian shrinkage estimation: the Canadian ASSENT-3 economic analysis.

Journal Article Health 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 ... Full text Link to item Cite

The birth of the Canadian Academy of Health Sciences.

Journal Article Clin Invest Med · April 2005 Link to item Cite

Economic analysis of the Assessment of the Safety and Efficacy of a New Thrombolytic Regimen (ASSENT-3) study: costs of reperfusion strategies in acute myocardial infarction.

Journal Article Am 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 ... Full text Link to item Cite

First experience with direct, selective factor Xa inhibition in patients with non-ST-elevation acute coronary syndromes: results of the XaNADU-ACS Trial.

Journal Article J 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. ... Full text Link to item Cite

Prognostic usefulness of white blood cell count and temperature in acute myocardial infarction (from the CARDINAL Trial).

Journal Article Am 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 ... Full text Link to item Cite

The interaction among sex, hemoglobin and outcomes in a specialty heart failure clinic.

Journal Article Can 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 ... Link to item Cite

Impact of specialist follow-up in outpatients with congestive heart failure.

Journal Article CMAJ · 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 ... Full text Link to item Cite

Assessing risk in FRISC.

Journal Article Eur Heart J · January 2005 Full text Link to item Cite

An academic ECG core lab perspective of the FDA initiative for digital ECG capture and data management in large-scale clinical trials

Journal Article Drug 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 ... Cite

Outcomes of patients with acute coronary syndromes and prior percutaneous coronary intervention: a pooled analysis of three randomized clinical trials.

Journal Article Eur 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 ... Full text Link to item Cite

Lessons learned from a clinical trial.

Journal Article Circulation · December 7, 2004 Full text Link to item Cite

A marriage of enhancement: fibrinolysis and conjunctive therapy.

Journal Article Thromb 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 ... Full text Link to item Cite

Prognostic value of predischarge electrocardiographic measurement of infarct size after thrombolysis: insights from GUSTO I Economics and Quality of Life substudy.

Journal Article Am 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 ... Full text Link to item Cite

An international perspective on heart failure and left ventricular systolic dysfunction complicating myocardial infarction: the VALIANT registry.

Journal Article Eur 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 ... Full text Link to item Cite

Relationship of blood transfusion and clinical outcomes in patients with acute coronary syndromes.

Journal Article JAMA · 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 ... Full text Link to item Cite

Long-term mortality of patients with acute myocardial infarction in the United States and Canada: comparison of patients enrolled in Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO)-I.

Journal Article Circulation · 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 ... Full text Link to item Cite

The 2004 ACC/AHA Guidelines: a perspective and adaptation for Canada by the Canadian Cardiovascular Society Working Group.

Journal Article Can 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 ... Link to item Cite

Association of revascularisation with low mortality in non-ST elevation acute coronary syndrome, a report from GUSTO IV-ACS.

Journal Article Eur 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 ... Full text Link to item Cite

Usefulness of spironolactone in a specialized heart failure clinic.

Journal Article Am 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 ... Full text Link to item Cite

Efficacy and safety of two unfractionated heparin dosing strategies with tenecteplase in acute myocardial infarction (results from Assessment of the Safety and Efficacy of a New Thrombolytic Regimens 2 and 3).

Journal Article Am 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 ... Full text Link to item Cite

Enoxaparin vs unfractionated heparin in high-risk patients with non-ST-segment elevation acute coronary syndromes managed with an intended early invasive strategy: primary results of the SYNERGY randomized trial.

Journal Article JAMA · 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 ... Full text Link to item Cite

Aborted myocardial infarction in patients with ST-segment elevation: insights from the Assessment of the Safety and Efficacy of a New Thrombolytic Regimen-3 Trial Electrocardiographic Substudy.

Journal Article J 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 ... Full text Link to item Cite

Dynamic prognostication in non-ST-elevation acute coronary syndromes: insights from GUSTO-IIb and PURSUIT.

Journal Article Am 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 ... Full text Link to item Cite

Variations in pre-hospital fibrinolysis process of care: insights from the Assessment of the Safety and Efficacy of a New Thrombolytic 3 Plus international acute myocardial infarction pre-hospital care survey.

Journal Article Eur 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 ... Full text Link to item Cite

Six-month outcomes of percutaneous coronary balloon angioplasty in acute coronary syndromes: Results from the PURSUIT trial.

Journal Article Can 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 ... Link to item Cite

Efficacy of tenecteplase in combination with enoxaparin, abciximab, or unfractionated heparin: one-year follow-up results of the Assessment of the Safety of a New Thrombolytic-3 (ASSENT-3) randomized trial in acute myocardial infarction.

Journal Article Am 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 ... Full text Link to item Cite

Impact of different patterns of invasive care on quality of life outcomes in patients with non-ST elevation acute coronary syndrome: results from the GUSTO-IIb Canada-United States substudy.

Journal Article Can 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 ... Link to item Cite

Rapid stereoselective access to key pumiliotoxin precursors from a common intermediate.

Journal Article J 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 ... Full text Link to item Cite

Do evidence-based treatments provide incremental benefits to patients with congestive heart failure already receiving angiotensin-converting enzyme inhibitors? A secondary analysis of one-year outcomes from the Assessment of Treatment with Lisinopril and Survival (ATLAS) study.

Journal Article Clin 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- ... Full text Link to item Cite

Bleeding events with abciximab in acute coronary syndromes without early revascularization: An analysis of GUSTO IV-ACS.

Journal Article Am 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 ... Full text Link to item Cite

The use of beta-blockers in a tertiary care heart failure clinic: dosing, tolerance, and outcomes.

Journal Article Arch 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 ... Full text Link to item Cite

Therapeutic exercise for individuals with heart failure: special attention to older women with heart failure.

Journal Article J 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 ... Full text Link to item Cite

Facilitated percutaneous coronary intervention versus primary percutaneous coronary intervention: design and rationale of the Facilitated Intervention with Enhanced Reperfusion Speed to Stop Events (FINESSE) trial.

Journal Article Am 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 ... Full text Link to item Cite

Prognostic value of ECG changes in non-ST elevation ACS patients

Journal Article Cardiology 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 ... Cite

Combining baseline clinical descriptors and real-time response to therapy: the incremental prognostic value of continuous ST-segment monitoring in acute myocardial infarction.

Journal Article Am 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 ... Full text Link to item Cite

The Warfarin and Antiplatelet Therapy in Heart Failure trial (WATCH): rationale, design, and baseline patient characteristics.

Journal Article J 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 ... Full text Link to item Cite

Interinstitutional variation in the use of abciximab for percutaneous coronary intervention.

Journal Article Can 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 ... Link to item Cite

Renal insufficiency and heart failure: prognostic and therapeutic implications from a prospective cohort study.

Journal Article Circulation · 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 ... Full text Link to item Cite

Outcome of acute ST-segment elevation myocardial infarction in diabetics treated with fibrinolytic or combination reduced fibrinolytic therapy and platelet glycoprotein IIb/IIIa inhibition: lessons from the GUSTO V trial.

Journal Article J 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 ... Full text Link to item Cite

Synthesis of the putative structures of homopumiliotoxins 235C and 233F

Journal Article Tetrahedron 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 ... Full text Cite

International differences in evolution of early discharge after acute myocardial infarction.

Journal Article Lancet · 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 ... Full text Link to item Cite

Differential treatment benefit of platelet glycoprotein IIb/IIIa inhibition with percutaneous coronary intervention versus medical therapy for acute coronary syndromes: exploration of methods.

Journal Article Circulation · 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 ... Full text Link to item Cite

Innovative strategic Canadian research training from TomorrOw's Research Cardiovascular Health Care Professionals (TORCH).

Journal Article Clin 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 ... Link to item Cite

Creatine kinase-MB elevation after percutaneous coronary intervention predicts adverse outcomes in patients with acute coronary syndromes.

Journal Article Eur 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 ... Full text Link to item Cite

Initial experience with factor-Xa inhibition in percutaneous coronary intervention: the XaNADU-PCI Pilot.

Journal Article J 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 ... Full text Link to item Cite

A rapid troponin I assay is not optimal for determination of troponin status and prediction of subsequent cardiac events at suspicion of unstable coronary syndromes.

Journal Article Int 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 ... Full text Link to item Cite

Activation of the inflammation, coagulation, and fibrinolysis systems, without influence of abciximab infusion in patients with non-ST-elevation acute coronary syndromes treated with dalteparin: a GUSTO IV substudy.

Journal Article Am 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 ... Full text Link to item Cite

A new synthetic approach to 2,3-dideoxy-2-fluoro-β-D-threo- pentofuranose, the fluorofuranose unit of the anti-HIV-active nucleoside, β-FddA

Journal Article Tetrahedron Letters · January 19, 2004 The fluorinated furanose unit of the anti-HIV-active nucleoside (2,3-dideoxy-2-fluoro-β-D-threo-pentofuranosyl)adenine, β-FddA, has been synthesized as its 5-trityl derivative with high stereocontrol from (S)-trityl glycidol and phenylthioacetic acid. © 20 ... Full text Cite

International variation in the use of evidence-based medicines for acute coronary syndromes.

Journal Article Eur 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 ... Full text Link to item Cite

Aspirin use post-acute coronary syndromes: intolerance, bleeding and discontinuation.

Journal Article J 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 ... Full text Link to item Cite

Impact of sex on long-term mortality from acute myocardial infarction vs unstable angina.

Journal Article Arch 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 ... Full text Link to item Cite

From controlled trials to clinical practice: monitoring transmyocardial revascularization use and outcomes.

Journal Article J 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 ... Full text Link to item Cite

Risk of intracranial haemorrhage with combined fibrinolytic and glycoprotein IIb/IIIa inhibitor therapy in acute myocardial infarction. Dichotomous response as a function of age in the GUSTO V trial.

Journal Article Eur 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 ... Full text Link to item Cite

Does 24-hour ST-segment resolution postfibrinolysis add prognostic value to a Q wave? An ASSENT 2 electrocardiographic substudy.

Journal Article Am 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 ... Full text Link to item Cite

Outcome of urgent and elective percutaneous coronary interventions after pharmacologic reperfusion with tenecteplase combined with unfractionated heparin, enoxaparin, or abciximab.

Journal Article J 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 ... Full text Link to item Cite

Effect of pexelizumab, an anti-C5 complement antibody, as adjunctive therapy to fibrinolysis in acute myocardial infarction: the COMPlement inhibition in myocardial infarction treated with thromboLYtics (COMPLY) trial.

Journal Article Circulation · 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 ... Full text Link to item Cite

Pexelizumab, an anti-C5 complement antibody, as adjunctive therapy to primary percutaneous coronary intervention in acute myocardial infarction: the COMplement inhibition in Myocardial infarction treated with Angioplasty (COMMA) trial.

Journal Article Circulation · 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 ... Full text Link to item Cite

Collaborative Angiographic Patency Trial Of Recombinant Staphylokinase (CAPTORS II).

Journal Article Am 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 ... Full text Link to item Cite

International differences in in-hospital revascularization and outcomes following acute myocardial infarction: a multilevel analysis of patients in ASSENT-2.

Journal Article Eur 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 ... Full text Link to item Cite

Troponin T levels and risk of 30-day outcomes in patients with the acute coronary syndrome: prospective verification in the GUSTO-IV trial.

Journal Article Am 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 ... Full text Link to item Cite

ST segment resolution in ASSENT 3: insights into the role of three different treatment strategies for acute myocardial infarction.

Journal Article Eur 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 ... Full text Link to item Cite

N-terminal pro-brain natriuretic peptide and other risk markers for the separate prediction of mortality and subsequent myocardial infarction in patients with unstable coronary artery disease: a Global Utilization of Strategies To Open occluded arteries (GUSTO)-IV substudy.

Journal Article Circulation · 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 ... Full text Link to item Cite

Efficacy and safety of tenecteplase in combination with the low-molecular-weight heparin enoxaparin or unfractionated heparin in the prehospital setting: the Assessment of the Safety and Efficacy of a New Thrombolytic Regimen (ASSENT)-3 PLUS randomized trial in acute myocardial infarction.

Journal Article Circulation · 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 ... Full text Link to item Cite

Do cardiac troponins provide prognostic insight in hemodialysis patients?

Journal Article Can 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 ... Link to item Cite

One-year follow-up of the ASSENT-2 trial: a double-blind, randomized comparison of single-bolus tenecteplase and front-loaded alteplase in 16,949 patients with ST-elevation acute myocardial infarction.

Journal Article Am 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 ... Full text Link to item Cite

The impact of gender on the treatment and outcomes of patients with early reinfarction after fibrinolysis: insights from ASSENT-2.

Journal Article Eur 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 ... Full text Link to item Cite

Two hard lessons.

Journal Article Lancet · April 26, 2003 Full text Link to item Cite

Prognostic value of isolated troponin elevation across the spectrum of chest pain syndromes.

Journal Article Am 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 ... Full text Link to item Cite

Troponin and C-reactive protein have different relations to subsequent mortality and myocardial infarction after acute coronary syndrome: a GUSTO-IV substudy.

Journal Article J 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 ... Full text Link to item Cite

Implantable cardioverter defibrillators in primary and secondary prevention: a systematic review of randomized, controlled trials.

Journal Article Ann 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 ... Full text Link to item Cite

Impact of on-site cardiac interventional facilities on management and outcome of patients with acute coronary syndromes.

Journal Article Can 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 ... Link to item Cite

Do guidelines influence practice?

Journal Article Heart · March 2003 Full text Link to item Cite

Does the discharge ECG provide additional prognostic insight(s) in non-ST elevation ACS patients from that acquired on admission?

Journal Article Eur 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 ... Full text Link to item Cite

Sustained ventricular arrhythmias and mortality among patients with acute myocardial infarction: results from the GUSTO-III trial.

Journal Article Am 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 ... Full text Link to item Cite

Troponin T and quantitative ST-segment depression offer complementary prognostic information in the risk stratification of acute coronary syndrome patients.

Journal Article J 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 ... Full text Link to item Cite

Cost effectiveness in Canada of eptifibatide treatment for acute coronary syndrome patients using PURSUIT subgroup analysis.

Journal Article Can 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 ... Link to item Cite

Development and validation of a simple model to predict severe coronary artery disease after myocardial infarction: potential impact on cardiac catheterization use in the United States and Canada.

Journal Article Am 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) ... Full text Link to item Cite

Long-term results after the glycoprotein IIb/IIIa inhibitor abciximab in unstable angina: one-year survival in the GUSTO IV-ACS (Global Use of Strategies To Open Occluded Coronary Arteries IV--Acute Coronary Syndrome) Trial.

Journal Article Circulation · 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 ... Full text Link to item Cite

Randomized evaluation of the safety and efficacy of enoxaparin versus unfractionated heparin in high-risk patients with non-ST-segment elevation acute coronary syndromes receiving the glycoprotein IIb/IIIa inhibitor eptifibatide.

Journal Article Circulation · 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 ... Full text Link to item Cite

Anemia is common in heart failure and is associated with poor outcomes: insights from a cohort of 12 065 patients with new-onset heart failure.

Journal Article Circulation · 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 ... Full text Link to item Cite

Prehospital management of acute ST-elevation myocardial infarction: a time for reappraisal in North America.

Journal Article Am 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 ... Full text Link to item Cite

Enoxaparin is safer and more effective than heparin in acute coronary syndrome

Journal Article Evidence-based Cardiovascular Medicine · January 1, 2003 Full text Cite

Time-based risk assessment after myocardial infarction. Implications for timing of discharge and applications to medical decision-making.

Journal Article Eur 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 ... Full text Link to item Cite

Does chronic Chlamydia pneumoniae infection increase the risk of myocardial injury? Insights from patients with non-ST-elevation acute coronary syndromes.

Journal Article Am 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 ... Full text Link to item Cite

A letter from CMAJ's editorial board to the CMA.

Journal Article CMAJ · November 26, 2002 Link to item Cite

The waiting game: facing the consequences.

Journal Article CMAJ · November 26, 2002 Link to item Cite

Mortality at 1 year with combination platelet glycoprotein IIb/IIIa inhibition and reduced-dose fibrinolytic therapy vs conventional fibrinolytic therapy for acute myocardial infarction: GUSTO V randomized trial.

Journal Article JAMA · 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 ... Full text Link to item Cite

The ebb and flow of the NHS waiting list: how do recruitment and admission affect event-based measures of the length of 'time-to-admission'?

Journal Article Stat 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 ... Full text Link to item Cite

Safety and efficacy of abciximab combined with dalteparin in treatment of acute coronary syndromes.

Journal Article Eur 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 ... Full text Link to item Cite

Do the investigative sites that take part in a positive clinical trial translate that evidence into practice?

Journal Article Am 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 ... Full text Link to item Cite

Development and prognosis of non-Q-wave myocardial infarction in the thrombolytic era.

Journal Article Am 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 ... Full text Link to item Cite

Sustained ventricular arrhythmias among patients with acute coronary syndromes with no ST-segment elevation: incidence, predictors, and outcomes.

Journal Article Circulation · 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 ... Full text Link to item Cite

Does eptifibatide confer a greater benefit to patients with unstable angina than with non-ST segment elevation myocardial infarction? Insights from the PURSUIT Trial.

Journal Article Eur 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 ... Full text Link to item Cite

Predicting outcome after thrombolysis in acute myocardial infarction according to ST-segment resolution at 90 minutes: a substudy of the GUSTO-III trial. Global Use of Strategies To Open occluded coronary arteries.

Journal Article Am 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 ... Full text Link to item Cite

Prognostic significance of elevated troponin I after percutaneous coronary intervention.

Journal Article J 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 ... Full text Link to item Cite

The failure of orally administered glycoprotein IIb/IIIa inhibitors to prevent recurrent cardiac events.

Journal Article Am 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 ... Full text Link to item Cite

First experience with direct factor Xa inhibition in patients with stable coronary disease: a pharmacokinetic and pharmacodynamic evaluation.

Journal Article Circulation · 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 ... Full text Link to item Cite

Losartan potassium (Cozaar).

Journal Article Circulation · April 23, 2002 Full text Link to item Cite

Misreporting of myocardial infarction end points: results of adjudication by a central clinical events committee in the PARAGON-B trial. Second Platelet IIb/IIIa Antagonist for the Reduction of Acute Coronary Syndrome Events in a Global Organization Network Trial.

Journal Article Am 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 ... Full text Link to item Cite

Persistence of delays in presentation and treatment for patients with acute myocardial infarction: The GUSTO-I and GUSTO-III experience.

Journal Article Ann 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 ... Full text Link to item Cite

Outcomes of patients with acute coronary syndromes and prior coronary artery bypass grafting: results from the platelet glycoprotein IIb/IIIa in unstable angina: receptor suppression using integrilin therapy (PURSUIT) trial.

Journal Article Circulation · 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 ... Full text Link to item Cite

Platelet glycoprotein IIb/IIIa inhibitors in acute coronary syndromes: a meta-analysis of all major randomised clinical trials.

Journal Article Lancet · 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 ... Full text Link to item Cite

The prognostic value of creatine kinase elevations extends across the whole spectrum of acute coronary syndromes.

Journal Article J 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 ... Full text Link to item Cite

Incidence and predictors of bleeding events after fibrinolytic therapy with fibrin-specific agents: a comparison of TNK-tPA and rt-PA.

Journal Article Eur 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 ... Full text Link to item Cite

Safety of the weight-adjusted dosing regimen of tenecteplase in the ASSENT-Trial.

Journal Article Am 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 ... Full text Link to item Cite

Thrombin-specific anticoagulation with bivalirudin versus heparin in patients receiving fibrinolytic therapy for acute myocardial infarction: the HERO-2 randomised trial.

Journal Article Lancet · 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 ... Full text Link to item Cite

Time to treatment influences the impact of ST-segment resolution on one-year prognosis: insights from the assessment of the safety and efficacy of a new thrombolytic (ASSENT-2) trial.

Journal Article Circulation · 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 ... Full text Link to item Cite

Randomised trials of secondary prevention programmes in coronary heart disease: systematic review.

Journal Article BMJ · 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 ... Full text Link to item Cite

Early reinfarction after fibrinolysis: experience from the global utilization of streptokinase and tissue plasminogen activator (alteplase) for occluded coronary arteries (GUSTO I) and global use of strategies to open occluded coronary arteries (GUSTO III) trials.

Journal Article Circulation · 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 ... Full text Link to item Cite

Cardiovascular critical event pathways for the progression of heart failure; a report from the ATLAS study.

Journal Article Eur 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 ... Full text Link to item Cite

Efficacy and safety of tenecteplase in combination with enoxaparin, abciximab, or unfractionated heparin: the ASSENT-3 randomised trial in acute myocardial infarction.

Journal Article Lancet · 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 ... Full text Link to item Cite

Prognostic value of ST segment depression in acute coronary syndromes: insights from PARAGON-A applied to GUSTO-IIb. PARAGON-A and GUSTO IIb Investigators. Platelet IIb/IIIa Antagonism for the Reduction of Acute Global Organization Network.

Journal Article J 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 ... Full text Link to item Cite

Benefit of glycoprotein IIb/IIIa inhibition in patients with acute coronary syndromes and troponin t-positive status: the paragon-B troponin T substudy.

Journal Article Circulation · 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 ... Full text Link to item Cite

Effect of lipid-lowering therapy on early mortality after acute coronary syndromes: an observational study.

Journal Article Lancet · 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 ... Full text Link to item Cite

A systematic review of randomized trials of disease management programs in heart failure.

Journal Article Am 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 ... Full text Link to item Cite

Reactivation of ischemic events in acute coronary syndromes: results from GUSTO-IIb. Gobal Use of Strategies To Open occluded arteries in acute coronary syndromes.

Journal Article J 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 ... Full text Link to item Cite

Specific and non-specific measurements of tissue angiotensin II cascade members.

Conference J 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 ... Full text Link to item Cite

Bolus fibrinolysis: risk, benefit, and opportunities.

Journal Article Circulation · February 27, 2001 Full text Link to item Cite

Toleration of high doses of angiotensin-converting enzyme inhibitors in patients with chronic heart failure: results from the ATLAS trial. The Assessment of Treatment with Lisinopril and Survival.

Journal Article Arch 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 ... Full text Link to item Cite

Temporal evolution in the management of acute ST elevation myocardial infarction: The seven-year GUSTO experience from Canada and the United States

Journal Article Canadian 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 ... Cite

Comparative effects of low and high doses of the angiotensin-converting enzyme inhibitor, lisinopril, on morbidity and mortality in chronic heart failure

Journal Article Congestive 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 ... Cite

Efficacy and safety of high-dose lisinopril in chronic heart failure patients at high cardiovascular risk, including those with diabetes mellitus. Results from the ATLAS trial.

Journal Article Eur 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 ... Full text Link to item Cite

New strategies for acute coronary syndromes

Conference Sapporo Medical Journal · December 1, 2000 Cite

Low doses vs. high doses of the angiotensin converting-enzyme inhibitor lisinopril in chronic heart failure: a cost-effectiveness analysis based on the Assessment of Treatment with Lisinopril and Survival (ATLAS) study. The ATLAS Study Group.

Journal Article Eur 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, ... Full text Link to item Cite

Survival outcomes 1 year after reperfusion therapy with either alteplase or reteplase for acute myocardial infarction: results from the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) III Trial.

Journal Article Circulation · 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 ... Full text Link to item Cite

Canadian-American differences in the management of acute coronary syndromes in the GUSTO IIb trial: one-year follow-up of patients without ST-segment elevation. Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) II Investigators.

Journal Article Circulation · 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 ... Full text Link to item Cite

Myocardial infarction redefined--a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction.

Journal Article J 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 ... Full text Link to item Cite

Myocardial infarction redefined--a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction.

Journal Article Eur 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 ... Full text Link to item Cite

First steps in analysing NHS waiting times: avoiding the 'stationary and closed population' fallacy.

Journal Article Stat 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 ... Full text Link to item Cite

Dose-finding, safety, and tolerability study of an oral platelet glycoprotein IIb/IIIa inhibitor, lotrafiban, in patients with coronary or cerebral atherosclerotic disease.

Journal Article Circulation · 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 ... Full text Link to item Cite

Acute coronary findings at autopsy in heart failure patients with sudden death: results from the assessment of treatment with lisinopril and survival (ATLAS) trial.

Journal Article Circulation · 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 ... Full text Link to item Cite

Use of resources, quality of life, and clinical outcomes in patients with and without new Q waves after thrombolytic therapy for acute myocardial infarction (from the GUSTO-I trial).

Journal Article Am 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 ... Full text Link to item Cite

Predictors of outcome in patients with acute coronary syndromes without persistent ST-segment elevation. Results from an international trial of 9461 patients. The PURSUIT Investigators.

Journal Article Circulation · 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 ... Full text Link to item Cite

Prediction of 1-year survival after thrombolysis for acute myocardial infarction in the global utilization of streptokinase and TPA for occluded coronary arteries trial.

Journal Article Circulation · 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 ... Full text Link to item Cite

Collaborative angiographic patency trial of recombinant staphylokinase (CAPTORS).

Journal Article Am 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 ... Full text Link to item Cite

Adverse effects of corticosteroids on the cardiovascular system.

Journal Article Can 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 ... Link to item Cite

Cost effectiveness of early discharge after uncomplicated acute myocardial infarction.

Journal Article N 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 ... Full text Link to item Cite

Unrepresentative, invalid and misleading: are waiting times for elective admission wrongly calculated?

Journal Article J 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 ... Link to item Cite

Predictors of cardiogenic shock after thrombolytic therapy for acute myocardial infarction.

Journal Article J 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 ... Full text Link to item Cite

Comparative effects of low and high doses of the angiotensin-converting enzyme inhibitor, lisinopril, on morbidity and mortality in chronic heart failure. ATLAS Study Group.

Journal Article Circulation · 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 ... Full text Link to item Cite

Risk stratification with a point-of-care cardiac troponin T test in acute myocardial infarction. GUSTOIII Investigators. Global Use of Strategies To Open Occluded Coronary Arteries.

Journal Article Am 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 ... Full text Link to item Cite

Pursuing progress in acute coronary syndromes.

Journal Article Circulation · October 12, 1999 Full text Link to item Cite

Single-bolus tenecteplase compared with front-loaded alteplase in acute myocardial infarction: the ASSENT-2 double-blind randomised trial.

Journal Article Lancet · 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 ... Full text Link to item Cite

Insights into the contemporary epidemiology and outpatient management of congestive heart failure.

Journal Article Am 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 ... Full text Link to item Cite

A comparison of U.S. and Canadian cardiac catheterization practices in detecting severe coronary artery disease after myocardial infarction: efficiency, yield and long-term implications.

Journal Article J 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 ... Full text Link to item Cite

Anticoagulant therapy in unstable angina.

Journal Article Cardiol 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 ... Full text Link to item Cite

Prior aspirin use predicts worse outcomes in patients with non-ST-elevation acute coronary syndromes. PURSUIT Investigators. Platelet IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy.

Journal Article Am 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 ... Full text Link to item Cite

Improved outcome in heart failure.

Journal Article International journal of clinical practice. Supplement · April 1, 1999 Cite

Improved outcome in heart failure.

Conference Int J Clin Pract Suppl · April 1999 Link to item Cite

Baseline clinical characteristics of patients recruited into the assessment of treatment with lisinopril and survival study.

Journal Article Eur 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 ... Full text Link to item Cite

Supraventricular tachycardia terminated by external mechanical stimulation: a case of "pothole conversion".

Journal Article Pacing 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 ... Full text Link to item Cite

Death and nonfatal reinfarction within the first 24 hours after presentation with an acute coronary syndrome: experience from GUSTO-IIb. Global Utilization of Strategies for Total Occlusion.

Journal Article Am 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 ... Full text Link to item Cite

Frequency and clinical outcome of cardiogenic shock during acute myocardial infarction among patients receiving reteplase or alteplase. Results from GUSTO-III. Global Use of Strategies to Open Occluded Coronary Arteries.

Journal Article Eur 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 ... Full text Link to item Cite

Endothelial nitric oxide synthase increases in left atria of dogs with pacing-induced heart failure

Journal Article American 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 ... Cite

Endothelial nitric oxide synthase increases in left atria of dogs with pacing-induced heart failure.

Journal Article Am 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 ... Full text Link to item Cite

Potential impact of evidence-based medicine in acute coronary syndromes: insights from GUSTO-IIb. Global Use of Strategies to Open Occluded Arteries in Acute Coronary Syndromes trial.

Journal Article J 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 ... Full text Link to item Cite

Combining thrombolysis with the platelet glycoprotein IIb/IIIa inhibitor lamifiban: results of the Platelet Aggregation Receptor Antagonist Dose Investigation and Reperfusion Gain in Myocardial Infarction (PARADIGM) trial.

Journal Article J 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 ... Full text Link to item Cite

Value of serial troponin T measures for early and late risk stratification in patients with acute coronary syndromes. The GUSTO-IIa Investigators.

Journal Article Circulation · 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 ... Full text Link to item Cite

Acute coronary syndromes in the GUSTO-IIb trial: prognostic insights and impact of recurrent ischemia. The GUSTO-IIb Investigators.

Journal Article Circulation · 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 ... Full text Link to item Cite

Atenolol use and clinical outcomes after thrombolysis for acute myocardial infarction: the GUSTO-I experience. Global Utilization of Streptokinase and TPA (alteplase) for Occluded Coronary Arteries.

Journal Article J 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 ... Full text Link to item Cite

International, randomized, controlled trial of lamifiban (a platelet glycoprotein IIb/IIIa inhibitor), heparin, or both in unstable angina. The PARAGON Investigators. Platelet IIb/IIIa Antagonism for the Reduction of Acute coronary syndrome events in a Global Organization Network.

Journal Article Circulation · 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 ... Full text Link to item Cite

Randomized comparison of direct thrombin inhibition versus heparin in conjunction with fibrinolytic therapy for acute myocardial infarction: results from the GUSTO-IIb Trial. Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes (GUSTO-IIb) Investigators.

Journal Article J 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 ... Full text Link to item Cite

Higher T-wave amplitude associated with better prognosis in patients receiving thrombolytic therapy for acute myocardial infarction (a GUSTO-I substudy). Global Utilization of Streptokinase and Tissue plasminogen Activator for Occluded Coronary Arteries.

Journal Article Am 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 ... Full text Link to item Cite

Rationale and clinical evidence for the use of GP IIb/IIIa inhibitors in acute coronary syndromes.

Journal Article Am 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 ... Full text Link to item Cite

Rationale and clinical evidence for the use of GP IIb/IIIa inhibitors in acute coronary syndromes.

Journal Article Eur 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 ... Link to item Cite

Clinical cardiology: New frontiers

Journal Article Circulation · March 31, 1998 Cite

Prognostic significance of ST segment shift early after resolution of ST elevation in patients with myocardial infarction treated with thrombolytic therapy: the GUSTO-I ST Segment Monitoring Substudy.

Journal Article J 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 ... Full text Link to item Cite

Regional differences in the characteristics and treatment of patients participating in an international heart failure trial. The Assessment of Treatment with Lisinopril and Survival (ATLAS) Trial Investigators.

Journal Article J 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 ... Full text Link to item Cite

Cardiac troponin T and cardiac troponin I: relative values in short-term risk stratification of patients with acute coronary syndromes. GUSTO-IIa Investigators.

Journal Article Clin 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 ... Link to item Cite

Non-Q-wave versus Q-wave myocardial infarction after thrombolytic therapy: angiographic and prognostic insights from the global utilization of streptokinase and tissue plasminogen activator for occluded coronary arteries-I angiographic substudy. GUSTO-I Angiographic Investigators.

Journal Article Circulation · 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 ... Full text Link to item Cite

ST segment monitoring in patients with acute ischemic syndromes: Past and future

Conference Journal of Thrombosis and Thrombolysis · January 1, 1998 Full text Cite

Management of unstable angina: Tailoring therapeutic elements and intensity to risk profile

Journal Article ACC 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 ... Full text Cite

Prognostic implications of early reduced heart rate variability after infarction

Journal Article Cardiology 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 ... Cite

Spectrum of ischemic heart disease and the role of biochemical markers.

Journal Article Clin 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 ... Link to item Cite

A comparison of reteplase with alteplase for acute myocardial infarction.

Journal Article N 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 ... Full text Link to item Cite

Ticlopidine-associated pancytopenia: implications of an acetylsalicylic acid alternative.

Journal Article Can 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 ... Link to item Cite

Age-dependent augmentation of cardiac endothelial NOS in a genetic rat model of heart failure.

Journal Article Am 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, ... Full text Link to item Cite

Thrombolytic therapy: time to treatment.

Journal Article CMAJ · August 1, 1997 Link to item Cite

Carvedilol reduced death and hospitalization in congestive heart failure

Journal Article Evidence-Based Medicine · July 1, 1997 Cite

A clinical trial comparing primary coronary angioplasty with tissue plasminogen activator for acute myocardial infarction.

Journal Article N 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 ... Full text Link to item Cite

Incidence and predictors of bleeding after contemporary thrombolytic therapy for myocardial infarction. The Global Utilization of Streptokinase and Tissue Plasminogen activator for Occluded coronary arteries (GUSTO) I Investigators.

Journal Article Circulation · 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 ... Full text Link to item Cite

Evaluation of the Heart and Stroke Foundation of Canada Research Scholarship Program: research productivity and impact.

Journal Article Can 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 ... Link to item Cite

Incidence and impact on outcome of streptokinase allergy in the GUSTO-I trial. Global Utilization of Streptokinase and t-PA in Occluded Coronary Arteries.

Journal Article Am 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 ... Full text Link to item Cite

Time to treatment with thrombolytic therapy: determinants and effect on short-term nonfatal outcomes of acute myocardial infarction. Canadian GUSTO Investigators. Global Utilization of Streptokinase and + PA for Occluded Coronary Arteries.

Journal Article CMAJ · 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 ... Link to item Cite

Novel methodology for echocardiographic quantification of cardiac shape.

Journal Article Can 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 ... Link to item Cite

Does a hypertonic saline load predict fluid retention in pacing induced heart failure?

Journal Article Cardiovasc 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 ... Full text Link to item Cite

Unstable angina--report from a Canadian expert roundtable.

Journal Article Can 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 ... Link to item Cite

Non-Q wave infarction after thrombolytic therapy.

Journal Article J Am Coll Cardiol · November 15, 1996 Full text Link to item Cite

Cardiac troponin T levels for risk stratification in acute myocardial ischemia. GUSTO IIA Investigators.

Journal Article N 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 ... Full text Link to item Cite

Evolution of the CCU from rhythm, function and protection to reperfusion and beyond: a personal journey and perspective.

Journal Article Can 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 ... Link to item Cite

One-year results from the Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries (GUSTO-I) trial. GUSTO-I Investigators.

Journal Article Circulation · 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 ... Full text Link to item Cite

A comparison of recombinant hirudin with heparin for the treatment of acute coronary syndromes.

Journal Article N 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 ... Full text Link to item Cite

Perspectives gained from large-scale thrombolytic comparative trials.

Conference Eur 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 ... Full text Link to item Cite

Biatrial appendage hypertrophy but not ventricular hypertrophy: a unique feature of canine pacing-induced heart failure.

Journal Article J 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 ... Full text Link to item Cite

Time from symptom onset to treatment and outcomes after thrombolytic therapy. GUSTO-1 Investigators.

Journal Article J 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 ... Full text Link to item Cite

Late assessment of thrombolytic efficacy (LATE) study: prognosis in patients with non-Q wave myocardial infarction. (LATE Study Investigators).

Journal Article J 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 ... Full text Link to item Cite

Non-invasive prediction of reperfusion and coronary artery patency by continuous ST segment monitoring in the GUSTO-I trial.

Journal Article Eur Heart J · May 1996 In the GUSTO-I ECG ischaemia monitoring substudy, 1067 patients underwent continuous ST segment monitoring, using vector-derived 12-lead (406 patients), 12-lead (373 patients) and 3-lead Holter (288 patients) ECG recording systems. Simultaneous angiograms ... Full text Link to item Cite

Heart rate variability assessment early after acute myocardial infarction. Pathophysiological and prognostic correlates. GUSTO ECG Substudy Investigators. Global Utilization of Streptokinase and TPA for Occluded Arteries.

Journal Article Circulation · 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 ... Full text Link to item Cite

Plasma and cardiac tissue atrial and brain natriuretic peptides in experimental heart failure.

Journal Article J 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 ... Full text Link to item Cite

The 49th parallel: how much latitude?

Journal Article J Am Coll Cardiol · November 1, 1995 Full text Link to item Cite

Bleeding risks, risk factors and management of bleeding complications after treatment with anticoagulants, specific antithrombins, thrombolytics IIb-IIIa receptor blockers.

Conference Eur 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 ... Full text Link to item Cite

Evaluation of paradoxic beneficial effects of smoking in patients receiving thrombolytic therapy for acute myocardial infarction: mechanism of the "smoker's paradox" from the GUSTO-I trial, with angiographic insights. Global Utilization of Streptokinase and Tissue-Plasminogen Activator for Occluded Coronary Arteries.

Journal Article J 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 ... Full text Link to item Cite

Abnormal amniotic fetal antigen 2 concentrations in trisomy 18 and trisomy 21.

Journal Article Hum 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 ... Full text Link to item Cite

Regional variation across the United States in the management of acute myocardial infarction. GUSTO-1 Investigators. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries.

Journal Article N 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 ... Full text Link to item Cite

How does intermittent pacing modify the response to rapid ventricular pacing in experimental heart failure?

Journal Article J 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 ... Full text Link to item Cite

Noninvasive assessment of speed and stability of infarct-related artery reperfusion: results of the GUSTO ST segment monitoring study. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries.

Journal Article J 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 ... Full text Link to item Cite

Differences in the treatment of myocardial infarction between the United States and Canada. A survey of physicians in the GUSTO trial.

Journal Article Med 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 ... Full text Link to item Cite

Cost effectiveness of thrombolytic therapy with tissue plasminogen activator as compared with streptokinase for acute myocardial infarction.

Journal Article N 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 ... Full text Link to item Cite

Variations in patient management and outcomes for acute myocardial infarction in the United States and other countries. Results from the GUSTO trial. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries.

Journal Article JAMA · 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 ( ... Full text Link to item Cite

The typing of fetal antigen 2 in human amniotic fluid.

Journal Article Clin 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, ... Full text Link to item Cite

Usefulness of ischemic response to mental stress in predicting silent myocardial ischemia during ambulatory monitoring.

Journal Article Am 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 ... Full text Link to item Cite

Maximizing the benefits of thrombolytic therapy for acute myocardial infarction.

Journal Article CMAJ · 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 ... Link to item Cite

Pathophysiology and time course of silent myocardial ischaemia during mental stress: clinical, anatomical, and physiological correlates.

Journal Article Br 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 ... Full text Link to item Cite

Metaiodobenzylguanidine imaging in diabetes mellitus: assessment of cardiac sympathetic denervation and its relation to autonomic dysfunction and silent myocardial ischemia.

Journal Article J 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 ... Full text Link to item Cite

Lipoprotein(a) and apolipoproteins B and A-I after acute myocardial infarction.

Journal Article Can 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 ... Link to item Cite

Detection of silent ischemia adds to the prognostic value of coronary anatomy and left ventricular function in predicting outcome in unstable angina patients.

Journal Article Can 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 ... Link to item Cite

Inhalation injury

Journal Article Topics 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 ... Cite

Graded exercise testing following thrombolytic therapy for acute myocardial infarction: the importance of timing and infarct location. TPAT Study Group.

Journal Article Can 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 ... Link to item Cite

Chronic false aneurysms of the left ventricle: management revisited.

Journal Article Can 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 ... Link to item Cite

Use of medical resources and quality of life after acute myocardial infarction in Canada and the United States.

Journal Article N 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 ... Full text Link to item Cite

Extracellular matrix remodeling after balloon angioplasty injury in a rabbit model of restenosis.

Journal Article Circ 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 ... Full text Link to item Cite

Endothelium-dependent relaxations in canine coronary arteries are enhanced in early heart failure and persist in recovery.

Journal Article Can 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 ... Full text Link to item Cite

Comparison of the appropriateness of coronary angiography and coronary artery bypass graft surgery between Canada and New York State.

Journal Article JAMA · 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 ... Link to item Cite

Importance of ST-segment depression as a determinant of ventricular premature complex frequency after thrombolysis for acute myocardial infarction. Tissue Plasminogen Activator: Toronto (TPAT) Study Group.

Journal Article Am 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 ... Full text Link to item Cite

Sarcoplasmic reticulum Ca-release channel and ATP-synthesis activities are early myocardial markers of heart failure produced by rapid ventricular pacing in dogs.

Journal Article Can 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 ... Full text Link to item Cite

Effects of thrombolytic therapy administered 6 to 24 hours after myocardial infarction on the signal-averaged ECG. Results of a multicenter randomized trial. LATE Ancillary Study Investigators. Late Assessment of Thrombolytic Efficacy.

Journal Article Circulation · 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: ... Full text Link to item Cite

Frequency of transient reductions in left ventricular ejection fraction at rest in coronary artery disease.

Journal Article Am 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 ... Full text Link to item Cite

A predictive index for length of stay in the intensive care unit following cardiac surgery.

Journal Article CMAJ · 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 ... Link to item Cite

Abnormalities of cardiac sympathetic function in pacing-induced heart failure as assessed by [123I]metaiodobenzylguanidine scintigraphy.

Journal Article Circulation · 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 ... Full text Link to item Cite

Does ambulatory monitoring contribute to exercise testing and myocardial perfusion scintigraphy in the prediction of the extent of coronary artery disease in stable angina?

Journal Article Am 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 ... Full text Link to item Cite

Structural remodelling in heart failure: gelatinase induction.

Journal Article Can 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 ... Link to item Cite

Recovery of attenuated baroreflex sensitivity in conscious dogs after reversal of pacing induced heart failure.

Journal Article Cardiovasc 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 ... Full text Link to item Cite

Development of a radioimmunoassay for fetal antigen 2.

Journal Article Clin Chim Acta · January 14, 1994 Full text Link to item Cite

Measurement of angiotensin II: use of two injectors to minimize HPLC shadowing.

Journal Article Peptides · 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 ... Full text Link to item Cite

Noradrenaline biosynthesis and metabolism during development and recovery from pacing-induced heart failure in the dog.

Journal Article Can 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 ... Full text Link to item Cite

Myocardial energetics and blood flow in acute rapid ventricular pacing.

Journal Article Can 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 ... Full text Link to item Cite

Left ventricular remodelling and disparate changes in contractility and relaxation during the development of and recovery from experimental heart failure.

Journal Article Cardiovasc 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 ... Full text Link to item Cite

Medical advances in the treatment of congestive heart failure.

Journal Article Circulation · 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 ... Full text Link to item Cite

The effects of tissue plasminogen activator, streptokinase, or both on coronary-artery patency, ventricular function, and survival after acute myocardial infarction.

Journal Article N 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 ... Full text Link to item Cite

An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction.

Journal Article N 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 ... Full text Link to item Cite

Dual natriuretic peptide system in experimental heart failure.

Journal Article J 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 ... Full text Link to item Cite

Impact of tissue plasminogen activator and heparin versus heparin alone on quantitative coronary angiographic findings in myocardial infarction. The Toronto Tissue Plasminogen Activator Trial Study Group.

Journal Article Am 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 ... Full text Link to item Cite

Beta adrenoceptor recovery after heart failure in the dog.

Journal Article Cardiovasc 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 ... Full text Link to item Cite

Left ventricular myocardial blood flow, metabolism, and effects of treatment with enalapril: further insights into the mechanisms of canine experimental pacing-induced heart failure.

Journal Article J 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 ... Link to item Cite

Plasma endothelin in chronic heart failure.

Journal Article Circulation · February 1993 Link to item Cite

Thrombolytic therapy in acute myocardial infarction

Journal Article Current Opinion in Cardiology · January 1, 1993 Full text Cite

Postcoronary thrombolysis management.

Conference Can J Cardiol · 1993 Link to item Cite

Pathophysiology and prognostic significance of Holter-detected ST segment depression after myocardial infarction. The Tissue Plasminogen Activator: Toronto (TPAT) Study Group.

Journal Article J 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 ... Full text Link to item Cite

Aggressive clinical pattern of angina at restenosis following coronary angioplasty in unstable angina.

Journal Article Am 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. ... Full text Link to item Cite

Impact of enalapril therapy on in vitro coronary artery responsiveness in pacing-induced heart failure.

Journal Article Can 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 ... Full text Link to item Cite

Reverse redistribution on exercise thallium scintigraphy: relationship to coronary patency and ventricular function after myocardial infarction.

Journal Article Can 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: ... Link to item Cite

Temporal alterations in peripheral vascular responsiveness during both the development and recovery from pacing-induced heart failure.

Journal Article J 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 ... Full text Link to item Cite

Remodeling and reparation of the cardiovascular system.

Journal Article J 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 ... Full text Link to item Cite

Myocardial myoglobin deficiency in various animal models of congestive heart failure.

Journal Article J 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 ... Full text Link to item Cite

Psychiatric morbidity during the early phase of coronary care for myocardial infarction: association with cardiac diagnosis and outcome.

Journal Article Can 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 ... Full text Link to item Cite

Acute reduction of lipoprotein(a) by tissue-type plasminogen activator.

Journal Article Circulation · 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 ... Full text Link to item Cite

Atrial natriuretic factor: pharmacokinetics and cyclic GMP response in relation to biologic effects in severe heart failure.

Journal Article J 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 ... Link to item Cite

Evaluation of a prolonged infusion of recombinant tissue-type plasminogen activator (Duteplase) in preventing reocclusion following successful thrombolysis in acute myocardial infarction.

Journal Article Am 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 ... Full text Link to item Cite

Thrombolytic therapy and unstable angina.

Journal Article Circulation · May 1992 Link to item Cite

Confronting the issues of patient safety and investigator conflict of interest in an international clinical trial of myocardial reperfusion

Journal Article Journal 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 ... Cite

Evaluation of indices of left ventricular contractility and relaxation in evolving canine experimental heart failure.

Journal Article Cardiovasc 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 ... Full text Link to item Cite

Cardiogenic shock after acute myocardial infarction

Journal Article Annals of Internal Medicine · January 1, 1992 Cite

Thrombolysis in unstable angina. Randomized double-blind trial of t-PA and placebo.

Journal Article Circulation · 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 ... Full text Link to item Cite

Will thrombolytic therapy prevent cardiac events in unstable angina?

Journal Article Cardiology Board Review · January 1, 1992 Cite

Elevated left atrial pressure does not cause left-to-right shunting after mitral balloon valvuloplasty.

Journal Article Cathet 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 ... Full text Link to item Cite

Novel vascular effects of isoprenaline following pacing-induced heart failure in the dog.

Journal Article Eur 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 ... Full text Link to item Cite

Effects of hemoperfusion during percutaneous transluminal coronary angioplasty on left ventricular function.

Journal Article Am 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 ... Full text Link to item Cite

Sequential echocardiographic-Doppler assessment of left ventricular remodelling and mitral regurgitation during evolving experimental heart failure.

Journal Article Cardiovasc 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 ... Full text Link to item Cite

Coronary patency, infarct size and left ventricular function after thrombolytic therapy for acute myocardial infarction: results from the tissue plasminogen activator: Toronto (TPAT) placebo-controlled trial. TPAT Study Group.

Journal Article J 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 ... Full text Link to item Cite

Sequential changes in atrial pressures, dimensions, and plasma atrial natriuretic factor concentrations during volume loading in hemodynamically normal human subjects.

Journal Article J 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 ... Link to item Cite

Detection of silent myocardial ischemia in diabetes mellitus.

Journal Article Am 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 ... Full text Link to item Cite

Response of atrial natriuretic factor to acute and chronic increases of atrial pressures in experimental heart failure in dogs. Role of changes in heart rate, atrial dimension, and cardiac tissue concentration.

Journal Article Circulation · 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 ... Full text Link to item Cite

Report of the Canadian Cardiovascular Society's consensus conference on the Management of the Postmyocardial Infarction Patient.

Journal Article CMAJ · 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 ... Link to item Cite

Inhibitory role of the coronary arterial endothelium to alpha-adrenergic stimulation in experimental heart failure.

Journal Article Circ 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 ... Full text Link to item Cite

Plasma concentration time course and pharmacological effects of a standardized oral amiodarone dosing regimen in humans.

Journal Article Can 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 ... Link to item Cite

Cardiac and muscle fatigue due to relative functional overload induced by excessive stimulation, hypersensitive excitation-contraction coupling, or diminished performance capacity correlates with sarcoplasmic reticulum failure.

Journal Article Can 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 ... Full text Link to item Cite

Ultrastructural studies of unstable angina in living man.

Journal Article Mod 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 ... Link to item Cite

Quantitative analysis of exercise SPECT thallium in the detection of coronary disease

Journal Article American 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 ... Cite

Pacing-induced heart failure in the dog: evaluation of peripheral vascular alpha-adrenoceptor subtypes.

Journal Article J 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 ... Full text Link to item Cite

Prognosis in medically stabilized unstable angina: early Holter ST-segment monitoring compared with predischarge exercise thallium tomography.

Journal Article Ann 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 ... Full text Link to item Cite

SK&F 96365, a novel inhibitor of receptor-mediated calcium entry.

Journal Article Biochem 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 ... Full text Link to item Cite

Fibrillar collagen and remodeling of dilated canine left ventricle.

Journal Article Circulation · 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 ... Full text Link to item Cite

Response of atrial natriuretic factor to postural change in patients with heart failure versus subjects with normal hemodynamics.

Journal Article J 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 ... Full text Link to item Cite

Endothelium modulation of the effects of nitroglycerin on blood vessels from dogs with pacing-induced heart failure.

Journal Article Br 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 ... Full text Link to item Cite

Pathophysiological role of changing atrial size and pressure in modulation of atrial natriuretic factor during evolving experimental heart failure.

Journal Article Cardiovasc 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 ... Full text Link to item Cite

Pharmacokinetics, hemodynamic, renal, and neurohormonal effects of atrial natriuretic factor in experimental heart failure.

Journal Article Clin 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 ... Link to item Cite

A new method for hemodynamic and echocardiographic assessment of conscious dogs: comparison with thiopental-morphine anaesthesia.

Journal Article Clin 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) ... Link to item Cite

Prognostic importance of ST-segment shift in hospitalized unstable angina patients

Journal Article Cardiology Board Review · January 1, 1990 Cite

Management of asymptomatic chronic aortic regurgitation with left ventricular dysfunction: a decision analysis.

Journal Article J 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 ... Full text Link to item Cite

Disposition of amiodarone and its proximate metabolite, desethylamiodarone, in the dog for oral administration of single-dose and short-term drug regimens.

Journal Article Drug 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 ... Link to item Cite

Design and synthesis of a series of glycerol-derived receptor mediated calcium entry (RMCE) blockers

Journal Article European 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 ... Full text Cite

Rapid ventricular pacing of dogs to heart failure: biochemical and physiological studies.

Journal Article Can 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 ... Full text Link to item Cite

Symposium: Thrombolytic therapy in acute myocardial infarction

Conference Annals of the Royal College of Physicians and Surgeons of Canada · January 1, 1990 Cite

Coronary revascularization after thrombolytic therapy for myocardial infarction: what caseloads could Canadian centres face?

Journal Article CMAJ · 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 ... Link to item Cite

Reply

Journal Article The American Journal of Cardiology · July 15, 1989 Full text Cite

Intracoronary thrombus and complex morphology in unstable angina. Relation to timing of angiography and in-hospital cardiac events.

Journal Article Circulation · 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 ... Full text Link to item Cite

Tissue plasminogen activator: Toronto (TPAT) placebo-controlled randomized trial in acute myocardial infarction.

Journal Article J 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 ... Full text Link to item Cite

Vascular smooth muscle responsiveness to noradrenaline and phenylephrine following experimental heart failure in dogs.

Journal Article Cardiovasc 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 ... Full text Link to item Cite

Guidelines for the use of intravenous thrombolytic agents in acute myocardial infarction. Ontario Medical Association Consensus Group on Thrombolytic Therapy.

Journal Article CMAJ · 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 ... Link to item Cite

ST segment shift in unstable angina: pathophysiology and association with coronary anatomy and hospital outcome.

Journal Article J 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 ... Full text Link to item Cite

Alpha 1-adrenoceptor activity in arterial smooth muscle following congestive heart failure.

Journal Article Can 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 ... Full text Link to item Cite

Role of resting thallium201 perfusion in predicting coronary anatomy, left ventricular wall motion, and hospital outcome in unstable angina pectoris.

Journal Article Am 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 ... Full text Link to item Cite

Alterations in serum sodium in relation to atrial natriuretic factor and other neuroendocrine variables in experimental pacing-induced heart failure.

Journal Article J 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 ... Full text Link to item Cite

Circulatory pathophysiology of cardiac failure

Journal Article Current Opinion in Cardiology · January 1, 1989 Full text Cite

Comparison of rest and exercise thallium-201 kinetics in man and implications for quantitation.

Journal Article Am 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 ... Link to item Cite

Recovery from heart failure: structural and functional analysis in a canine model.

Journal Article Can 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 ... Full text Link to item Cite

Usefulness of exercise electrocardiography and thallium scintigraphy in unstable angina pectoris in predicting the extent and severity of coronary artery disease.

Journal Article Am 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 ... Full text Link to item Cite

Physiological effects of synthetic atrial natriuretic factor in normal conscious dogs.

Journal Article Clin 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 ... Link to item Cite

Angiographic morphology in unstable angina pectoris.

Journal Article Am 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 ... Full text Link to item Cite

Early recovery from heart failure: insights into the pathogenesis of experimental chronic pacing-induced heart failure.

Journal Article J 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 ... Link to item Cite

Intravenous nisoldipine in severe congestive heart failure.

Journal Article J 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 ... Full text Link to item Cite

Congestive heart failure.

Journal Article CMAJ · 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 ... Link to item Cite

Symposium: Antithrombotic therapy in coronary artery disease

Journal Article Annals of the Royal College of Physicians and Surgeons of Canada · January 1, 1988 Cite

Intramolecular [4+2] cycloaddition of α,β-unsaturated hydrazones as a route to annelated pyridines

Journal Article Tetrahedron Letters · January 1, 1988 The first examples of the intramolecular Diels-Alder reaction of α,β-unsaturated hydrazones are described. A novel phosphonate (4) has been utilized in the preparation of substrates (2). © 1988. ... Full text Cite

Microalbuminuria in normal pregnancy: Relation to obstetric factors

Journal Article Journal 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 ... Full text Cite

N-acetylcysteine does not modify nitroglycerin-induced tolerance in canine vascular rings.

Journal Article J 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 ... Full text Link to item Cite

Serum magnesium and potassium in acute myocardial infarction. Influence on ventricular arrhythmias.

Journal Article Arch 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 ... Link to item Cite

Pharmacokinetic-hemodynamic studies of transdermal nitroglycerin in congestive heart failure.

Journal Article J 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 ... Full text Link to item Cite

A comparative evaluation of hemodynamic and neurohumoral effects of nitroglycerin and nifedipine in congestive heart failure.

Journal Article Am 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 ... Full text Link to item Cite

Cycloaddition reactions of oximes; powerful new carbon-carbon bond forming methodology

Journal Article Journal 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 ... Full text Cite

Tandem intramolecular Michael addition and 1,3-dipolar cycloaddition reactions of oximes; versatile new carbon-carbon bond forming methodology

Journal Article Journal 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. ... Full text Cite

Distribution of amiodarone and its metabolite, desethylamiodarone, in human tissues

Journal Article Canadian 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) ... Full text Cite

Rapid ventricular pacing in the dog: pathophysiologic studies of heart failure.

Journal Article Circulation · 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 ... Full text Link to item Cite

Influence of skin site on bioavailability of nitroglycerin ointment in congestive heart failure.

Journal Article Am 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 ... Full text Link to item Cite

Medical treatment of pregnancy hypertension.

Journal Article Br 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. ... Link to item Cite

Swallow syncope.

Journal Article Can 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 ... Link to item Cite

Ethacrynic acid: acute hemodynamic effects and influence on the in vivo and in vitro response to nitroglycerin in the dog.

Journal Article J 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 ... Link to item Cite

X=y-zh systems as potential 1,3-dipoles-5. Intramolecular cycloadditions of imines of α-amino acid esters

Journal Article Tetrahedron · 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 ... Full text Cite

Hemolytic anemia following insertion of Ionescu-Shiley mitral valve bioprosthesis.

Journal Article Can 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 ... Link to item Cite

Biases in the measurement of arterial pressure.

Journal Article Crit 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 ... Full text Link to item Cite

Reproducibility of the pharmacokinetic-hemodynamic response to nitroglycerin in the dog: a model for studying the effects of chronic treatment.

Journal Article J 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 ... Full text Link to item Cite

Pharmacokinetic-hemodynamic studies of disopyramide.

Journal Article J 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 ... Link to item Cite

Sex-related difference in the metabolism of isosorbide dinitrate following incubation in human blood.

Journal Article Biochem 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 ... Full text Link to item Cite

Tolerance to organic nitrates: clinical and experimental perspectives.

Journal Article Am 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 ... Full text Link to item Cite

Determination of disopyramide and mono-N-desisopropyl-disopyramide in serum by gas-liquid chromatography with nitrogen-selective detection.

Journal Article J 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 ... Full text Link to item Cite

Investigation of the role of prostaglandins in nitroglycerin-induced relaxation of isolated rabbit blood vessels.

Journal Article Can 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 ... Full text Link to item Cite

Rapid high-performance liquid chromatographic analysis of amiodarone and N-desethyl-amiodarone in serum.

Journal Article Can 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 ... Full text Link to item Cite

Arterial-venous nitroglycerin gradient during intravenous infusion in man.

Journal Article Circulation · 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 ... Full text Link to item Cite

Investigations into the role of sulfhydryl groups in the mechanism of action of the nitrates.

Journal Article Can 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 ... Full text Link to item Cite

The spectrum of unstable angina: prognostic role of serum creatine kinase determination.

Journal Article Am 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 ... Full text Link to item Cite

Pharmacokinetic-hemodynamic response to consecutive infusions of nitroglycerin in the dog

Journal Article Clinical and Investigative Medicine · January 1, 1982 Cite

Influence of ethacrynic acid on hemodynamic response to iv nitroglycerin

Journal Article Clinical Research · January 1, 1982 Cite

Canine vascular rings: An in vitro model to examine the effects of in vivo drug treatment

Journal Article Clinical and Investigative Medicine · January 1, 1982 Cite

On-line microcomputer system for analysis of precordial maps.

Journal Article J 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 ... Full text Link to item Cite

Clinical trials:randomization before consent.

Journal Article Biomedicine · 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 ... Link to item Cite

Vasodilator therapy in acute myocardial infarction

Journal Article Practical Cardiology · January 1, 1981 Cite

Effects of sustained nitroglycerin delivery on the arterial-venous gradient in the dog

Journal Article Clinical and Investigative Medicine · January 1, 1981 Cite

Cardiac depression by intravenous disopyramide in patients with left ventricular dysfunction.

Journal Article Am 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 ... Full text Link to item Cite

Rapid disappearance of nitroglycerin following incubation with human blood.

Journal Article Can 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 ... Full text Link to item Cite

Plasma nitroglycerin gradient during intravenous infusion in man

Journal Article Clinical Research · January 1, 1980 Cite

Plasma nitroglycerin gradient during intravenous infusion in man

Journal Article Circulation · January 1, 1980 Cite

Contributions of hemodynamic monitoring to the treatment of chronic congestive heart failure.

Journal Article Can 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 ... Link to item Cite

A new design for randomized trials.

Journal Article N Engl J Med · October 4, 1979 Link to item Cite

Blood levels after sublingual nitroglycerin.

Journal Article Circulation · 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 ... Full text Link to item Cite

Parenteral disopyramide in patients with left ventricular dysfunction

Journal Article Clinical Research · January 1, 1979 Cite

Behaviour and coronary artery disease: is this the missing link?

Journal Article Can Med Assoc J · September 23, 1978 Link to item Cite

Preservation of pre-excitation despite acute myocardial infarction complicated by complete heart block.

Journal Article Can 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 ... Link to item Cite

Prinzmetal's angina, normal coronary arteries and pericarditis.

Journal Article Can 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 ... Link to item Cite

Comparative vasodilator studies in congestive cardiac failures

Journal Article Clinical Research · January 1, 1978 Cite

Plasma levels following sublingual nitroglycerin

Journal Article Clinical Research · January 1, 1978 Cite

Reply

Journal Article The American Journal of Cardiology · January 1, 1978 Full text Cite

Effects of propranolol on the hemodynamic, coronary sinus blood flow and myocardial metabolic response to atrial pacing.

Journal Article Am 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 ... Full text Link to item Cite

Nitroglycerin ointment in acute myocardial infarction.

Journal Article Am 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 ... Full text Link to item Cite

Comparative effects of lidocaine and procainamide on acutely impaired hemodynamics.

Journal Article Am 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 ... Full text Link to item Cite

Letter: Swan-Ganz catheter repair.

Journal Article Circulation · July 1976 Full text Link to item Cite

Hemodynamic effects of nitroglycerin ointment in congestive cardiac failure

Journal Article Annals of the Royal College of Physicians and Surgeons of Canada · January 1, 1976 Cite

Effect of nitroglycerin ointment on the clinical and hemodynamic response to exercise

Journal Article The 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 ... Full text Cite

Vasodilator therapy in acute myocardial infarction. A comparison of sodium nitroprusside and nitroglycerin.

Journal Article Circulation · 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 ... Full text Link to item Cite

Letter: Discovery of paravalvular defects.

Journal Article J Thorac Cardiovasc Surg · August 1974 Link to item Cite

Incomplete relaxation between beats after myocardial hypoxia and ischemia.

Journal Article J 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 ... Full text Link to item Cite

The complications of brachial arteriotomy.

Journal Article J Thorac Cardiovasc Surg · March 1971 Link to item Cite