Journal ArticleAm Heart J · January 2025
BACKGROUND: Although guidelines recommend low-density lipoprotein cholesterol (LDL-C) to be < 70 mg/dL in patients with atherosclerotic cardiovascular disease (ASCVD), the rate of achieving this goal remains suboptimal. We sought to understand real world c ...
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Journal ArticleQual Life Res · December 2024
PURPOSE: Meaningful score differences (MSDs), as defined by recent FDA guidance, can improve the interpretation of outcome measure scores and score changes. Well-accepted methods for estimating MSDs typically rely on external anchor variables, but the appl ...
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Journal ArticleJ Am Heart Assoc · November 5, 2024
BACKGROUND: Lipoprotein (a) is an independent risk factor for atherosclerotic cardiovascular disease. However, lipoprotein (a) testing remains variable and it is unclear what factors influence testing and if testing changes clinical management. METHODS AND ...
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Journal ArticleJ Card Fail · November 2024
BACKGROUND: Randomized controlled trials typically require study-specific visits, which can burden participants and sites. Remote follow-up, such as centralized call centers for participant-reported or site-reported, holds promise for reducing costs and en ...
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Journal ArticleJACC Heart Fail · November 2024
BACKGROUND: Optimal medical therapy (OMT) scoring may stratify clinical risk in real-world chronic heart failure with reduced ejection fraction (HFrEF) by integrating use and dosing of guideline-directed medical therapy (GDMT) for HFrEF. OBJECTIVES: The pu ...
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Journal ArticleJournal of Clinical and Translational Science · October 31, 2024
Efficient evidence generation to assess the clinical and economic impact of medical therapies is critical amid rising healthcare costs and aging populations. However, drug development and clinical trials remain far too expensive and inefficient for all sta ...
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Journal ArticleESC heart failure · October 2024
AimsClinical trials in heart failure with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF) commonly have detailed eligibility criteria. This may contribute to challenges with efficient enrolment and questions regarding the generalizabi ...
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Journal ArticleJAMA Netw Open · October 1, 2024
IMPORTANCE: The effect of montelukast in reducing symptom duration among outpatients with mild to moderate COVID-19 is uncertain. OBJECTIVE: To assess the effectiveness of montelukast compared with placebo in treating outpatients with mild to moderate COVI ...
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Journal ArticleEur J Heart Fail · September 19, 2024
AIMS: Patients with heart failure (HF) with improved ejection fraction (HFimpEF) may face residual risks of clinical events that are comparable to those experienced by patients with HF whose left ventricular ejection fraction (LVEF) has consistently been a ...
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Journal ArticleTrials · September 16, 2024
Clinical evidence generation from and for representative populations can be improved through increased research access and ease of trial participation. To improve access and participation, a modern trial infrastructure is needed that broadens research into ...
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Journal ArticleJ Card Fail · September 7, 2024
BACKGROUND: In VICTORIA (Vericiguat Global Study in Subjects with Heart Failure with Reduced Ejection Fraction), participants with heart failure (HF) and reduced ejection fraction, vericiguat decreased the primary composite outcome (time to first HF hospit ...
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Journal ArticleJ Intensive Care Med · September 2024
BACKGROUND: There is limited evidence that beta-blockers may provide benefit for patients with moderate-severe traumatic brain injury (TBI) during the acute injury period. Larger studies on utilization patterns and impact on outcomes in clinical practice a ...
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Journal ArticleJACC Heart Fail · September 2024
BACKGROUND: Patients recently hospitalized for heart failure (HF) are at a higher risk of adverse clinical outcomes, but they may experience a greater absolute and relative benefit from effective therapies than individuals who are considered more "stable." ...
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Journal ArticleAm Heart J · September 2024
The limitations of the explanatory clinical trial framework include the high expense of implementing explanatory trials, restrictive entry criteria for participants, and redundant logistical processes. These limitations can result in slow evidence generati ...
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Journal ArticleAm Heart J · September 2024
BACKGROUND: There is a dearth of research on immunophenotyping in peripheral artery disease (PAD). This study aimed to describe the baseline characteristics, immunophenotypic profile, and quality of life (QoL) of participants with PAD in the Project Baseli ...
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Journal ArticleEur J Heart Fail · September 2024
AIMS: The primary aim was to evaluate the effect of dapagliflozin according to QRS duration across the spectrum of left ventricular ejection fraction (LVEF), given that prolongation of QRS duration is associated with less favourable ventricular remodelling ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · September 2024
BACKGROUND: The foundation for managing heart failure with reduced ejection fraction (HFrEF) is adherence to guideline-directed medical therapy. Finding an association between medication adherence and patients' health status (their symptoms, function, and ...
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Journal ArticleJAMA Cardiol · September 1, 2024
IMPORTANCE: Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of morbidity and mortality in the US. Although aspirin is recommended for secondary prevention of ASCVD, there was no difference in safety and effectiveness of aspirin dos ...
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Journal ArticleJAMA Cardiol · September 1, 2024
IMPORTANCE: Pragmatic randomized clinical trials (RCTs) often use multiple data sources to examine clinical events, but the relative contribution of data sources to clinical end-point rates is understudied. OBJECTIVE: To assess the contribution of data sou ...
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Journal ArticleBMJ Open · August 7, 2024
OBJECTIVES: To evaluate whether the effectiveness and safety of low (81 mg daily) versus high-dose (325 mg daily) aspirin is consistent across races among patients with established atherosclerotic cardiovascular disease (ASCVD). DESIGN: A secondary analysi ...
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Journal ArticleAnesth Analg · August 1, 2024
BACKGROUND: Traumatic brain injury (TBI) is an expensive and common public health problem. Management of TBI oftentimes includes sedation to facilitate mechanical ventilation (MV) for airway protection. Dexmedetomidine has emerged as a potential candidate ...
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Journal ArticleJ Clin Neurosci · August 2024
BACKGROUND: Traumatic brain injury (TBI) triggers autonomic dysfunction and inflammatory response that can result in secondary brain injuries. Dexmedetomidine is an alpha-2 agonist that may modulate autonomic function and inflammation and has been increasi ...
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Journal ArticleJACC Adv · August 2024
BACKGROUND: Elevated interleukin (IL)-6 levels have been linked to adverse outcomes in patients with and without baseline cardiovascular disease (CVD). OBJECTIVES: The purpose of this study was to examine the association between circulating IL-6 levels and ...
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Journal ArticleCirculation · July 23, 2024
BACKGROUND: Cardiovascular disease and stroke are common and costly, and their prevalence is rising. Forecasts on the prevalence of risk factors and clinical events are crucial. METHODS: Using the 2015 to March 2020 National Health and Nutrition Examinatio ...
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Journal ArticleEur Heart J Cardiovasc Pharmacother · July 16, 2024
AIMS: Large outcome trials have demonstrated cardiovascular benefits of selected glucagon-like peptide-1 (GLP-1) receptor agonists. We examined coronary disease outcomes in the Harmony Outcomes trial of the GLP-1 receptor agonist albiglutide. METHODS AND R ...
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Journal ArticleEur J Heart Fail · July 2024
AIMS: Although much is known about the usefulness of heart failure (HF)-specific instruments for assessing patient well-being, less is known about the value of generic instruments for the measurement of health-related quality of life (HRQL) in HF. The aim ...
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Journal ArticleEuropean journal of heart failure · July 2024
AimsType 2 diabetes (T2D) and heart failure (HF) frequently coexist, but whether clinical outcomes and treatment effects of sodium-glucose cotransporter 2 inhibitors (SGLT2i) vary in relation to background glucose-lowering therapy (GLT) in this po ...
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Journal ArticleThe lancet. Diabetes & endocrinology · July 2024
BackgroundSodium-glucose co-transporter-2 (SGLT2) inhibitors have been studied in patients with heart failure, type 2 diabetes, chronic kidney disease, atherosclerotic cardiovascular disease, and acute myocardial infarction. Individual trials were ...
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Journal ArticleAdv Ther · July 2024
INTRODUCTION: Hereditary transthyretin amyloidosis (ATTRv, also referred to as hATTR; ORPHA 271861) and wild-type ATTR amyloidosis (ATTRwt; ORPHA 330001) are rare, progressive, systemic protein misfolding disorders with heterogeneous clinical presentations ...
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Journal ArticleEur J Heart Fail · June 19, 2024
AIMS: Ferric carboxymaltose (FCM) is guideline-recommended for iron deficiency (ID) in heart failure with reduced ejection fraction (HFrEF). Despite a well-established safety profile, the magnitude and clinical significance of FCM-induced hypophosphataemia ...
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Journal ArticleJ Am Coll Cardiol · June 11, 2024
BACKGROUND: Empagliflozin reduces the risk of heart failure (HF) hospitalizations but not all-cause mortality when started within 14 days of acute myocardial infarction (AMI). OBJECTIVES: This study sought to evaluate the association of left ventricular ej ...
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Journal ArticleJACC Adv · June 2024
BACKGROUND: Decompensated heart failure (HF) can be categorized as de novo or worsening of chronic HF. In PARAGLIDE-HF (Prospective comparison of ARNI with ARB Given following stabiLization In DEcompensated HFpEF), among patients with an ejection fraction ...
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Journal ArticleJ Card Fail · May 26, 2024
BACKGROUND: In PARAGLIDE-HF, in patients with ejection fraction (EF) > 40%, stabilized after worsening heart failure (WHF), sacubitril/valsartan led to greater reduction in plasma NT-proBNP levels and was associated with clinical benefit compared to valsar ...
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Journal ArticleCirculation · May 21, 2024
BACKGROUND: Empagliflozin reduces the risk of heart failure (HF) events in patients with type 2 diabetes at high cardiovascular risk, chronic kidney disease, or prevalent HF irrespective of ejection fraction. Whereas the EMPACT-MI trial (Effect of Empaglif ...
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Journal ArticleDiabetes Obes Metab · May 2024
AIM: To analyse the effects of albiglutide, a glucagon-like peptide 1 receptor agonist, on cardiovascular outcomes in older adults aged ≥65 years with type 2 diabetes and cardiovascular disease who participated in the Harmony Outcomes trial (NCT02465515). ...
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Journal ArticleJACC Heart Fail · May 2024
BACKGROUND: In VICTORIA (Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction), vericiguat compared with placebo reduced cardiovascular death or heart failure (HF) hospitalization in patients with HF with reduced ejection f ...
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Journal ArticleAm Heart J · May 2024
AIMS: Type 2 diabetes (T2D) is a risk factor for cardiovascular and non-cardiovascular mortality. However, global distribution of cause-specific deaths in T2D is poorly understood. We characterized cause-specific deaths by geographic region among individua ...
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Journal ArticleJAMA Cardiol · May 1, 2024
IMPORTANCE: Accurate risk prediction of morbidity and mortality in patients with heart failure with preserved ejection fraction (HFpEF) may help clinicians risk stratify and inform care decisions. OBJECTIVE: To develop and validate a novel prediction model ...
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Journal ArticleN Engl J Med · April 25, 2024
BACKGROUND: Empagliflozin improves cardiovascular outcomes in patients with heart failure, patients with type 2 diabetes who are at high cardiovascular risk, and patients with chronic kidney disease. The safety and efficacy of empagliflozin in patients who ...
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Journal ArticleJACC Heart Fail · April 2024
BACKGROUND: Although beta-blockers are not recommended for the treatment of heart failure with preserved ejection fraction (HFpEF) according to the latest European Society of Cardiology and American Heart Association/American College of Cardiology/Heart Fa ...
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Journal ArticleCrit Care Med · April 1, 2024
OBJECTIVE: To examine early sedation patterns, as well as the association of dexmedetomidine exposure, with clinical and functional outcomes among mechanically ventilated patients with moderate-severe traumatic brain injury (msTBI). DESIGN: Retrospective c ...
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Journal ArticleAm Heart J · April 2024
The global pharmaceutical industry portfolio is skewed towards cancer and rare diseases due to more predictable development pathways and financial incentives. In contrast, drug development for major chronic health conditions that are responsible for a larg ...
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Journal ArticleEur J Heart Fail · April 2024
AIMS: Patients with heart failure (HF) and history of myocardial infarction (MI) face a higher risk of disease progression and clinical events. Whether sodium-glucose cotransporter 2 inhibitors may modify clinical trajectory in such individuals remains inc ...
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Journal ArticleJ Am Coll Cardiol · March 26, 2024
BACKGROUND: The efficacy and safety of sacubitril/valsartan in patients hospitalized with heart failure (HF) across the spectrum of left ventricular ejection fraction (EF) has not been described. OBJECTIVES: Data from randomized trials of sacubitril/valsar ...
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Journal ArticleJ Am Heart Assoc · March 5, 2024
BACKGROUND: The sodium glucose cotransporter-2 inhibitors are guideline-recommended to treat heart failure across the spectrum of left ventricular ejection fraction; however, economic evaluations of adding sodium glucose cotransporter-2 inhibitors to stand ...
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Journal ArticleJ Card Fail · March 2024
BACKGROUND: Sleep apnea is more common in patients with heart failure (HF) than in the general population, but little is known about its association with clinical outcomes in various HF phenotypes or how it might modify the effect of HF therapy. OBJECTIVES ...
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Journal ArticlePsychiatry Res · March 2024
The Patient Health Questionnaire 9 (PHQ-9) is the current standard outpatient screening tool for measuring and tracking the nine symptoms of major depressive disorder (MDD). While the PHQ-9 was originally conceptualized as a unidimensional measure, it has ...
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Journal ArticleJAMA Cardiol · March 1, 2024
IMPORTANCE: Heart failure with improved ejection fraction (HFimpEF), defined as prior left ventricular ejection fraction (LVEF) 40% or lower that has increased to greater than 40%, is understudied. OBJECTIVE: To examine mode of death and the association of ...
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Journal ArticleJ Am Heart Assoc · February 20, 2024
BACKGROUND: In patients with atherosclerotic cardiovascular disease, increasing age is concurrently associated with higher risks of ischemic and bleeding events. The objectives are to determine the impact of aspirin dose on clinical outcomes according to a ...
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Journal ArticleJAMA Cardiol · February 1, 2024
IMPORTANCE: An initial decline in estimated glomerular filtration rate (eGFR) is expected after initiating a sodium-glucose cotransporter-2 inhibitor (SGLT2i) and has been observed across patients with diabetes, chronic kidney disease, and heart failure. O ...
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Journal ArticleCirc Heart Fail · February 2024
BACKGROUND: Clinical trials in heart failure (HF) traditionally use time-to-event analyses focusing on death and hospitalization for HF. These time-to-first event analyses may have more limited abilities to assess the probability of benefiting from a thera ...
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Journal ArticleJACC Asia · February 2024
BACKGROUND: Patients with heart failure (HF) with mildly reduced or preserved ejection fraction in Asia may have different clinical characteristics and outcomes compared with patients from other parts of the world. OBJECTIVES: The purpose of this study was ...
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Journal ArticleDiabetes Care · January 1, 2024
OBJECTIVE: Patients with diabetes mellitus (DM) and concomitant atherosclerotic cardiovascular disease (ASCVD) must be on the most effective dose of aspirin to mitigate risk of future adverse cardiovascular events. RESEARCH DESIGN AND METHODS: ADAPTABLE, a ...
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Journal ArticleJAMA · December 26, 2023
IMPORTANCE: The effect of higher-dose fluvoxamine in reducing symptom duration among outpatients with mild to moderate COVID-19 remains uncertain. OBJECTIVE: To assess the effectiveness of fluvoxamine, 100 mg twice daily, compared with placebo, for treatin ...
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Journal ArticleEur Heart J · December 21, 2023
BACKGROUND AND AIMS: Whereas a beneficial effect of intravenous ferric carboxymaltose (FCM) on symptoms and exercise capacity among patients with iron deficiency and heart failure (HF) has been consistently demonstrated, the effects of treatment on clinica ...
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Journal ArticleClin Infect Dis · December 15, 2023
While the coronavirus disease 2019 (COVID-19) pandemic continues to present global challenges, sufficient time has passed to reflect on lessons learned and use those insights to inform policy and approaches to prepare for the next pandemic. In May 2022, th ...
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Journal ArticleCirculation · December 12, 2023
BACKGROUND: Apparent treatment-resistant hypertension (aTRH) is prevalent and associated with adverse outcomes in heart failure with mildly reduced or preserved ejection fraction. Less is known about the potential role of sodium-glucose co-transporter 2 in ...
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Journal ArticleJ Card Fail · December 2023
BACKGROUND: Heart failure (HF) may complicate acute coronary syndrome (ACS) and is associated with a high burden of short- and long-term morbidity and mortality. Only limited data regarding future ischemic events and rehospitalization are available for pat ...
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Journal ArticleAm Heart J · December 2023
BACKGROUND: Prior clinical trials have investigated intravenous iron in patients with heart failure (HF) and iron deficiency, but the safety and efficacy of this therapy remains unclear. METHODS: We report the baseline demographics and clinical characteris ...
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Journal ArticleEur J Heart Fail · December 2023
AIM: COVID-19 may affect clinical risk in patients with heart failure. DELIVER began before and was conducted during the COVID-19 pandemic. This study aimed to evaluate the association between COVID-19 and clinical outcomes among DELIVER participants. METH ...
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Journal ArticleCirc Heart Fail · December 2023
BACKGROUND: Although elevated resting heart rate (HR) is associated with a higher risk of cardiovascular events in patients with heart failure with reduced ejection fraction in sinus rhythm (SR), the relationship between HR and outcomes among patients with ...
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Journal ArticleCirculation · November 28, 2023
BACKGROUND: Hospitalization is recognized as a sentinel event in the disease trajectory of patients with heart failure (HF), but not all patients experiencing clinical decompensation are ultimately hospitalized. Outpatient intensification of diuretics is c ...
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Journal ArticleJ Am Coll Cardiol · November 7, 2023
BACKGROUND: Sodium-glucose cotransporter-2 (SGLT2) inhibitors are guideline recommended in the management of heart failure (HF). Although these therapies can be initiated even in patients with comorbid chronic kidney disease, some patients may face deterio ...
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Journal ArticleJ Card Fail · November 2023
BACKGROUND: Clinical and echocardiographic features may carry diverse information about the development of heart failure (HF). Therefore, we determined heterogeneity in clinical and echocardiographic phenotypes and its association with exercise capacity. M ...
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Journal ArticleJACC Heart Fail · November 2023
BACKGROUND: Cardio-renal-metabolic (CRM) conditions are individually common among patients with heart failure (HF), but the prevalence and influence of overlapping CRM conditions in this population have not been well-studied. OBJECTIVES: This study aims to ...
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Journal ArticleJ Thorac Cardiovasc Surg · November 2023
AIM: The "2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease" provides recommendations to guide clinicians in the diagnosis, genetic evaluation and family screening, medical therapy, endovascular and surgical treatment, and long-term ...
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Journal ArticleJAMA Cardiol · November 1, 2023
IMPORTANCE: Clinicians recommend enteric-coated aspirin to decrease gastrointestinal bleeding in secondary prevention of coronary artery disease even though studies suggest platelet inhibition is decreased with enteric-coated vs uncoated aspirin formulatio ...
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Journal ArticleJ Am Heart Assoc · October 17, 2023
Background The ADAPTABLE (Aspirin Dosing: A Patient-Centric Trial Assessing Benefits and Long-Term Effectiveness) was a large, pragmatic, randomized controlled trial that found no difference between high- versus low-dose aspirin for secondary prevention of ...
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ConferenceCirculation · October 3, 2023
BACKGROUND: The VICTORIA trial (Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction) demonstrated that, in patients with high-risk heart failure, vericiguat reduced the primary composite outcome of cardiovascular death or ...
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Journal ArticleJACC Heart Fail · October 2023
BACKGROUND: Patients with heart failure (HF) have a high burden of multimorbidity, often necessitating numerous medications. There may be clinical concern about introducing another medication, especially among individuals with polypharmacy. OBJECTIVES: Thi ...
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Journal ArticleAm Heart J · October 2023
BACKGROUND: Among patients with established cardiovascular disease, the ADAPTABLE trial found no significant differences in cardiovascular events and bleeding rates between 81 mg and 325 mg of aspirin (ASA) daily. In this secondary analysis from the ADAPTA ...
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Journal ArticleN Engl J Med · September 21, 2023
BACKGROUND: The effectiveness of inhaled glucocorticoids in shortening the time to symptom resolution or preventing hospitalization or death among outpatients with mild-to-moderate coronavirus disease 2019 (Covid-19) is unclear. METHODS: We conducted a dec ...
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Journal ArticleN Engl J Med · September 14, 2023
BACKGROUND: Ferric carboxymaltose therapy reduces symptoms and improves quality of life in patients who have heart failure with a reduced ejection fraction and iron deficiency. Additional evidence about the effects of ferric carboxymaltose on clinical even ...
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Journal ArticleJCI Insight · September 8, 2023
Metabolic mechanisms underlying the heterogeneity of major adverse cardiovascular (CV) event (MACE) risk in individuals with type 2 diabetes mellitus (T2D) remain unclear. We hypothesized that circulating metabolites reflecting mitochondrial dysfunction pr ...
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Journal ArticleJ Am Coll Cardiol · September 5, 2023
BACKGROUND: Because clinical characteristics and prognosis vary by geographic region in patients with heart failure (HF), the response to treatment may also vary. A previous report suggested that the efficacy of sodium-glucose cotransporter-2 inhibitor eff ...
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Journal ArticleAm Heart J · September 2023
BACKGROUND: Catastrophic disruptions in care delivery threaten the operational efficiency and potentially the validity of clinical research efforts, in particular randomized clinical trials. Most recently, the COVID-19 pandemic affected essentially all asp ...
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Journal ArticleCirc Heart Fail · September 2023
BACKGROUND: We examined whether the primary composite outcome (cardiovascular death or heart failure hospitalization) was related to differences in background use and dosing of guideline-directed medical therapy in patients with heart failure with reduced ...
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Journal ArticleContemp Clin Trials · September 2023
BACKGROUND: Digitization (using novel digital tools and strategies) and consumerism (taking a consumer-oriented approach) are increasingly commonplace in clinical trials, but the implications of these changes are not well described. METHODS: We assembled a ...
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Journal ArticleEur J Heart Fail · September 2023
AIMS: Empagliflozin has been shown to reduce the risk of adverse cardiovascular outcomes in patients with type 2 diabetes and in those with heart failure. The impact of empagliflozin in post-acute myocardial infarction (AMI) patients is unknown. METHODS AN ...
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Journal ArticleEur J Heart Fail · September 2023
AIMS: The Dapagliflozin Evaluation to Improve the Lives of Patients with Preserved Ejection Fraction Heart Failure (DELIVER) trial demonstrated the sodium-glucose cotransporter 2 inhibitor dapagliflozin to be beneficial in patients with symptomatic heart f ...
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Journal ArticleCrit Care Explor · September 2023
OBJECTIVES: We aimed to 1) describe patterns of beta-blocker utilization among critically ill patients following moderate-severe traumatic brain injury (TBI) and 2) examine the association of early beta-blocker exposure with functional and clinical outcome ...
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Journal ArticleCirc Heart Fail · September 2023
BACKGROUND: Heart failure remains a global health burden, and patients hospitalized are particularly at risk, but genetic associates for subsequent death or rehospitalization are still lacking. METHODS: The genetic substudy of the ASCEND-HF trial (Acute St ...
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Journal ArticleEur Heart J · August 14, 2023
AIMS: The PARAGLIDE-HF trial demonstrated reductions in natriuretic peptides with sacubitril/valsartan compared with valsartan in patients with heart failure (HF) with mildly reduced or preserved ejection fraction who had a recent worsening HF event, but w ...
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Journal ArticleEur Heart J · August 14, 2023
AIMS: Dapagliflozin reduced the combined risk of worsening heart failure or cardiovascular death among patients with heart failure with mildly reduced or preserved ejection fraction. In this study, the safety and efficacy of dapagliflozin according to back ...
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Journal ArticleJ Am Coll Cardiol · August 8, 2023
BACKGROUND: Sodium-glucose cotransporter-2 (SGLT2) inhibitors and GLP-1 receptor agonists (GLP-1 RAs) reduce adverse cardiovascular outcomes in type 2 diabetes (T2D). However, the efficacy of combination therapy is unclear. OBJECTIVES: The aim of this stud ...
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Journal ArticleEur J Heart Fail · August 2023
AIMS: Dapagliflozin resulted in significant and sustained reductions in first and recurrent heart failure (HF) hospitalizations among patients with HF across the spectrum of ejection fraction. How treatment with dapagliflozin differentially impacts hospita ...
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Journal ArticleJ Card Fail · August 2023
BACKGROUND: Hospitalization due to heart failure (HFH) is a major source of morbidity, consumes significant economic resources and is a key endpoint in HF clinical trials. HFH events vary in severity and implications, but they are typically considered equi ...
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Journal ArticleJACC Heart Fail · August 2023
BACKGROUND: Initiation of evidence-based medications for patients with heart failure with reduced ejection fraction (HFrEF) during hospitalization in contemporary practice is unknown. OBJECTIVES: This study characterized opportunities for and achievement o ...
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Journal ArticleJ Am Heart Assoc · July 18, 2023
Background Splanchnic nerve modulation (SNM) is an emerging procedure to reduce cardiac filling pressures in heart failure. Although the main contributor to reduction in cardiac preload is thought to be increased venous capacitance in the splanchnic circul ...
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Journal ArticleJ Am Coll Cardiol · July 4, 2023
BACKGROUND: U.S. guidelines recommend consideration of sacubitril/valsartan in chronic heart failure (HF) and mildly reduced or preserved ejection fraction (EF). Whether initiation is safe and effective in EF >40% after a worsening heart failure (WHF) even ...
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Journal ArticleJ Am Heart Assoc · July 4, 2023
Background Internet-based participation has the potential to enhance pragmatic and decentralized trials, where representative study populations and generalizability to clinical practice are key. We aimed to study the differences between internet and nonint ...
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Journal ArticleJ Neurosurg Anesthesiol · July 1, 2023
INTRODUCTION: Early circulatory shock following traumatic brain injury (TBI) is a multifactorial process; however, the impact of brain injury biomarkers on the risk of shock has not been evaluated. We examined the association between neuronal injury biomar ...
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Journal ArticleEuropean journal of heart failure · July 2023
AimsPatients recently hospitalized for heart failure (HF) often have unstable haemodynamics and experience worsening renal failure, and are at elevated risk for recurrent HF events. In DELIVER, dapagliflozin reduced HF events or cardiovascular dea ...
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Journal ArticleEur J Heart Fail · July 2023
AIMS: Patients with heart failure experience a high burden of symptoms and physical limitations, and poor quality of life. Dapagliflozin reduces heart failure hospitalization and cardiovascular death in patients with reduced, mildly reduced, and preserved ...
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Journal ArticleJAMA cardiology · July 2023
ImportanceDapagliflozin has been shown to improve overall health status based on aggregate summary scores of the Kansas City Cardiomyopathy Questionnaire (KCCQ) in patients with heart failure (HF) with mildly reduced or preserved ejection fraction ...
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Journal ArticleEur Heart J · June 25, 2023
AIMS: Because an increased risk of amputation with canagliflozin was reported in the CANVAS trials, there has been a concern about the safety of sodium-glucose cotransporter 2 inhibitors in patients with peripheral artery disease (PAD) who are at higher ri ...
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Journal ArticleJAMA · June 20, 2023
IMPORTANCE: Use of oral vitamin K antagonists (VKAs) may place patients undergoing endovascular thrombectomy (EVT) for acute ischemic stroke caused by large vessel occlusion at increased risk of complications. OBJECTIVE: To determine the association betwee ...
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Journal ArticleBMJ Open · June 16, 2023
OBJECTIVE: We studied the safety and efficacy of hydroxychloroquine (HCQ) as pre-exposure prophylaxis for COVID-19 in healthcare workers (HCWs), using a meta-analysis of randomised controlled trials (RCTs). DATA SOURCES: PubMed and EMBASE databases were se ...
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Journal ArticleJ Card Fail · June 2023
BACKGROUND: The PARAGON-HF trial studied the effect of sacubitril/valsartan (Sac/Val) compared with valsartan (Val) on clinical outcomes in patients with chronic heart failure with preserved ejection fraction (HFpEF) or mildly reduced EF (HFmrEF). Further ...
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Journal ArticleCirc Genom Precis Med · June 2023
BACKGROUND: Epigenetic clocks estimate chronologic age using methylation levels at specific loci. We tested the hypothesis that accelerated epigenetic aging is associated with abnormal values in a range of clinical, imaging, and laboratory characteristics. ...
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Journal ArticleJournal of the American Geriatrics Society · June 2023
Whether initiation of statins could increase survival free of dementia and disability in adults aged ≥75 years is unknown. PREVENTABLE, a double-blind, placebo-controlled randomized pragmatic clinical trial, will compare high-intensity statin therapy (ator ...
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Journal ArticleJAMA Cardiol · June 1, 2023
IMPORTANCE: In the Dapagliflozin Evaluation to Improve the Lives of Patients With Preserved Ejection Fraction Heart Failure (DELIVER) trial, dapagliflozin reduced the risk of time to first worsening heart failure (HF) event or cardiovascular death in patie ...
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Journal ArticleJ Intensive Care Med · May 2023
Objectives: Describe contemporary ECMO utilization patterns among patients with traumatic brain injury (TBI) and examine clinical outcomes among TBI patients requiring ECMO. Design: Retrospective cohort study. Setting: Premier Healthcare Database (PHD) bet ...
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Journal ArticleJACC Heart Fail · May 2023
BACKGROUND: Vericiguat reduced the risk of cardiovascular death (CVD) or hospitalization for heart failure (HF) in patients with worsening HF and reduced left ventricular ejection fraction (LVEF). OBJECTIVES: The authors assessed the association of LVEF wi ...
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ConferenceInt J Infect Dis · April 2023
OBJECTIVES: To determine whether hydroxychloroquine (HCQ) is safe and effective at preventing COVID-19 infections among health care workers (HCWs). METHODS: In a 1: 1 randomized, placebo-controlled, double-blind, parallel-group, superiority trial at 34 US ...
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Journal ArticleJ Card Fail · April 2023
BACKGROUND: Circulating biomarkers may be useful in understanding prognosis and treatment efficacy in heart failure with reduced ejection fraction. In the VICTORIA (Vericiguat Global Study in Subjects with Heart Failure with Reduced Ejection Fraction) tria ...
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Journal ArticleJAMA Cardiol · April 1, 2023
IMPORTANCE: Gout is common in patients with heart failure (HF), and sodium-glucose cotransporter 2 inhibitors, a foundational treatment for HF, reduce uric acid levels. OBJECTIVE: To examine the reported prevalence of gout at baseline, the association betw ...
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Journal ArticleJACC Heart Fail · April 2023
BACKGROUND: Initiation and up-titration of guideline-directed medical therapies (GDMTs) for heart failure with reduced ejection fraction (HFrEF) remains suboptimal, in part because of concerns regarding tolerability and adverse events (AEs). OBJECTIVES: Th ...
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Journal ArticleJACC Heart Fail · April 2023
BACKGROUND: Black people have a higher incidence and prevalence of heart failure (HF) than White people, and once HF has developed, they may have worse outcomes. There is also evidence that the response to several pharmacologic therapies may differ between ...
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Journal ArticleCirculation · April 2023
BackgroundHow patient characteristics and outcomes vary according to the duration of heart failure (HF) is unknown in individuals with mildly reduced or preserved ejection fraction. We compared these, and the efficacy and safety of dapagliflozin, ...
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Journal ArticleVasc Med · April 2023
BACKGROUND: We aimed to understand the effects of aspirin dose on outcomes in patients with peripheral artery disease (PAD) as well as their participation in a pragmatic randomized controlled trial. METHODS: In a subanalysis of the Aspirin Dosing: A Patien ...
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Journal ArticleJAMA · March 21, 2023
IMPORTANCE: It is unknown whether ivermectin, with a maximum targeted dose of 600 μg/kg, shortens symptom duration or prevents hospitalization among outpatients with mild to moderate COVID-19. OBJECTIVE: To evaluate the effectiveness of ivermectin at a max ...
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Journal ArticleCirculation · February 21, 2023
BACKGROUND: Sodium-glucose cotransporter-2 inhibitors have emerged as a key pharmacotherapy in heart failure (HF) with both reduced and preserved ejection fraction. The benefit of other HF therapies may be modified by sex, but whether sex modifies the trea ...
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Journal ArticleEur J Heart Fail · February 2023
AIMS: Influenza vaccination is associated with reduced cardiopulmonary morbidity and mortality among patients with heart failure or recent myocardial infarction. The immune response to vaccination frequently results in mild adverse reactions (AR), which le ...
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Journal ArticleCirc Heart Fail · February 2023
BACKGROUND: Heuristic biases are increasingly recognized, and potentially modifiable, contributors to patient care and outcomes. Left digit bias is a cognitive bias where continuous variables are categorized by their left-most digit. The impact of this heu ...
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Journal ArticleJournal of the American College of Cardiology · February 2023
BackgroundPatients with heart failure with mildly reduced ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF) experience a high burden of symptoms, physical limitations, and poor quality of life; improving health ...
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Journal ArticleJ Thromb Thrombolysis · February 2023
The ADA (Age-D-dimer-Albumin) score was developed to identify hospitalized patients at an increased risk for thrombosis in the coronavirus infectious disease-19 (COVID-19) setting. The study aimed to validate the ADA score for predicting thrombosis in a no ...
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Journal ArticleJAMA · January 24, 2023
IMPORTANCE: The effectiveness of fluvoxamine to shorten symptom duration or prevent hospitalization among outpatients with mild to moderate symptomatic COVID-19 is unclear. OBJECTIVE: To evaluate the efficacy of low-dose fluvoxamine (50 mg twice daily) for ...
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Journal ArticleJAMA Cardiol · January 1, 2023
IMPORTANCE: Sodium-glucose cotransporter 2 inhibitors are known to reduce heart failure events and slow progression of kidney disease among patients with heart failure and a reduced ejection fraction. OBJECTIVE: To determine the effect of dapagliflozin on ...
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Journal ArticleJournal of the American College of Cardiology · January 2023
Although chronic kidney disease is characterized by low glomerular filtration rate (GFR) or albuminuria, estimated GFR (eGFR) is more widely utilized as a marker of risk profile in cardiovascular diseases, including heart failure (HF). The presence and mag ...
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Journal ArticleAnesth Analg · December 1, 2022
BACKGROUND: Early hypotension after severe traumatic brain injury (sTBI) is associated with increased mortality and poor long-term outcomes. Current guidelines suggest the use of intravenous vasopressors, commonly norepinephrine and phenylephrine, to suppo ...
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Journal ArticleJ Card Fail · December 2022
BACKGROUND: Differences between patients hospitalized for heart failure with reduced ejection fraction (HFrEF) vs HF with preserved EF (HFpEF) are not well-characterized, particularly as pertains to in-hospital decongestion and longitudinal patient-reporte ...
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Journal ArticleJACC Heart Fail · December 2022
BACKGROUND: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is used for diagnostic and prognostic evaluation in heart failure (HF). Previous clinical trials in heart failure with mildly reduced ejection fraction (HFmrEF) or heart failure with preserv ...
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Journal ArticleJAMA Cardiol · December 1, 2022
IMPORTANCE: Dapagliflozin was recently shown to reduce cardiovascular death or worsening heart failure (HF) events in patients with HF with mildly reduced or preserved ejection fraction in the Dapagliflozin Evaluation to Improve the Lives of Patients With ...
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Journal ArticleJAMA Cardiol · December 1, 2022
IMPORTANCE: Patient-reported health data can facilitate clinical event capture in pragmatic clinical trials. However, few data are available on the fitness for use of patient-reported data in large-scale health research. OBJECTIVE: To evaluate the concorda ...
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Journal ArticleEur J Heart Fail · December 2022
AIMS: The effects of adding a sodium-glucose cotransporter 2 (SGLT2) inhibitor to a mineralocorticoid receptor antagonist (MRA) or an angiotensin receptor-neprilysin inhibitor (ARNI) in patients with heart failure (HF) and mildly reduced ejection fraction ...
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Journal ArticleLancet Diabetes Endocrinol · December 2022
BACKGROUND: Type 2 diabetes and prediabetes are risk factors for heart failure and adverse heart failure outcomes. The Dapagliflozin Evaluation to Improve the Lives of Patients with Preserved Ejection Fraction Heart Failure (DELIVER) trial showed that dapa ...
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Journal ArticleNature medicine · December 2022
With modern treatments for heart failure with reduced ejection fraction (EF), indicative of impaired cardiac systolic function, patients may exhibit an increase in EF. Limited data are available regarding the clinical management of this growing population, ...
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Journal ArticleSci Rep · November 22, 2022
There is increasing evidence that HFpEF is a heterogeneous clinical entity and distinct molecular pathways may contribute to pathophysiology. Leveraging unbiased proteomics to identify novel biomarkers, this study seeks to understand the underlying molecul ...
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Journal ArticleJ Affect Disord · November 15, 2022
BACKGROUND: The General Anxiety Disorder-7 (GAD-7) questionnaire is a standard tool used for screening and follow-up of patients with Generalized Anxiety Disorder (GAD). Although it is generally accepted that anxiety correlates with clinical and psychosoci ...
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Journal ArticleJ Am Coll Cardiol · November 8, 2022
BACKGROUND: Recent guidelines support consideration of sodium-glucose cotransporter-2 inhibitors in the long-term management of heart failure (HF) with mildly reduced or preserved ejection fraction. Patients and clinicians may be interested in the expected ...
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Journal ArticleAm Heart J · November 2022
BACKGROUND: Patients with acute myocardial infarction (MI) are at risk for developing heart failure (HF) and subsequently are at an increased risk of mortality. Sodium-glucose cotransporter-2 inhibitors have been proven to improve outcomes in patients with ...
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Journal ArticleEuropean heart journal · November 2022
AimsObesity is common and associated with unique phenotypic features in heart failure with preserved ejection fraction (HFpEF). Therefore, understanding the efficacy and safety of new therapies in HFpEF patients with obesity is important. The effe ...
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Journal ArticleJ Am Coll Cardiol · November 1, 2022
BACKGROUND: Atrial fibrillation (AF) is common in heart failure (HF), is associated with worse outcomes compared with sinus rhythm, and may modify the effects of therapy. OBJECTIVES: This study examined the effects of dapagliflozin according to the presenc ...
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Journal ArticleCirculation · November 2022
A task force composed of American Heart Association (AHA) Research Committee members established processes to measure the performance of the AHA's research portfolio and evaluated key outcomes that are fundamental to the overall success of the program. Thi ...
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Journal ArticleJ Am Coll Cardiol · October 4, 2022
BACKGROUND: Patients recently hospitalized for heart failure (HF) are at high risk for rehospitalization and death. OBJECTIVES: The purpose of this study was to investigate clinical outcomes and response to dapagliflozin in patients with HF with mildly red ...
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Journal ArticleClin Trials · October 2022
BACKGROUND/AIM: The number of coronavirus disease 2019 deaths and cases continues to increase globally. Novel therapies are urgently needed to treat patients with coronavirus disease 2019. We sought to provide a critical review of trials designed during th ...
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Journal ArticleJ Card Fail · October 2022
BACKGROUND: It is unknown whether digital applications can improve guideline-directed medical therapy (GDMT) and outcomes in heart failure with reduced ejection fraction (HFrEF). METHODS AND RESULTS: Care Optimization Through Patient and Hospital Engagemen ...
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Journal ArticleCirculation · October 2022
BackgroundFrailty is increasing in prevalence. Because patients with frailty are often perceived to have a less favorable risk/benefit profile, they may be less likely to receive new pharmacologic treatments. We investigated the efficacy and toler ...
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Journal ArticleEur J Heart Fail · October 2022
AIMS: This pre-specified analysis of the DELIVER trial examined whether clinical benefits of dapagliflozin in heart failure (HF) with left ventricular ejection fraction (LVEF) >40% varied by baseline New York Heart Association (NYHA) class and examined the ...
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Journal ArticleJAMA Cardiol · October 1, 2022
IMPORTANCE: Despite advances in cardiac care, patients remain at a high risk of death and the development of heart failure (HF) following myocardial infarction (MI). These risks are highest in patients with reduced ejection fraction (EF) or signs of HF imm ...
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Journal ArticleContemp Clin Trials · October 2022
Efficiency in clinical trial recruitment and enrollment remains a major challenge in many areas of clinical medicine. In particular, despite the prevalence of heart failure with preserved ejection fraction (HFpEF), identifying patients with HFpEF for clini ...
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Journal ArticleJAMA · October 2022
ImportanceThe effectiveness of ivermectin to shorten symptom duration or prevent hospitalization among outpatients in the US with mild to moderate symptomatic COVID-19 is unknown.ObjectiveTo evaluate the efficacy of ivermectin, 400 μg/kg, ...
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Journal ArticleCirculation. Heart failure · October 2022
BackgroundThe prevalence of heart failure with mildly reduced or preserved ejection fraction markedly increases with age, with older individuals disproportionately facing excess risk for mortality and hospitalization.MethodsThe DELIVER tr ...
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Journal ArticleN Engl J Med · September 22, 2022
BACKGROUND: Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of hospitalization for heart failure and cardiovascular death among patients with chronic heart failure and a left ventricular ejection fraction of 40% or less. Whether SGLT2 inh ...
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Journal ArticleJ Am Heart Assoc · September 20, 2022
Heart failure remains among the most common and morbid health conditions. The Heart Failure Strategically Focused Research Network (HF SFRN) was funded by the American Heart Association to facilitate collaborative, high-impact research in the field of hear ...
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Journal ArticleLancet · September 3, 2022
BACKGROUND: SGLT2 inhibitors are strongly recommended in guidelines to treat patients with heart failure with reduced ejection fraction, but their clinical benefits at higher ejection fractions are less well established. Two large-scale trials, DELIVER and ...
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Journal ArticleJ Card Fail · September 2022
BACKGROUND: The role of blood volume (BV) expansion vs a change in vascular compliance in worsening heart failure (HF) remains under debate. We aimed to assess the relationship between BV and resting and stress hemodynamics in worsening HF and to further e ...
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Journal ArticleNeurosurgery · September 1, 2022
BACKGROUND: Extracranial multisystem organ failure is a common sequela of severe traumatic brain injury (TBI). Risk factors for developing circulatory shock and long-term functional outcomes of this patient subset are poorly understood. OBJECTIVE: To ident ...
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Journal ArticleEur J Heart Fail · September 2022
AIM: We assessed a subset of the 5040 patients in VICTORIA receiving sacubitril/valsartan, either at randomization (n = 731) or post-randomization drop-in use (n = 425), to evaluate the relationship between the efficacy and safety of combination therapy wi ...
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Journal ArticleAm J Cardiol · September 1, 2022
Patients with acute coronary syndrome (ACS) are at risk for recurrent adverse events, and multiple reports suggest that this risk is increased in patients with concomitant diabetes mellitus (DM) and peripheral artery disease (PAD). The aim of this article ...
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Journal ArticleJACC Heart Fail · September 2022
BACKGROUND: The effect of vericiguat on sequential N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and influence of this relationship on clinical outcomes is unknown. OBJECTIVES: This study assessed the relationship between changes in NT-proBN ...
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Journal ArticleNat Med · September 2022
Whether the sodium-glucose cotransporter 2 inhibitor dapagliflozin reduces the risk of a range of morbidity and mortality outcomes in patients with heart failure regardless of ejection fraction is unknown. A patient-level pooled meta-analysis of two trials ...
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Journal ArticleJ Card Fail · August 2022
BACKGROUND: Health system-level interventions to improve use of guideline-directed medical therapy (GDMT) often fail in the acute care setting. We sought to identify factors associated with high performance in adoption of GDMT among health systems in CONNE ...
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Journal ArticleJ Card Fail · August 2022
BACKGROUND: Patients with heart failure (HF) and reduced ejection fraction suffer from a relapsing and remitting disease course, where early treatment changes may improve outcomes. We assessed the clinical integration and safety of the HeartLogic multisens ...
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Journal ArticleCardiovasc Diabetol · July 18, 2022
BACKGROUND: We examined multi-dimensional clinical and laboratory data in participants with normoglycemia, prediabetes, and diabetes to identify characteristics of prediabetes and predictors of progression from prediabetes to diabetes or reversion to no di ...
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Journal ArticleJ Card Fail · July 2022
BACKGROUND: For patients hospitalized for heart failure with reduced ejection fraction (HFrEF), guidelines recommend optimization of medical therapy prior to discharge. The degree to which changes in medical therapy occur during hospitalizations for HFrEF ...
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Journal ArticleJACC Heart Fail · July 2022
BACKGROUND: The LIFE (LCZ696 In Hospitalized Advanced Heart FailurE) trial, which evaluated sacubitril/valsartan in patients with advanced heart failure (HF) with reduced ejection fraction and recent New York Heart Association functional class IV symptomat ...
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Journal ArticleJ Am Heart Assoc · June 20, 2022
Background There are limited data on the use of angiotensin receptor neprilysin inhibitors (ARNIs) in minority populations with heart failure (HF) with reduced ejection fraction. We used data from the CHAMP-HF (Change the Management of Patients With Heart ...
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Journal ArticleSci Rep · June 2, 2022
Heart failure with reduced ejection fraction (HFrEF) is increasingly treated with medications for type 2 diabetes mellitus (T2DM). Whether metabolic derangements in HFrEF and T2DM are associated with differential outcomes remains unclear. Therefore, unders ...
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Journal ArticleContemp Clin Trials · June 2022
Randomized controlled trials (RCT) are the gold standard for evaluating the effectiveness and safety of interventions and treatments, yet traditional clinical trials have relied on cumbersome and redundant processes such as electronic data entry which invo ...
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Journal ArticleJACC Heart Fail · June 2022
Acute coronary syndrome (ACS) is frequently complicated by evidence of heart failure (HF). Those at highest risk for acute decompensated HF in the setting of ACS (ACS-HF) are older, female, and have preexisting heart disease, type 2 diabetes mellitus, hype ...
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Journal ArticleCirc Heart Fail · June 2022
BACKGROUND: We examined the effects of vericiguat compared with placebo in patients with heart failure with reduced ejection fraction enrolled in VICTORIA (Vericiguat Global Study in Patients With Heart Failure With Reduced Ejection Fraction) on health sta ...
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Journal ArticleTrials · May 21, 2022
BACKGROUND: The COVID-19 pandemic has considerably disrupted nearly all aspects of daily life, including healthcare delivery and clinical research. Because pragmatic clinical trials are often embedded within healthcare delivery systems, they may be at high ...
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Journal ArticleCirculation · May 3, 2022
AIM: The "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure" replaces the "2013 ACCF/AHA Guideline for the Management of Heart Failure" and the "2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failu ...
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Journal ArticleJ Am Coll Cardiol · May 3, 2022
AIM: The "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure" replaces the "2013 ACCF/AHA Guideline for the Management of Heart Failure" and the "2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failu ...
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Journal ArticleCirculation · May 3, 2022
AIM: The "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure" replaces the "2013 ACCF/AHA Guideline for the Management of Heart Failure" and the "2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failu ...
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Journal ArticleEur J Heart Fail · May 2022
AIMS: Coronary artery disease (CAD) portends worse outcomes in heart failure (HF). We aimed to characterize patients with CAD and worsening HF with reduced ejection fraction (HFrEF) and evaluate post hoc whether vericiguat treatment effect varied according ...
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Journal ArticleEur J Heart Fail · May 2022
AIMS: We assessed for an association between improvements in left ventricular ejection fraction (LVEF) and future outcomes, including health status, in routine clinical practice. METHODS AND RESULTS: CHAMP-HF was a registry of outpatients with heart failur ...
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Journal ArticleJ Card Fail · May 2022
BACKGROUND: The 2022 American College of Cardiology/American Heart Association/Heart Failure Society of America (AHA/ACC/HFSA) Guideline for the Management of Heart Failure replaces the 2013 ACCF/AHA Guideline for the Management of Heart Failure and the 20 ...
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Journal ArticleJ Card Fail · May 2022
AIM: The "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure" replaces the "2013 ACCF/AHA Guideline for the Management of Heart Failure" and the "2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failu ...
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Journal ArticleJournal of the American College of Cardiology · May 2022
Sodium glucose cotransporter-2 (SGLT2) inhibitors improve cardiorenal outcomes in patients with type 2 diabetes mellitus, chronic kidney disease, and chronic heart failure. SGLT2 inhibitors also reduce the risk of cardiovascular mortality and hospitalizati ...
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Journal ArticleEur Heart J · April 6, 2022
Patients are ultimately the end-users of medical therapies and need to be actively integrated as contributors and decision-makers in the process of product development throughout product lifecycles. This is increasingly being recognized by patients, invest ...
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Journal ArticleJ Neurosurg Anesthesiol · April 1, 2022
BACKGROUND: Traumatic brain injury (TBI) is a major global health problem. Little research has addressed extracranial organ dysfunction following TBI, particularly myocardial injury. Using a sensitive marker of myocardial injury-high sensitivity troponin ( ...
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Journal ArticleStroke · April 2022
BACKGROUND: The benefits of tPA (tissue-type plasminogen activator) in acute ischemic stroke are time-dependent. However, delivery of thrombolytic therapy rapidly after hospital arrival was initially occurring infrequently in hospitals in the United States ...
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Journal ArticleNeurocrit Care · April 2022
BACKGROUND: The aim of this study was to describe the utilization patterns of brain tissue oxygen (PbtO2) monitoring following severe traumatic brain injury (TBI) and determine associations with mortality, health care use, and pulmonary toxicity. METHODS: ...
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Journal ArticleContemp Clin Trials · April 2022
Data monitoring committees (DMCs) play a critical role in protecting the safety of participants and integrity of clinical studies. While there are well-established DMC guidelines for traditional, randomized controlled trials, the clinical trial community i ...
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Journal ArticleJ Card Fail · March 2022
BACKGROUND: The comparative effectiveness of differing dosages of guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) on clinical and patient-reported outcomes in clinical practice in the United States is unkn ...
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Journal ArticleAm Heart J · March 2022
BACKGROUND: We aimed to investigate the associations of glycemic markers (hemoglobin A1C [HbA1C], fasting plasma glucose [FPG] and glycemic status [normoglycemia, prediabetes and diabetes]) with incident heart failure (HF) and its subtypes, among Blacks. M ...
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Journal ArticleJACC Heart Fail · March 2022
OBJECTIVES: The authors sought to characterize associations between initiation of metformin and sulfonylurea therapy and clinical outcomes among patients with comorbid heart failure (HF) and diabetes (overall and by ejection fraction [EF] phenotype). BACKG ...
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Journal ArticleThromb Res · March 2022
Obesity is associated with cardiovascular complications such as diabetes and hypertension. However, obesity and high body mass index (BMI) can also be linked to improved clinical outcomes in certain patient populations. This counterintuitive observation is ...
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Journal ArticleJACC Heart Fail · March 2022
OBJECTIVES: This report describes the baseline clinical profiles and management of DELIVER (Dapagliflozin Evaluation to Improve the Lives of Patients With Preserved Ejection Fraction Heart Failure) trial participants and how these compare with those in oth ...
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Journal ArticleEClinicalMedicine · March 2022
BACKGROUND: The extent to which healthcare worker (HCWs) experiences during the COVID-19 pandemic vary by race or ethnicity after adjustment for confounding factors is not currently known. METHODS: We performed an observational prospective cohort study of ...
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Journal ArticleJAMA · February 22, 2022
IMPORTANCE: Current guidelines recommend against use of intravenous alteplase in patients with acute ischemic stroke who are taking non-vitamin K antagonist oral anticoagulants (NOACs). OBJECTIVE: To evaluate the safety and functional outcomes of intraveno ...
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Journal ArticleCirc Res · February 4, 2022
RATIONALE: Cardiovascular disease remains the leading cause of death in women. To address its determinants including persisting cardiovascular risk factors amplified by sex and race inequities, novel personalized approaches are needed grounded in the engag ...
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Journal ArticleNeurocrit Care · February 2022
BACKGROUND: Early hypotension following moderate to severe traumatic brain injury (TBI) is associated with increased mortality and poor long-term outcomes. Current guidelines suggest the use of intravenous vasopressors to support blood pressure following T ...
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Journal ArticleJ Card Fail · February 2022
BACKGROUND: Clinical practice guidelines support sustained use of renin-angiotensin-aldosterone-system (RAAS) inhibitors over time in heart failure with reduced ejection fraction, yet few data are available regarding the frequency, timing or predictors of ...
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Journal ArticleESC Heart Fail · February 2022
AIMS: We aimed to develop a risk prediction tool that incorporated both clinical events and worsening health status for patients with heart failure (HF) with reduced ejection fraction (HFrEF). Identifying patients with HFrEF at increased risk of a poor out ...
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Journal ArticleClin Pharmacol Ther · January 2022
Concerns regarding both the limited generalizability and the slow pace of traditional randomized trials have led to calls for greater use of real-world evidence in the evaluation of new treatments or products. Real-world clinical trials or pragmatic trials ...
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Journal ArticleClin Pharmacol Ther · January 2022
The randomized controlled trial (RCT) is the gold standard for evaluating the causal effects of medications. Limitations of RCTs have led to increasing interest in using real-world evidence (RWE) to augment RCT evidence and inform decision making on medica ...
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Journal ArticleClin Pharmacol Ther · January 2022
Concerns regarding both the limited generalizability and the slow pace of traditional randomized trials have led to calls for greater use of real-world evidence (RWE) in the evaluation of new treatments or products. The RWE label has been used to refer to ...
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Journal ArticleClin Pharmacol Ther · January 2022
Concerns regarding both the limited generalizability and the slow pace of traditional randomized trials have led to calls for greater use of real-world evidence (RWE) in the evaluation of new treatments or products. RWE studies often rely on real-world dat ...
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Journal ArticleJAMA Cardiol · January 1, 2022
IMPORTANCE: The use of sacubitril/valsartan is not endorsed by practice guidelines for use in patients with New York Heart Association class IV heart failure with a reduced ejection fraction because of limited clinical experience in this population. OBJECT ...
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Journal ArticleDiabetes Res Clin Pract · January 2022
AIMS: The Exenatide Study of Cardiovascular Event Lowering (EXSCEL) trial assessed once-weekly exenatide (EQW) vs. placebo, added to usual care in 14,752 patients with type 2 diabetes mellitus (Clinicaltrials.gov: NCT01144338). We assessed the lifetime cos ...
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Journal ArticleJ Cardiovasc Comput Tomogr · 2022
BACKGROUND: Coronary artery calcium (CAC) and left ventricular diastolic dysfunction (LVDD) are strong predictors of cardiovascular events and share common risk factors. However, their independent association remains unclear. METHODS: In the Project Baseli ...
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Chapter · January 1, 2022
Randomized clinical trials form the cornerstone of evidence-based medicine and are required to accurately determine cause-effect relationships and treatment effects of medical interventions. Nonetheless, contemporary clinical trials are becoming increasing ...
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Journal ArticleCirculation · December 7, 2021
The coronavirus disease 2019 (COVID-19) pandemic has had worldwide repercussions for health care and research. In spring 2020, most non-COVID-19 research was halted, hindering research across the spectrum from laboratory-based experimental science to clini ...
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Journal ArticleAtherosclerosis · December 2021
BACKGROUND AND AIMS: Polyvascular disease is an independent predictor of major adverse cardiovascular events (MACE). The relationship between the number of diseased arterial beds and MACE is unknown. How MACE risk changes in individuals with type 2 diabete ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · December 2021
BACKGROUND: The ADAPTABLE trial (Aspirin Dosing: A Patient-Centric Trial Assessing Benefits and Long-Term Effectiveness) is the first randomized trial conducted within the National Patient-Centered Clinical Research Network to use the electronic health rec ...
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Journal ArticleJ Am Heart Assoc · November 16, 2021
Background Although safety and tolerability of vericiguat were established in the VICTORIA (Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction) trial in patients with heart failure with reduced ejection fraction, some sub ...
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Journal ArticleCirculation · November 2, 2021
BACKGROUND: In the VICTORIA trial (Vericiguat Global Study in Patients with Heart Failure with Reduced Ejection Fraction), anemia occurred more often in patients treated with vericiguat (7.6%) than with placebo (5.7%). We explored the association between v ...
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ConferenceJ Intensive Care Med · November 2021
OBJECTIVE: To examine racial and ethnic differences in the utilization of 3 interventions (tracheostomy placement, gastrostomy tube placement, and hospice utilization) among patients with severe acute brain injury (SABI). DESIGN: Retrospective cohort study ...
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Journal ArticleCirc Heart Fail · November 2021
BACKGROUND: Diuretics are a mainstay therapy for the symptomatic treatment of heart failure. However, in contemporary US outpatient practice, the degree to which diuretic dosing changes over time and the associations with clinical outcomes and health care ...
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Journal ArticleJACC Basic Transl Sci · November 2021
Although there is an established bidirectional relationship between heart failure with reduced ejection fraction and liver disease, the association between heart failure with preserved ejection fraction (HFpEF) and liver diseases, such as nonalcoholic fatt ...
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Journal ArticleNeurocrit Care · October 2021
BACKGROUND/OBJECTIVE: Traumatic brain injury (TBI) is a leading cause of morbidity, mortality, and disability in the USA. While cardiopulmonary dysfunction can result in poor outcomes following severe TBI, the impact of acute kidney injury (AKI) is poorly ...
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Journal ArticleDiabet Med · October 2021
AIMS: Although models exist to predict amputation among people with type 2 diabetes with foot ulceration or infection, we aimed to develop a prediction model for a broader range of major adverse limb events (MALE)-including gangrene, revascularization and ...
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Journal ArticleCrit Care Med · October 1, 2021
OBJECTIVES: Traumatic brain injury is a leading cause of death and disability in the United States. While the impact of early multiple organ dysfunction syndrome has been studied in many critical care paradigms, the clinical impact of early multiple organ ...
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Journal ArticleESC Heart Fail · October 2021
AIMS: Implantable device-based sensor measurements including heart sounds, markers of ventilation, and thoracic impedance have been shown to predict heart failure (HF) hospitalizations. We sought to assess how these parameters changed prior to COVID-19 (Co ...
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Journal ArticleContemp Clin Trials · October 2021
BACKGROUND: The SARS CoV-2 virus has caused one of the deadliest pandemics in recent history, resulting in over 170 million deaths and global economic disruption. There remains an urgent need for clinical trials to test therapies for treatment and preventi ...
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Journal ArticleStroke Vasc Neurol · September 2021
BACKGROUND AND PURPOSE: Depression is common after stroke and is often treated with antidepressant medications (AD). ADs have also been hypothesised to improve stroke recovery, although recent randomised trials were neutral. We investigated the patterns of ...
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Journal ArticleAm Heart J · September 2021
Cardiovascular (CV) outcome studies of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have shifted the paradigm of type 2 diabetes management given their benefits regarding a reduction in major adverse CV events. However, the relationship between GL ...
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Journal ArticleAm Heart J · September 2021
BACKGROUND: Decongestion is a primary goal during hospitalizations for decompensated heart failure (HF). However, data surrounding the preferred route and strategy of diuretic administration are limited with varying results in prior studies. METHODS: This ...
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Journal ArticleCirc Heart Fail · September 2021
BACKGROUND: Randomized controlled trials (RCTs) often target enrollment of patients with demographics and outcomes less representative of the broader population of interest. To provide context for the VICTORIA trial (Vericiguat Global Study in Subjects Wit ...
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Journal ArticleJ Am Heart Assoc · August 17, 2021
Background Sacubitril/Valsartan has been highly efficacious in randomized trials of heart failure with reduced ejection fraction (HFrEF). However, the effectiveness of sacubitril/valsartan in older patients hospitalized for HFrEF in real-world US practice ...
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Journal ArticleJ Am Heart Assoc · August 17, 2021
Background People living with HIV are at increased risk of developing diastolic dysfunction, heart failure, and sudden cardiac death, all of which have been characterized by higher levels of myocardial fibrosis. Transmethylamine-N-oxide (TMAO), a dietary g ...
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ConferenceESC Heart Failure · August 1, 2021
Aims: Improving the health status (symptoms, function, and quality of life) of patients with heart failure with reduced ejection fraction (HFrEF) is a primary treatment goal. Angiotensin receptor neprilysin inhibitors (ARNI) improve short-term health statu ...
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Journal ArticleEur J Heart Fail · August 2021
AIMS: Vericiguat reduced the primary composite outcome of cardiovascular death or heart failure (HF) hospitalization in patients with worsening HF with reduced ejection fraction (HFrEF) and a lower limit of baseline estimated glomerular filtration rate (eG ...
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Journal ArticleESC Heart Fail · August 2021
AIMS: Associations between growth differentiation factor-15 (GDF-15), cardiovascular outcomes, and exercise capacity among patients with a recent hospitalization for heart failure (HHF) and heart failure with reduced ejection fraction (HFrEF) are unknown. ...
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Journal ArticleEur J Heart Fail · August 2021
AIMS: We evaluated the relation between baseline and new-onset atrial fibrillation (AF) and outcomes, and assessed whether vericiguat modified the likelihood of new-onset AF in patients with worsening heart failure (HF) with reduced ejection fraction in VI ...
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Journal ArticleJAMA · July 27, 2021
IMPORTANCE: Adoption of guideline-directed medical therapy for patients with heart failure is variable. Interventions to improve guideline-directed medical therapy have failed to consistently achieve target metrics, and limited data exist to inform efforts ...
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Journal ArticleTrials · July 19, 2021
BACKGROUND: The electronic health record (EHR) contains a wealth of clinical data that may be used to streamline the identification of potential clinical trial participants. However, there is little empirical information on site-level facilitators of and b ...
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Journal ArticleEur J Heart Fail · July 2021
Volume recruitment from the splanchnic compartment is an important physiological response to stressors such as physical activity and blood loss. In the setting of heart failure (HF), excess fluid redistribution from this compartment leads to increased card ...
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Journal ArticleEuropean journal of heart failure · July 2021
AimsSodium-glucose co-transporter 2 (SGLT2) inhibitors, originally developed as glucose-lowering agents, have been shown to reduce heart failure hospitalizations in patients with type 2 diabetes without established heart failure, and in patients w ...
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Journal ArticleJAMA Netw Open · July 1, 2021
IMPORTANCE: Randomized clinical trials (RCTs) are critical in advancing patient care, yet conducting such large-scale trials requires tremendous resources and coordination. Clinical site start-up performance metrics can provide insight into opportunities f ...
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Journal ArticleJ Card Fail · June 24, 2021
BACKGROUND: The prediction of outcomes in patients with heart failure (HF) may inform prognosis, clinical decisions regarding treatment selection, and new trial planning. The VerICiguaT Global Study in Subjects With Heart Failure With Reduced Ejection Frac ...
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Journal ArticleHealth Qual Life Outcomes · June 13, 2021
OBJECTIVES: There has been limited success in achieving integration of patient-reported outcomes (PROs) in clinical trials. We describe how stakeholders envision a solution to this challenge. METHODS: Stakeholders from academia, industry, non-profits, insu ...
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Journal ArticleJAMA Cardiol · June 1, 2021
IMPORTANCE: The period following heart failure hospitalization (HFH) is a vulnerable time with high rates of death or recurrent HFH. OBJECTIVE: To evaluate clinical characteristics, outcomes, and treatment response to vericiguat according to prespecified i ...
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Journal ArticleJ Card Fail · June 2021
BACKGROUND: The inflammatory cytokine IL-6 has been previously implicated in the pathophysiology of acute decompensated heart failure (HF). Prior observations in acute HF patients have suggested that IL-6 may be associated with outcomes and modulated by ne ...
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Journal ArticleN Engl J Med · May 27, 2021
BACKGROUND: The appropriate dose of aspirin to lower the risk of death, myocardial infarction, and stroke and to minimize major bleeding in patients with established atherosclerotic cardiovascular disease is a subject of controversy. METHODS: Using an open ...
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Journal ArticleJ Am Coll Cardiol · May 18, 2021
Coronary artery disease (CAD) is highly prevalent in patients with heart failure (HF) and accounts for nearly two-thirds of cases. The use of percutaneous coronary intervention (PCI) in HF patients with CAD has markedly increased and has been suggested to ...
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Journal ArticleDiabetes Obes Metab · May 2021
AIM: To provide evidence on the cardiovascular and renal safety of metformin in chronic kidney disease (CKD) stages 3 to 4. MATERIALS AND METHODS: This post hoc analysis compared participants with an estimated glomerular filtration rate (eGFR) of 15 to 59 ...
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Journal ArticleJ Gen Intern Med · May 2021
BACKGROUND: The HERO registry was established to support research on the impact of the COVID-19 pandemic on US healthcare workers. OBJECTIVE: Describe the COVID-19 pandemic experiences of and effects on individuals participating in the HERO registry. DESIG ...
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Journal ArticleJAMA Cardiol · May 1, 2021
IMPORTANCE: It is unclear how New York Heart Association (NYHA) functional class compares with patient-reported outcomes among patients with heart failure (HF) in contemporary US clinical practice. OBJECTIVE: To characterize longitudinal changes and concor ...
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Journal ArticleJACC Heart Fail · May 2021
OBJECTIVES: The goal of this study was to evaluate differences in clinical and patient-reported outcomes between women and men hospitalized for acute HF. BACKGROUND: Among patients hospitalized for heart failure (HF), it is unclear if symptom burden, respo ...
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Journal ArticleCirc Heart Fail · May 2021
BACKGROUND: Iron deficiency (ID) has a prevalence of ≈40% to 50% among patients in heart failure (HF) with reduced ejection fraction and is associated with worse prognosis. Several trials demonstrated that intravenous ferric carboxymaltose leads to early a ...
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Journal ArticleAnesth Analg · April 1, 2021
BACKGROUND: Severe traumatic brain injury (TBI) can result in left ventricular dysfunction, which can lead to hypotension and secondary brain injuries. Although echocardiography is often used to examine cardiovascular function in multiple clinical settings ...
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Journal ArticleJACC Heart Fail · April 2021
OBJECTIVES: The authors estimated changes of stressed blood volume (SBV) induced by splanchnic nerve block (SNB) in patients with either decompensated or ambulatory heart failure with reduced ejection fraction (HFrEF). BACKGROUND: The splanchnic vascular c ...
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Journal ArticleCirc Heart Fail · April 2021
BACKGROUND: Hospitalization for heart failure (HF) is associated with increased risk of death among patients with chronic HF. The degree to which hospitalization for HF is a distinct biologic entity with independent prognostic value versus a marker of high ...
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Journal ArticleJ Particip Med · March 29, 2021
Sharing clinical trial data can provide value to research participants and communities by accelerating the development of new knowledge and therapies as investigators merge data sets to conduct new analyses, reproduce published findings to raise standards ...
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Journal ArticleJ Card Fail · March 2021
BACKGROUND: Prior analyses suggest an association between formula-based plasma volume (PV) estimates and outcomes in heart failure (HF). We assessed the association between estimated PV status by the Duarte-ePV and Kaplan Hakim (KH-ePVS) formulas, and in-h ...
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Journal ArticleCirculation · February 2, 2021
AIM: This executive summary of the valvular heart disease guideline provides recommendations for clinicians to diagnose and manage valvular heart disease as well as supporting documentation to encourage their use. METHODS: A comprehensive literature search ...
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Journal ArticleESC Heart Fail · February 2021
AIMS: Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous condition, and tissue congestion manifested by oedema is not present in all patients. We compared clinical characteristics, exercise capacity, and outcomes in patients with HFp ...
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Journal ArticleTrials · January 25, 2021
BACKGROUND: New considerations during the ethical review processes may emerge from innovative, yet unfamiliar operational methods enabled in pragmatic randomized controlled trials (RCT), potentially making institutional review board (IRB) evaluation more c ...
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Journal ArticleJAMA · January 5, 2021
IMPORTANCE: Influenza is temporally associated with cardiopulmonary morbidity and mortality among those with cardiovascular disease who may mount a less vigorous immune response to vaccination. Higher influenza vaccine dose has been associated with reduced ...
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Journal ArticleJ Clin Epidemiol · January 2021
OBJECTIVE: To describe PCORnet, a clinical research network developed for patient-centered outcomes research on a national scale. STUDY DESIGN AND SETTING: Descriptive study of the current state and future directions for PCORnet. We conducted cross-section ...
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Journal ArticleJACC Heart Fail · January 2021
OBJECTIVES: The authors sought to evaluate the association of heart failure hospitalization (HFH) with guideline-directed medical therapy (GDMT) prescribing patterns among patients with heart failure with reduced ejection fraction (HFrEF). BACKGROUND: HFH ...
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Journal ArticlePLoS One · 2021
Newer data platforms offer increased opportunity to share multidimensional health data with research participants, but the preferences of participants for which data to receive and how is evolving. Our objective is to describe the preferences and expectati ...
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Journal ArticleJ Am Heart Assoc · December 15, 2020
Background Ultrafiltration is not commonly used because of higher incidence of worsening renal function without improved decongestion. We examined differential outcomes of high versus low fluid removal and preserved versus reduced ejection fraction (EF) in ...
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Journal ArticleJ Am Coll Cardiol · December 15, 2020
Fine particulate air pollution <2.5 μm in diameter (PM2.5) is a major environmental threat to global public health. Multiple national and international medical and governmental organizations have recognized PM2.5 as a risk factor for cardiopulmonary diseas ...
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Journal ArticleStat Med · December 10, 2020
Cluster randomized trials (CRTs) refer to experiments with randomization carried out at the cluster or the group level. While numerous statistical methods have been developed for the design and analysis of CRTs, most of the existing methods focused on test ...
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Journal ArticleAm Heart J · December 2020
BACKGROUND: In PARADIGM-HF, sacubitril/valsartan improved quality of life (QOL) versus enalapril in heart failure with reduced ejection fraction (HFrEF), yet limited data are available regarding QOL changes after sacubitril/valsartan initiation in routine ...
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Journal ArticleTher Innov Regul Sci · November 2020
In late 2018, the Food and Drug Administration (FDA) outlined a framework for evaluating the possible use of real-world evidence (RWE) to support regulatory decision-making. This framework was created to facilitate studies that would generate high-quality ...
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Journal ArticleJACC Heart Fail · November 2020
OBJECTIVES: The purpose of this study was to examine the treatment effect of vericiguat in relation to N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels at randomization. BACKGROUND: Vericiguat compared with placebo reduced the primary outcome o ...
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Journal ArticleJAMA · October 20, 2020
IMPORTANCE: Patients with heart failure and preserved ejection fraction (HFpEF) are at high risk of mortality, hospitalizations, and reduced functional capacity and quality of life. OBJECTIVE: To assess the efficacy of the oral soluble guanylate cyclase st ...
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Journal ArticleJACC Heart Fail · October 2020
The PARADIGM-HF (Prospective Comparison of Angiotensin II Receptor Blocker Neprilysin Inhibitor With Angiotensin-Converting Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure) trial reported that sacubitril/valsartan (S ...
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Journal ArticleCirculation · September 22, 2020
With worsening epidemiological trends for both the incidence and prevalence of type 2 diabetes mellitus (T2DM) and heart failure (HF) worldwide, it is critical to implement optimal prevention and treatment strategies for patients with these comorbidities, ...
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Journal ArticleJACC Heart Fail · September 2020
OBJECTIVES: We hypothesized that splanchnic nerve blockade (SNB) would attenuate increased exercise-induced cardiac filling pressures in patients with chronic HF. BACKGROUND: Chronic heart failure (HF) is characterized by limited exercise capacity driven i ...
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Journal ArticleJ Am Coll Cardiol · August 4, 2020
Concerns about the external validity of traditional randomized clinical trials (RCTs), together with the widespread availability of real-world data and advanced data analytic tools, have led to claims that common sense and clinical observation, rather than ...
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ConferenceEur J Heart Fail · August 2020
AIMS: Hyperkalaemia and hypokalaemia are common in heart failure and associated with worse outcomes. However, the optimal potassium range is unknown. We sought to determine the optimal range of potassium in patients with heart failure and reduced ejection ...
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Journal ArticleJ Cardiovasc Transl Res · August 2020
Patients hospitalized for heart failure (HF) remain at high risk for early readmission. A post hoc analysis was performed of the biomarker substudy of the ASCEND-HF trial. An in-hospital congestion score was derived using orthopnea, pedal edema, and NT-pro ...
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Journal ArticleAm Heart J · August 2020
UNLABELLED: Little is known about the impact of accountable care organizations (ACO) on hospitalized heart failure (HF) patients, a high-cost and high-risk population. OBJECTIVE: We linked Medicare fee-for-service claims from 2013 to 2015 with data from Am ...
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Journal ArticleAm J Cardiol · July 1, 2020
Lipoprotein (a) [Lp(a)] is a low-density, cholesterol-containing lipoprotein that differs from other low-density lipoproteins due to the presence of apolipoprotein(a) bound to its surface apolipoprotein B100. Multiple epidemiologic studies, including Mende ...
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Journal ArticleCirc Heart Fail · July 2020
BACKGROUND: Among patients with heart failure (HF) with reduced ejection fraction (EF), improvements in left ventricular EF (LVEF) are associated with better outcomes and remain an important treatment goal. Patient factors associated with LVEF improvement ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · July 2020
The pipeline of new cardiovascular drugs is relatively limited compared with many other clinical areas. Challenges causing lagging drug innovation include the duration and expense of cardiovascular clinical trials needed for regulatory evaluation and appro ...
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Journal ArticleJAMA Netw Open · July 1, 2020
IMPORTANCE: Most people with commercial health insurance in the US have high-deductible plans, but the association of such plans with major health outcomes is unknown. OBJECTIVE: To describe the association between enrollment in high-deductible health plan ...
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Journal ArticleJ Am Heart Assoc · June 16, 2020
Background There are conflicting data regarding the benefit of primary prevention implantable cardioverter-defibrillators (ICDs) in patients with diabetes mellitus and heart failure (HF) with reduced ejection fraction. We aimed to assess the comparative ef ...
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Journal ArticleEur Heart J · June 7, 2020
The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has important implications for the safety of participants in clinical trials and the research staff caring for them and, consequen ...
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Journal ArticleAm J Cardiol · June 1, 2020
The TOPCAT trial investigated spironolactone vs placebo in patients with heart failure with preserved ejection fraction (HFpEF). Although the primary endpoint was not statistically significant, treatment with spironolactone did reduce heart failure hospita ...
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Journal ArticleJAMA Cardiol · June 1, 2020
IMPORTANCE: Little is known about the utilization rates and outcomes of implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy defibrillator (CRT-D) placement among patients with advanced heart failure (HF). OBJECTIVE: To examin ...
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Journal ArticleEur J Heart Fail · June 2020
AIMS: Non-cardiac comorbidities are highly prevalent in patients with heart failure (HF). Our objective was to define the association between non-cardiac comorbidity burden and clinical outcomes, costs of care, and length of stay within a large randomized ...
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Journal ArticleJACC Heart Fail · June 2020
OBJECTIVES: The purpose of this study was to characterize the clinical profile, treatment patterns, and clinical outcomes of patients with comorbid diabetes mellitus (DM) and heart failure with reduced ejection fraction (HFrEF) in a contemporary, real-worl ...
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Journal ArticleN Engl J Med · May 14, 2020
BACKGROUND: The effect of vericiguat, a novel oral soluble guanylate cyclase stimulator, in patients with heart failure and reduced ejection fraction who had recently been hospitalized or had received intravenous diuretic therapy is unclear. METHODS: In th ...
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Journal ArticleJ Card Fail · May 2020
BACKGROUND: Diastolic dysfunction (DD) is common and occurs at an earlier age among human immunodeficiency virus-infected (HIV+) individuals, but the mechanisms and consequences of DD among HIV+ individuals are unclear. METHODS AND RESULTS: The Characteriz ...
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Journal ArticleDiabetes Obes Metab · May 2020
AIM: To assess whether the previously developed multivariable risk prediction framework (PRE score) could predict the renal effects observed in the EXSCEL cardiovascular outcomes trial using short-term changes in cardio-renal risk markers. MATERIALS AND ME ...
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Journal ArticleJAMA Cardiol · May 1, 2020
IMPORTANCE: Determining the right dosage of aspirin for the secondary prevention treatment of atherosclerotic cardiovascular disease (ASCVD) remains an unanswered and critical question. OBJECTIVE: To report the rationale and design for a randomized clinica ...
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Journal ArticleAm Heart J · May 2020
BACKGROUND: Ivabradine is guideline-recommended to reduce heart failure (HF) hospitalization in patients with stable chronic HF with reduced ejection fraction (EF). Ivabradine initiation following acute HF has had limited evaluation, and there are few rand ...
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Journal ArticleCirc Heart Fail · May 2020
BACKGROUND: The FIGHT (Functional Impact of GLP-1 [glucagon-like peptide-1] for Heart Failure Treatment) trial randomized 300 patients with heart failure with reduced ejection fraction (HFrEF) and a recent hospitalization for heart failure to liraglutide v ...
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Journal ArticleCJC Open · May 2020
This joint Canadian Heart Failure Society and the CCS Heart Failure guidelines report has been developed to provide a pan-Canadian snapshot of the current state of clinic-based ambulatory heart failure (HF) care in Canada with specific reference to element ...
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Journal ArticleCirculation · April 28, 2020
BACKGROUND: EXSCEL (Exenatide Study of Cardiovascular Event Lowering) assessed the impact of once-weekly exenatide 2 mg versus placebo in patients with type 2 diabetes mellitus, while aiming for glycemic equipoise. Consequently, greater drop-in of open-lab ...
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Journal ArticleJ Neurosurg Anesthesiol · April 2020
BACKGROUND: Systolic dysfunction and reduction in left ventricular ejection fraction (LVEF) has been documented after traumatic brain injury (TBI). Speckle tracking is an emerging technology for myocardial strain assessment which has been utilized to ident ...
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Journal ArticleJACC. Heart failure · April 2020
ObjectivesThe purpose of this study was to evaluate the association of physical activity (PA) level and longitudinal PA trajectory with a composite heart failure hospitalization and mortality endpoint over a 5-year follow-up period following impla ...
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Journal ArticleCirc Heart Fail · April 2020
BACKGROUND: Current guidelines recommend evaluation for underlying heart disease and reversible conditions for patients with new-onset heart failure (HF). There are limited data on contemporary testing for coronary artery disease (CAD) in patients with new ...
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Journal ArticleCirc Heart Fail · April 2020
BACKGROUND: In PIONEER-HF (Comparison of Sacubitril/Valsartan Versus Enalapril on Effect on NT-pro BNP in Patients Stabilized From an Acute Heart Failure Episode), the in-hospital initiation of sacubitril/valsartan in patients hospitalized for acute decomp ...
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Journal ArticleLancet · March 21, 2020
Certain limitations of evidence available on drugs and devices at the time of market approval often persist in the post-marketing period. Often, post-marketing research landscape is fragmented. When regulatory agencies require pharmaceutical and device man ...
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Journal ArticleAm J Cardiol · March 15, 2020
Randomized data suggest lenient rate control (resting heart rate <110 beats/min) is noninferior to strict rate control (resting heart rate <80 beats/min) in patients with atrial fibrillation (AF). However, the optimal rate control strategy in patients with ...
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Journal ArticleEur Stroke J · March 2020
BACKGROUND: There are limited data on the safety of intravenous recombinant tissue plasminogen activator (rtPA) for treating acute ischemic stroke in patients with gastrointestinal malignancy or recent gastrointestinal bleeding within 21 days of their inde ...
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Journal ArticleJ Card Fail · March 2020
BACKGROUND: Although left atrial (LA) mechanical dysfunction in heart failure with preserved ejection fraction (HFpEF) is associated with poor clinical outcomes, the influence of LA myopathy on temporal changes in cardiovascular biomarkers is unclear. METH ...
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Journal ArticleDiabetes Care · March 2020
OBJECTIVE: We sought to confirm a bidirectional association between severe hypoglycemic events (SHEs) and cardiovascular (CV) event risk and to characterize individuals at dual risk. RESEARCH DESIGN AND METHODS: In a post hoc analysis of 14,752 Exenatide S ...
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Journal ArticleContemp Clin Trials Commun · March 2020
Stakeholders in the clinical research enterprise are aligned around the need to make clinical research in general, and randomized controlled trials in particular, more meaningful and efficient. To that end, we have built distributed research networks (DRNs ...
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Journal ArticleJ Card Fail · March 2020
BACKGROUND: Patients with heart failure with preserved ejection fraction (HFpEF) and chronic kidney disease (CKD) represent a high-risk phenotype. The Phosphodiesterase-5 Inhibition to Improve Clinical Status and Exercise Capacity in Heart Failure with Pre ...
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Journal ArticleJAMA Netw Open · February 5, 2020
IMPORTANCE: The ability to accurately predict in-hospital mortality for patients at the time of admission could improve clinical and operational decision-making and outcomes. Few of the machine learning models that have been developed to predict in-hospita ...
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Journal ArticleJ Thromb Thrombolysis · February 2020
Acutely ill medical patients with cancer are at increased risk of venous thromboembolism (VTE). Thromboprophylaxis is recommended in the presence of cancer, but its safety is not known. The aim of this study was to assess the efficacy and safety of extende ...
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Journal ArticleESC Heart Fail · February 2020
AIMS: Sodium-glucose co-transporter (SGLT)-2 inhibitors have been shown to reduce the risk of cardiovascular death and heart failure (HF) hospitalization in patients with type 2 diabetes mellitus (DM) and high cardiovascular risk in two large clinical outc ...
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Journal ArticleAm Heart J · February 2020
Many therapies have been shown to improve outcomes for patients with heart failure (HF) in controlled settings, but there are limited data available to inform best practices for hospital and post-discharge quality improvement initiatives. The CONNECT-HF st ...
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Journal ArticleDiabetes Care · February 2020
OBJECTIVE: To evaluate the impact of once-weekly exenatide (EQW) on microvascular and cardiovascular (CV) outcomes by baseline renal function in the Exenatide Study of Cardiovascular Event Lowering (EXSCEL). RESEARCH DESIGN AND METHODS: Least squares mean ...
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Journal ArticleAm Heart J · February 2020
BACKGROUND: Cardiorespiratory fitness (CRF) is closely linked to health status and clinical outcomes in heart failure (HF) patients. We aimed to test whether biomarkers can reflect CRF and its change over time. METHODS: This post hoc analysis used data fro ...
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Journal ArticleDiabetes Care · February 2020
OBJECTIVE: To compare medical resource use, costs, and health utilities for 14,752 patients with type 2 diabetes who were randomized to once-weekly exenatide (EQW) or placebo in addition to usual diabetes care in the Exenatide Study of Cardiovascular Event ...
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Journal ArticleCan J Cardiol · February 2020
In this update, we focus on selected topics of high clinical relevance for health care providers who treat patients with heart failure (HF), on the basis of clinical trials published after 2017. Our objective was to review the evidence, and provide recomme ...
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Journal ArticleRes Pract Thromb Haemost · February 2020
BACKGROUND: The identification of acutely ill patients at high risk for venous thromboembolism (VTE) may be determined clinically or by use of integer-based scoring systems. These scores demonstrated modest performance in external data sets. OBJECTIVES: To ...
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Journal ArticleJ Am Heart Assoc · January 7, 2020
Background We aimed to determine if there is an association between hospital quality and the likelihood of a given hospital being a preferred transfer destination for stroke patients. Methods and Results Data from Medicare claims identified acute ischemic ...
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Journal ArticleContemp Clin Trials · January 2020
Individual-level baseline covariate imbalance could happen more frequently in cluster randomized trials, and may influence the observed treatment effect. Using computer and real-data simulations, this paper quantifies the extent and impact of covariate imb ...
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Journal ArticleJACC Heart Fail · January 2020
BACKGROUND: In heart failure with reduced ejection fraction (HFrEF), elevated soluble neprilysin (sNEP) levels are associated with an increased risk of cardiovascular death, and its inhibition with sacubitril/valsartan has improved survival. OBJECTIVES: Th ...
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Journal ArticleJACC Heart Fail · January 2020
The mandatory federal pay-for-performance Hospital Readmissions Reduction Program (HRRP) was created to decrease 30-day hospital readmissions by instituting accountability and stimulating quality care and coordination, particularly during care transitions. ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · January 2020
Background Guidelines recommend against the use of intravenous tPA (tissue-type plasminogen activator; IV tPA) in acute ischemic stroke patients with prior ischemic stroke within 3 months. However, there are limited data on the safety of IV tPA in this pop ...
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Journal ArticleNPJ Digit Med · 2020
The Project Baseline Health Study (PBHS) was launched to map human health through a comprehensive understanding of both the health of an individual and how it relates to the broader population. The study will contribute to the creation of a biomedical info ...
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Journal ArticleJ Am Heart Assoc · December 17, 2019
Background Limited data exist to guide treatment for patients with heart failure with preserved ejection fraction and atrial fibrillation, including the important decision regarding rate versus rhythm control. Methods and Results We analyzed the Get With T ...
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Journal ArticleCirculation · December 17, 2019
Following regulatory guidance set forth in 2008 by the US Food and Drug Administration for new drugs for type 2 diabetes mellitus, many large randomized, controlled trials have been conducted with the primary goal of assessing the safety of antihyperglycem ...
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Journal ArticleAm J Cardiol · December 15, 2019
Underuse of hydralazine/nitrate (HYD/NIT) in black patients with heart failure and reduced ejection fraction (HFrEF) has been previously described, but whether this important treatment gap persists in contemporary practice is unknown. Sacubitril/valsartan ...
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Journal ArticleJ Thromb Haemost · December 2019
BACKGROUND: Extended-duration thromboprophylaxis with betrixaban reduces the risk of venous thromboembolism (VTE) without increasing major bleeding rates in acutely ill medical patients as compared to standard duration enoxaparin. We aimed to assess the ri ...
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Journal ArticleCirc Cardiovasc Interv · December 2019
BACKGROUND: Recent trials have identified anti-diabetes mellitus agents that lower major adverse cardiovascular event (MACE) rates, although some increase rates of lower-extremity amputation (LEA). Patients with peripheral artery disease (PAD) have greater ...
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Journal ArticleEur J Heart Fail · December 2019
AIM: Describe the distinguishing features of heart failure (HF) patients with reduced ejection fraction (HFrEF) in the VICTORIA (Vericiguat Global Study in Patients with Heart Failure with Reduced Ejection Fraction) trial. METHODS AND RESULTS: Key backgrou ...
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Journal ArticleCirculation · November 12, 2019
BACKGROUND: Once-weekly exenatide (EQW) had a neutral effect on hospitalization for heart failure (HHF) in the EXSCEL study (Exenatide Study of Cardiovascular Event Lowering), with no differential treatment effect on major adverse cardiac events by baselin ...
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Journal ArticleEur J Heart Fail · November 2019
AIMS: Neladenoson bialanate is a partial adenosine A1 receptor agonist with demonstrated beneficial effects on cardiac function in animal models. We aimed to assess the dose-response effect of neladenoson bialanate on cardiac structure and function, clinic ...
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Journal ArticleJACC Heart Fail · November 2019
OBJECTIVES: This study sought to determine the degree to which U.S. patients enrolled in a heart failure (HF) trial represent patients in routine U.S. clinical practice according to race and sex. BACKGROUND: Black patients and women are frequently under-re ...
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Journal ArticleJACC Heart Fail · November 2019
The adoption of mobile health (mHealth) devices is creating a unique opportunity to improve heart failure (HF) care. The rise of mHealth is driven by multiple factors including consumerism, policy changes in health care, and innovations in technology. Wear ...
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Journal ArticleCardiovasc Diabetol · October 22, 2019
BACKGROUND: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) improve cardiovascular and renal outcomes in patients with type 2 diabetes through distinct mechanisms. However, evidence on clinical ou ...
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Journal ArticleJAMA Neurol · October 1, 2019
IMPORTANCE: Current guidelines recommend direct oral anticoagulants (DOACs) over warfarin for stroke prevention in patients with atrial fibrillation (AF) who are at high risk. Despite demonstrated efficacy in clinical trials, real-world data of DOACs vs wa ...
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Journal ArticleCirculation · September 24, 2019
Aspirin is the cornerstone of the antithrombotic management of patients with established atherosclerotic cardiovascular disease, but major guidelines provide conflicting recommendations for its use in primary prevention. Findings from recent randomized tri ...
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Journal ArticleJ Card Fail · September 2019
BACKGROUND: Amino-terminal pro-B-type natriuretic peptide (NTproBNP) is closely associated with prognosis in acute decompensated heart failure (ADHF). As a result, there has been great interest measuring it during the course of treatment. The prognostic im ...
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Journal ArticleCan J Cardiol · September 2019
BACKGROUND: Acute heart failure (HF) patients with renal insufficiency and risk factors for diuretic resistance may be most likely to derive incremental improvement in congestion with the addition of spironolactone. METHODS: The Aldosterone Targeted Neuroh ...
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Journal ArticleAm J Cardiol · August 15, 2019
Congestion is associated with adverse outcomes in heart failure (HF) patients. We characterized congestion in patients hospitalized for HF and examined the association between congestion severity at admission and postdischarge outcomes. Using the OPTIMIZE- ...
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Journal ArticleJ Am Heart Assoc · August 6, 2019
Background Intravenous recombinant tissue-type plasminogen activator (rtPA) remains the only medical therapy to improve outcomes for acute ischemic stroke (AIS), but the safety of rtPA in AIS patients with a history of recent myocardial infarction (MI) rem ...
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Journal ArticleClin Trials · August 2019
While conducting a set of large-scale multi-site pragmatic clinical trials involving high-impact public health issues such as end-stage renal disease, opioid use, and colorectal cancer, there were substantial changes to both policies and guidelines relevan ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · August 2019
BACKGROUND: The necessity for rapid evaluation and treatment of acute ischemic stroke with intravenous tPA (tissue-type plasminogen activator) may increase the risk of administrating tPA to patients presenting with noncerebrovascular conditions that closel ...
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Journal ArticleJACC Heart Fail · July 2019
OBJECTIVES: The aim of this study was to use a multicenter, observational outpatient registry of patients with heart failure with reduced ejection fraction (HFrEF) to describe the association between changes in patients' medications with changes in health ...
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Journal ArticleClin Trials · June 2019
BACKGROUND/AIMS: Obtaining ethical approval from multiple institutional review boards is a long-standing challenge to multi-site clinical trials and often leads to significant delays in study activation and enrollment. As of 25 January 2018, the National I ...
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Journal ArticleAm Heart J · June 2019
UNLABELLED: Heart failure (HF) outcomes are especially poor in high-risk patients with certain comorbidities including diabetes mellitus (DM), chronic kidney disease (CKD), and chronic obstructive pulmonary disease (COPD). Whether early specialty or primar ...
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Journal ArticleDiabetes Care · June 2019
OBJECTIVE: Increases in serum calcitonin, a tumor marker for medullary thyroid carcinoma (MTC), have been associated with glucagon-like peptide 1 receptor agonist use in some preclinical studies. We report calcitonin changes in exenatide-treated and placeb ...
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Journal ArticleStroke · June 2019
Background and Purpose- Acute ischemic stroke patients with history of prior ischemic stroke plus concomitant diabetes mellitus (DM) were excluded from the ECASS III trial (European Cooperative Acute Stroke Study) because of safety concerns. However, there ...
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Journal ArticleJ Am Coll Cardiol · May 21, 2019
BACKGROUND: Guidelines recommend that patients with heart failure with reduced ejection fraction (HFrEF) have medical therapy titrated to target doses derived from clinical trials, as tolerated. The degree to which titration occurs in contemporary U.S. pra ...
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Journal ArticleInt J Environ Res Public Health · May 10, 2019
African Americans, other minorities and underserved populations are consistently under- represented in clinical trials. Such underrepresentation results in a gap in the evidence base, and health disparities. The ABC Cardiovascular Implementation Study (CVI ...
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Journal ArticleJ Am Heart Assoc · May 7, 2019
Background PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors effectively lower LDL (low-density lipoprotein) cholesterol and have been shown to reduce cardiovascular outcomes in high-risk patients. We used real-world electronic health record ...
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Journal ArticleAm Heart J · May 2019
BACKGROUND: Diabetes mellitus is an increasingly prevalent condition among heart failure (HF) patients. The long-term morbidity and mortality among patients with and without diabetes with HF with reduced (HFrEF), borderline (HFbEF), and preserved ejection ...
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Journal ArticleJAMA Cardiol · May 1, 2019
IMPORTANCE: Over the past decade, reducing 30-day readmission rates has been emphasized in the United States (including via the implementation of the Hospital Readmissions Reduction Program) but not Canada. OBJECTIVE: To examine changes that occurred from ...
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Journal ArticleCirc Heart Fail · May 2019
Background The VITALITY-HFpEF trial (Evaluate the Efficacy and Safety of the Oral sGC Stimulator Vericiguat to Improve Physical Functioning in Daily Living Activities of Patients With Heart Failure and Preserved Ejection Fraction) is designed to determine ...
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Journal ArticleJ Cardiovasc Med (Hagerstown) · April 2019
BACKGROUND: The IRONOUT-HF trial previously demonstrated that oral iron supplementation minimally increased iron stores and did not improve exercise capacity in patients with heart failure with a reduced ejection fraction (HFrEF) and iron deficiency. METHO ...
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Journal ArticleJACC Heart Fail · April 2019
OBJECTIVES: This study sought to determine the rate of use of target doses of foundational guideline-directed medical therapy (GDMT) in a contemporary cohort of patients with heart failure with reduced ejection fraction (HFrEF) across systolic blood pressu ...
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Journal ArticleIntensive Care Med · April 2019
PURPOSE: To assess the efficacy and safety of betrixaban for venous thromboembolism (VTE) prophylaxis among critically ill patients. METHODS: The APEX trial randomized 7513 acutely ill hospitalized patients to betrixaban for 35-42 days or enoxaparin for 10 ...
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Journal ArticleLancet · March 9, 2019
Heart failure is the most common cardiovascular reason for hospital admission for people older than 60 years of age. Few areas in medicine have progressed as remarkably as heart failure treatment over the past three decades. However, progress has been cons ...
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Journal ArticleHeart · March 2019
OBJECTIVE: To estimate the direction and magnitude of effect and quality of evidence for hospital-based heart failure (HF) quality improvement interventions on process of care measures and clinical outcomes among patients with acute HF. REVIEW METHODS: We ...
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Journal ArticleAm J Cardiol · February 15, 2019
Glycated hemoglobin (HbA1C) is a risk factor for new onset heart failure (HF). There is however a paucity of data evaluating its association with outcomes in patients with established HF. We assessed the relation of HbA1C with outcomes among hospitalized H ...
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Journal ArticleJ Am Coll Cardiol · February 12, 2019
Heart failure with preserved ejection fraction (HFpEF) is now the most common form of HF, affecting over 3 million adults in the United States alone. HFpEF is a heterogenous syndrome. One important phenotype may be related to comorbid conditions, including ...
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Journal ArticleJ Am Heart Assoc · February 5, 2019
Background The angiotensin-receptor/neprilysin inhibitor ( ARNI ) sacubitril/valsartan reduces hospitalization and mortality for patients with heart failure with reduced ejection fraction. However, adoption of ARNI into clinical practice has been slow. Fac ...
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Journal ArticleJ Stroke Cerebrovasc Dis · February 2019
BACKGROUND: Little is known about how hospitals are connected in the transfer of ischemic stroke (IS) patients. We aimed to describe differences in characteristics of transferred versus nontransferred patients and between transferring and receiving hospita ...
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Journal ArticleDiabetes Care · February 2019
OBJECTIVE: The sodium-glucose cotransporter 2 inhibitors (SGLT2i) empagliflozin and canagliflozin reduce the incidence of major adverse cardiovascular events (MACE), all-cause mortality (ACM), and renal events in cardiovascular outcomes trials, with observ ...
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Journal ArticleClin Cardiol · February 2019
BACKGROUND: When used in appropriately selected heart failure (HF) patients, cardiac resynchronization therapy (CRT) reduces mortality and hospitalization. It is not understood whether CRT implantation during hospitalization for HF is associated with simil ...
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Journal ArticleJ Am Coll Cardiol · January 22, 2019
BACKGROUND: Circulating high-density lipoprotein particle (HDL-P) subfractions impact atherogenesis, inflammation, and endothelial function, all of which are implicated in the pathobiology of heart failure (HF). OBJECTIVES: The authors sought to identify k ...
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Journal ArticleAm J Hematol · January 2019
Hypoalbuminemia is a common finding and independent predictor for unfavorable prognosis. The prognostic value of albumin measurement for short-term VTE prediction in hospitalized patients remains unclear. In the APEX trial (ClinicalTrials.gov identifier: N ...
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Journal ArticleJACC Heart Fail · January 2019
OBJECTIVES: This study sought to characterize the course of decongestion among patients hospitalized for acute heart failure (AHF) by history of atrial fibrillation (AF) and/or atrial flutter (AFL). BACKGROUND: AF/AFL and chronic heart failure (HF) commonl ...
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Journal ArticleCirc Heart Fail · January 2019
BACKGROUND: Hospitalizations for acute heart failure (HF) are significant events with downstream implications for patients, as well as healthcare systems and payers. However, from anecdotal experience, both hospitalization and postdischarge courses vary si ...
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Journal ArticlePLoS One · 2019
BACKGROUND: Cluster-randomized trials (CRTs) are being increasingly used to test a range of interventions, including medical interventions commonly used in clinical practice. Policies created by the NIH and the Food and Drug Administration (FDA) require th ...
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Journal ArticleClin Appl Thromb Hemost · 2019
Major medical illnesses place patients at risk of venous thromboembolism (VTE). Some risk factors including age ≥75 years or history of cancer place them at increased risk of VTE that extends for at least 5 to 6 weeks following hospital admission. Betrixab ...
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Journal ArticlePLoS One · 2019
BACKGROUND: Data from randomized controlled trials and observational studies on older adults who take statins for primary prevention of atherosclerotic cardiovascular disease are limited. To determine the incidence of statin use in older adults with and wi ...
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ConferenceJ Am Heart Assoc · December 18, 2018
Background We sought to study the prevalence of high-sensitivity troponin and its association with cardiac structure and outcomes in ambulatory and hospitalized patients with heart failure with a preserved ejection fraction ( HF p EF ). Methods and Results ...
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Journal ArticleCirculation · December 11, 2018
BACKGROUND: Landmark studies have demonstrated the safety and efficacy of implantable cardioverter-defibrillators (ICDs) in selected stable ambulatory patients with heart failure (HF) with a reduced ejection fraction receiving optimal medical therapy. It i ...
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ConferenceESC Heart Fail · December 2018
AIMS: Obesity is present in up to 45% of patients with heart failure (HF). Liraglutide, a glucagon-like peptide-1 (GLP-1) receptor antagonist, facilitates weight loss in obese patients. The efficacy of liraglutide as a weight loss agent among patients with ...
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Journal ArticleThromb Haemost · December 2018
AIM: Asymptomatic deep vein thrombosis (DVT) diagnosed with compression ultrasound (CUS) is a common endpoint in trials assessing the efficacy of anticoagulants to prevent venous thromboembolism (VTE), but the relationship of asymptomatic thrombus to mort ...
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Journal ArticleStroke · December 2018
Background and Purpose- Kidney dysfunction is common among patients hospitalized for ischemic stroke. Understanding the association of kidney disease with poststroke outcomes is important to properly adjust for case mix in outcome studies, payment models a ...
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Journal ArticleJ Clin Transl Sci · December 2018
Healthcare institutions may often prohibit "cold-calling" or direct contact with a potential research participant when the person initiating contact is unknown to the patient. This policy aims to maintain patient privacy, but may have unintended consequenc ...
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Journal ArticleJAMA · November 6, 2018
IMPORTANCE: There are few effective treatments for heart failure with preserved ejection fraction (HFpEF). Short-term administration of inorganic nitrite or nitrate preparations has been shown to enhance nitric oxide signaling, which may improve aerobic ca ...
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Journal ArticleAm J Cardiol · November 1, 2018
We aimed to study whether jugular venous distension (JVD) and peripheral edema were associated with worse outcomes in patients with acute heart failure in the Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure trial. Of 7,14 ...
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Journal ArticleEur J Heart Fail · November 2018
Despite major advances in the treatment of chronic heart failure (HF) with reduced ejection fraction (HFrEF), morbidity and mortality associated with the condition remain high, suggesting the need for additional treatment options, particularly haemodynamic ...
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Journal ArticleLancet · October 27, 2018
BACKGROUND: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine t ...
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Journal ArticleJ Am Heart Assoc · October 16, 2018
Background Adherence to evidence-based guidelines is an important quality indicator; yet, there is lack of assessment of adherence to performance measures in acute ischemic stroke for most world regions. Methods and Results We analyzed 19 604 patients with ...
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Journal ArticleJ Am Heart Assoc · October 2, 2018
Background In the EXSCEL (Exenatide Study of Cardiovascular Event Lowering), exenatide once-weekly resulted in a nonsignificant reduction in major adverse cardiovascular events ( MACEs ) and a nominal 14% reduction in all-cause mortality in 14 752 patients ...
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Journal ArticleJACC Heart Fail · October 2018
OBJECTIVES: This study sought to evaluate and contribute to the limited data on U.S. hospital practice patterns with respect to respiratory vaccination in patients hospitalized with heart failure (HF). BACKGROUND: Respiratory infection is a major driver of ...
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Journal ArticleJAMA Cardiol · October 1, 2018
IMPORTANCE: While 1 in 10 older patients hospitalized with heart failure (HF) die within 30 days, end-of-life care for this population is not well described. OBJECTIVE: To assess rates of discharge to hospice, readmission after hospice, and survival in hos ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · October 2018
BACKGROUND: Globalization of clinical trials fosters inclusion of higher and lower income countries, but the influence of enrolling country income level on heart failure trial performance is unclear. This study sought to evaluate associations between enrol ...
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Journal ArticleAm Heart J · September 2018
BACKGROUND: Albiglutide is a long-acting glucagon-like peptide-1 receptor agonist that improves glycemic control in patients with type 2 diabetes mellitus (T2DM). Harmony Outcomes is a randomized, double-blind, placebo-controlled trial of the effect of alb ...
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Journal ArticleClin Cardiol · September 2018
Heart failure (HF) and type 2 diabetes mellitus (T2DM) are two global pandemics, affecting over 25 and 420 million people, respectively. The prevalence of comorbid HF and T2DM is rising, and the prognosis remains poor. One central area of overlap of these ...
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Journal ArticleStroke · September 2018
Background and Purpose- Although there are no trials or large cohorts to inform clinical care, current guidelines caution against giving intravenous tPA (tissue-type plasminogen activator) to patients with acute ischemic stroke who are taking non-vitamin K ...
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Journal ArticleCirc Heart Fail · September 2018
Background Current guidelines recommend sacubitril/valsartan for patients with heart failure with reduced ejection fraction, but the rate of adoption in the United States has been slow. Methods and Results Using data from CHAMP-HF (Change the Management of ...
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Journal ArticleAm J Med · August 2018
BACKGROUND: Anemia is a common finding and independent predictor for adverse outcomes in hospitalized patients with medical illness. It remains unclear whether anemia is a risk factor for venous thromboembolism and whether the presence of anemia can refine ...
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Journal ArticleAm Heart J · August 2018
Electronic health records (EHRs) can be a major tool in the quest to decrease costs and timelines of clinical trial research, generate better evidence for clinical decision making, and advance health care. Over the past decade, EHRs have increasingly offer ...
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Journal ArticleAm Heart J · August 2018
BACKGROUND: Influenza leads to significant cardiopulmonary morbidity and mortality-particularly in patients with cardiovascular disease-that may be prevented with a standard influenza vaccine. However, patients with cardiovascular conditions have a reduced ...
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Journal ArticleJ Card Fail · August 2018
BACKGROUND: Circulating cardiac troponin levels (cTn), representative of myocardial injury, are commonly elevated in heart failure (HF) and related to adverse clinical events. However, whether cTn represents a spectrum of risk in HF is unclear. METHODS: Ba ...
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Journal ArticleCatheter Cardiovasc Interv · August 1, 2018
The stimulus to create this document was the recognition that ionizing radiation-guided cardiovascular procedures are being performed with increasing frequency, leading to greater patient radiation exposure and, potentially, to greater exposure for clinica ...
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Journal ArticleCatheter Cardiovasc Interv · August 1, 2018
The stimulus to create this document was the recognition that ionizing radiation-guided cardiovascular procedures are being performed with increasing frequency, leading to greater patient radiation exposure and, potentially, to greater exposure to clinical ...
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Journal ArticleJ Am Coll Cardiol · July 24, 2018
BACKGROUND: Guidelines strongly recommend patients with heart failure with reduced ejection fraction (HFrEF) be treated with multiple medications proven to improve clinical outcomes, as tolerated. The degree to which gaps in medication use and dosing persi ...
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Journal ArticleEur Heart J · July 1, 2018
AIMS: There is a paucity of data on the influence of diabetes on long-term outcomes after ischaemic stroke (IS). We assessed whether outcomes after IS differ between patients with and without diabetes. METHODS AND RESULTS: Patients aged ≥65 years (n = 409 ...
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Journal ArticleJ Card Fail · July 2018
BACKGROUND: Poor response to loop diuretic therapy is a marker of risk during heart failure hospitalization. We sought to describe baseline determinants of diuretic response and to further explore the relationship between this response and clinical outcome ...
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Journal ArticleClin Cardiol · July 2018
BACKGROUND: Heart rate and systolic blood pressure (SBP) are prognostic markers in heart failure (HF) with reduced ejection fraction (HFrEF). Their combination in rate pressure product (RPP) as well as their role in heart failure with preserved ejection fr ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · July 2018
BACKGROUND: Heart failure (HF) is the leading cause of morbidity and mortality in the United States. Despite advancement in the management of HF, outcomes remain suboptimal, particularly among the uninsured. In 2014, the Affordable Care Act expanded Medica ...
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ConferenceDiabetes · July 1, 2018
SGLT2i, empagliflozin and canagliflozin, have been shown to reduce the incidence of major adverse CV events (MACE), all-cause mortality (ACM) and renal events in CV outcomes trials (CVOTs), with robust real-world evidence (RWE) suggesting class eff ...
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ConferenceDiabetes · July 1, 2018
Background: EXSCEL was a multinational, randomized, blinded, placebo-controlled, pragmatic CV outcome trial of once-weekly exenatide on the background of usual care. We report exenatide’s impact on estimated glomerular filtration rate (eGFR), new m ...
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ConferenceDiabetes · July 1, 2018
Objectives: To evaluate the effect of exenatide 2mg once-weekly vs. placebo in addition to usual care on medical resource use among 14,572 patients with type 2 diabetes enrolled in the Exenatide Study of Cardiovascular Event Lowering (EXSCEL), whic ...
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Journal ArticleJ Am Coll Cardiol · June 12, 2018
BACKGROUND: Surveys of patients with cardiovascular disease have suggested that "home-time"-being alive and out of any health care institution-is a prioritized outcome. This novel measure has not been studied among patients with heart failure (HF). OBJECTI ...
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Journal ArticleJ Am Heart Assoc · June 12, 2018
BACKGROUND: The US Food and Drug Administration approved sacubitril/valsartan for patients with chronic heart failure (HF) with reduced ejection fraction in 2015 on the basis of the results of the PARADIGM-HF (Prospective Comparison of ARNI [Angiotensin Re ...
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Journal ArticleAm J Transplant · June 2018
Changes in heart transplantation (HT) donor and recipient demographics may influence the incidence of primary graft dysfunction (PGD). We conducted a retrospective study to evaluate PGD incidence, trends, and associated risk factors by analyzing consecutiv ...
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Journal ArticleAm Heart J · June 2018
BACKGROUND: Medicare utilizes 30-day risk-standardized readmission rates (RSRR) as a measure of hospital quality and applies penalties based on this measure. The objective of this study was to identify the relationship between hospital performance on 30-da ...
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Journal ArticleClin Cardiol · June 2018
BACKGROUND: Sex-based differences in acute coronary syndrome (ACS) mortality may attenuate with age due to better symptom recognition and prompt care. HYPOTHESIS: Age is a modifier of temporal trends in sex-based differences in ACS care. METHODS: Among 104 ...
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Journal ArticleJAMA Cardiol · June 1, 2018
IMPORTANCE: Among patients hospitalized with heart failure (HF), the long-term clinical implications of hospitalization at hospitals based on 30-day risk-standardized mortality rates (RSMRs) is not known. OBJECTIVE: To evaluate the association of hospital- ...
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Journal ArticleAm Heart J · June 2018
BACKGROUND: On May 20, 2016, US professional organizations in cardiology published joint treatment guidelines recommending the use of angiotensin-receptor neprilysin inhibitor (ARNI) for eligible patients with heart failure with reduced ejection fraction ( ...
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Journal ArticleCirc Heart Fail · June 2018
BACKGROUND: The increase in medical complexity among patients hospitalized with heart failure (HF) may be reflected by an increase in concomitant noncardiovascular comorbidities. Among patients hospitalized with HF, the temporal trends in the prevalence of ...
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Journal ArticleJACC Heart Fail · June 2018
OBJECTIVES: This study sought to describe the health status of outpatients with heart failure and reduced ejection fraction (HFrEF) by sex, race/ethnicity, and socioeconomic status (SES). BACKGROUND: Although a primary goal in treating patients with HFrEF ...
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Journal ArticleCirculation · May 8, 2018
BACKGROUND: Worsening renal function (WRF) in the setting of aggressive diuresis for acute heart failure treatment may reflect renal tubular injury or simply indicate a hemodynamic or functional change in glomerular filtration. Well-validated tubular injur ...
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Journal ArticleAm Heart J · May 2018
BACKGROUND: Deaths from drug intoxication have increased in the United States but outcomes of recipients of orthotopic heart transplantation (OHT) from these donors are not well characterized. METHODS: We performed a retrospective analysis of the United Ne ...
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Journal ArticleJACC Heart Fail · May 2018
OBJECTIVES: The purpose of this study was to analyze cumulative Medicare expenditures at index admission and after discharge by race or ethnicity. BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a growing proportion of heart failure ( ...
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Journal ArticleCirculation · April 17, 2018
BACKGROUND: Hospital volume is frequently used as a structural metric for assessing quality of care, but its utility in patients admitted with acute heart failure (HF) is not well characterized. Accordingly, we sought to determine the relationship between ...
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Journal ArticleAm Heart J · April 2018
BACKGROUND: Heart failure with preserved ejection fraction may be associated with chronotropic incompetence, but little is known about the incidence and prevalence of permanent pacemaker use in this population or factors associated with its use. METHODS: W ...
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Journal ArticleAm Heart J · April 2018
BACKGROUND: Approximately 15%-30% of patients in trials of medical thromboprophylaxis will have missing compression ultrasound (CUS) data. The goal of the present analysis was to perform analyses to minimize missing data. METHODS: The APEX trial randomized ...
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Journal ArticleJ Card Fail · April 2018
Antiretroviral therapy (ART) has been associated with a shift in the epidemiology of human immunodeficiency virus (HIV)-associated cardiomyopathy from a phenotype of primarily left ventricular (LV) systolic dysfunction to LV diastolic dysfunction (DD). Pat ...
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Journal ArticleAm Heart J · April 2018
OBJECTIVE: The objective is to assess the safety, tolerability, and efficacy of sacubitril/valsartan compared with enalapril in patients with heart failure (HF) with a reduced ejection fraction (EF) stabilized during hospitalization for acute decompensated ...
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Journal ArticleJACC Heart Fail · April 2018
OBJECTIVES: As the largest acute heart failure (AHF) trial conducted to date, the global ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure) trial database presented an opportunity to systematically describe the r ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · April 2018
BACKGROUND: Although a key treatment goal for patients with heart failure with reduced ejection fraction is to optimize their health status (their symptoms, function, and quality of life), the variability across outpatient practices in achieving this goal ...
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Journal ArticleJ Am Heart Assoc · April 1, 2018
BACKGROUND: Medication adherence improves outcomes for patients with heart failure, but adherence rates remain low. We examined the association between earlier postdischarge follow-up and medication adherence. METHODS AND RESULTS: We performed a retrospect ...
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Journal ArticleCirc Heart Fail · April 2018
BACKGROUND: Early ambulation (EA) is associated with improved outcomes for mechanically ventilated and stroke patients. Whether the same association exists for patients hospitalized with acute heart failure is unknown. We sought to determine whether EA amo ...
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Journal ArticleJ Am Heart Assoc · March 30, 2018
BACKGROUND: Adoption of electronic health record (EHR) systems has increased significantly across the nation. Whether EHR use has translated into improved quality of care and outcomes in heart failure (HF) is not well studied. METHODS AND RESULTS: We exami ...
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ConferenceEur J Heart Fail · March 2018
AIMS: The incidence of and factors associated with sudden cardiac death (SCD) early after an acute heart failure (HF) hospital admission have not been well defined. METHODS AND RESULTS: We assessed SCD and ventricular arrhythmias in the Acute Study of Clin ...
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Journal ArticleJ Hosp Med · March 2018
BACKGROUND: The Centers for Medicare & Medicaid Services rewards hospitals that have low 30-day riskstandardized mortality rates (RSMR) for heart failure (HF). OBJECTIVE: To describe the use of early comfort care for patients with HF, and whether hospitals ...
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Journal ArticleJAMA · February 6, 2018
IMPORTANCE: Although non-vitamin K antagonist oral anticoagulants (NOACs) are increasingly used to prevent thromboembolic disease, there are limited data on NOAC-related intracerebral hemorrhage (ICH). OBJECTIVE: To assess the association between preceding ...
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Journal ArticleJ Am Heart Assoc · February 3, 2018
BACKGROUND: Higher body mass index (BMI) is associated with lower circulating levels of N-terminal-pro-b-type natriuretic peptide (NT-proBNP). The Interaction between BMI and NT-proBNP with respect to clinical outcomes is not well characterized in patients ...
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Journal ArticleJACC Heart Fail · February 2018
This trial sought to evaluate whether vericiguat, a novel oral soluble guanylate cyclase (sGC) stimulator, was superior to placebo, on a background of standard of care, in increasing the time to the first occurrence of the composite endpoints of cardiovasc ...
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Journal ArticleEur J Heart Fail · February 2018
AIMS: Patients hospitalized for heart failure (HF) are at high risk for 30-day readmission. This study sought to examine the timings and causes of readmission within 30 days of an HF hospitalization. METHODS AND RESULTS: Timing and cause of readmission in ...
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Journal ArticleLancet Diabetes Endocrinol · February 2018
BACKGROUND: Glucagon-like peptide-1 (GLP-1) receptor agonists are effective glucose-lowering drugs. Findings from cardiovascular outcome trials showed cardiovascular safety of GLP-1 receptor agonists, but results for cardiovascular efficacy were varied. We ...
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Journal ArticleJ Am Heart Assoc · January 31, 2018
BACKGROUND: Lower care quality and an increase in adverse outcomes as a result of new medical trainees is a concept well rooted in popular belief, termed the "July phenomenon." Whether this phenomenon occurs in acute ischemic stroke has not been well studi ...
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Journal ArticleASAIO J · 2018
Frailty and heart failure share common pathways with symptoms that often coexist. Assessment of frailty may inform patient selection for left ventricular assist device (LVAD) therapy. Using Interagency Registry for Mechanically Assisted Circulatory Support ...
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Journal ArticleJAMA Cardiol · January 1, 2018
IMPORTANCE: Public reporting of hospitals' 30-day risk-standardized readmission rates following heart failure hospitalization and the financial penalization of hospitals with higher rates have been associated with a reduction in 30-day readmissions but hav ...
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Journal ArticleJ Thromb Thrombolysis · January 2018
UNLABELLED: Hospitalized acute medically ill patients with a history of venous thromboembolism (VTE) are at increased risk for recurrent VTE. We characterized the efficacy and safety of betrixaban for prevention of recurrent VTE in these high risk patients ...
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Journal ArticleASAIO J · 2018
Use of durable, continuous-flow left ventricular assist devices (LVADs) has expanded rapidly, although data are limited regarding optimization strategies before LVAD implantation. We examined current use of intra-aortic balloon pumps (IABPs) before LVAD im ...
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Journal ArticleJ Am Heart Assoc · December 23, 2017
BACKGROUND: Perceived risks of hyperkalemia and acute renal insufficiency may limit use of mineralocorticoid receptor antagonist (MRA) therapy in patients with heart failure, especially those with diabetes mellitus or chronic kidney disease. METHODS AND RE ...
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Journal ArticleThrombosis and haemostasis · December 2017
Background The aim of this study was to evaluate the effect of betrixaban on the occurrence of deep vein thrombosis (DVT) and also the extent of thrombus and to assess the association of baseline D-dimer with subsequent thrombus burden.
Methods In the APE ...
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Journal ArticleJ Am Coll Cardiol · November 14, 2017
BACKGROUND: Patients with heart failure (HF) have a poor prognosis and are categorized by ejection fraction (EF). OBJECTIVES: This study sought to characterize differences in outcomes in patients hospitalized with heart failure with preserved ejection frac ...
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Journal ArticleJ Am Coll Cardiol · November 7, 2017
Mitral regurgitation (MR) is a complex valve lesion that can pose significant management challenges for the cardiovascular clinician. This Expert Consensus Document emphasizes that recognition of MR should prompt an assessment of its etiology, mechanism, a ...
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Journal ArticlePharm Stat · November 2017
Competing risk methods are time-to-event analyses that account for fatal and/or nonfatal events that may potentially alter or prevent a subject from experiencing the primary endpoint. Competing risk methods may provide a more accurate and less biased estim ...
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Journal ArticleJ Thromb Thrombolysis · November 2017
BACKGROUND: Among patients hospitalized with acute heart failure (HF), the prognostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in short-term stroke prediction remains unclear. METHODS: In the APEX trial, 7513 patients hospitalized for ...
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Journal ArticleCan J Cardiol · November 2017
Since the inception of the Canadian Cardiovascular Society heart failure (HF) guidelines in 2006, much has changed in the care for patients with HF. Over the past decade, the HF Guidelines Committee has published regular updates. However, because of the ma ...
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Journal ArticleJ Thromb Haemost · October 2017
UNLABELLED: Essentials Anticoagulants prevent venous thromboembolism but may be associated with greater bleeding risks. Bivariate analysis assumes a non-linear relationship between efficacy and safety outcomes. Extended full-dose betrixaban is favorable ov ...
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Journal ArticleN Engl J Med · September 28, 2017
BACKGROUND: The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. METHODS: We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, ...
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Journal ArticleBMC Med Res Methodol · September 18, 2017
BACKGROUND: The clinical research enterprise is not producing the evidence decision makers arguably need in a timely and cost effective manner; research currently involves the use of labor-intensive parallel systems that are separate from clinical care. Th ...
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Journal ArticleJ Am Coll Cardiol · September 5, 2017
Advances in medicine have changed how patients experience the end of life. With longer life spans, there has also been an increase in years lived with disability. The clustering of illnesses in the last years of life is particularly pronounced in patients ...
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Journal ArticleJAMA Cardiol · September 1, 2017
IMPORTANCE: Persistent congestion is associated with worse outcomes in acute heart failure (AHF). Mineralocorticoid receptor antagonists administered at high doses may relieve congestion, overcome diuretic resistance, and mitigate the effects of adverse ne ...
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Journal ArticleEpidemiology · September 2017
BACKGROUND: The Jackson Heart Study (JHS) assesses cardiovascular disease risk factors among African Americans in Jackson, Mississippi. Whether characteristics of JHS participants differ from those of a broader African American population are unknown. METH ...
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Journal ArticleCirculation · August 22, 2017
Behavioral challenges are often present in human illness, so behavioral economics is increasingly being applied in healthcare settings to better understand why patients choose healthy or unhealthy behaviors. The application of behavioral economics to healt ...
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Journal ArticleJAMA Cardiol · August 1, 2017
IMPORTANCE: Phosphodiesterase-5 inhibition with sildenafil compared with a placebo had no effect on the exercise capacity or clinical status of patients with heart failure with preserved ejection fraction (HFpEF) in the PhosphodiesteRasE-5 Inhibition to Im ...
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Journal ArticleJ Am Heart Assoc · July 11, 2017
BACKGROUND: Extended-duration betrixaban showed a significant reduction in venous thromboembolism in the APEX trial (Acute Medically Ill VTE Prevention With Extended Duration Betrixaban Study). Given the variable clinical impact of different efficacy and s ...
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ConferenceEur J Heart Fail · July 2017
BACKGROUND: While abnormal left ventricular (LV) global longitudinal strain (GLS) has been described in patients with heart failure with preserved ejection fraction (HFpEF), its prevalence and clinical significance are poorly understood. METHODS AND RESULT ...
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ConferenceAm Heart J · July 2017
OBJECTIVES: We examined trends in CRT utilization overall and by sex and race and to assess whether CRT use is associated with a reduction in HF hospitalization and mortality. BACKGROUND: It is unknown whether underutilization and race/sex-based difference ...
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Journal ArticleJACC Heart Fail · July 2017
OBJECTIVES: This study analyzed HFpEF patient characteristics and clinical outcomes according to race/ethnicity and adjusted for patient and hospital characteristics along with socioeconomic status (SES). BACKGROUND: The proportion of hospitalizations for ...
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Journal ArticleAm J Cardiol · July 1, 2017
Differences in the clinical course of congestion by underlying ejection fraction (EF) have not been well-characterized in acute heart failure (AHF). A post hoc analysis was performed using pooled data from the Diuretic Optimization Strategies Evaluation in ...
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Journal ArticleAm Heart J · July 2017
BACKGROUND: Seasonal variation with winter preponderance of myocardial infarction incidence has been described decades ago, but only a few small studies have classified myocardial infarction based on ST-segment elevation. It is unclear whether seasonal and ...
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Journal ArticleAm Heart J · July 2017
UNLABELLED: MitraClip is an approved therapy for mitral regurgitation (MR); however, health care resource utilization pre- and post-MitraClip remains understudied. METHODS: Patients with functional and degenerative MR at high surgical risk in the EVEREST I ...
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Journal ArticleAm Heart J · July 2017
Heart failure (HF) with reduced ejection fraction (HFrEF) is a common and costly condition that diminishes patients' health status and confers a poor prognosis. Despite the availability of multiple guideline-recommended pharmacologic and cardiac device the ...
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Journal ArticleJ Am Coll Cardiol · June 27, 2017
BACKGROUND: It is unclear how patients hospitalized for acute heart failure (HF) who are long-term chronic HF survivors differ from those with more recent HF diagnoses. OBJECTIVES: The goal of this study was to evaluate the influence of HF chronicity on ac ...
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Journal ArticleAm J Respir Crit Care Med · June 15, 2017
The Division of Lung Diseases of the NHLBI and the Cardiovascular Medical Education and Research Fund held a workshop to discuss how to leverage the anticipated scientific output from the recently launched "Redefining Pulmonary Hypertension through Pulmona ...
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ConferenceCirc Heart Fail · June 2017
BACKGROUND: Daily physical activity assessed by accelerometers represents a novel method to assess the impact of interventions on heart failure (HF) patients' functional status. We hypothesized that daily activity varies by patient characteristics and corr ...
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Journal ArticleAm Heart J · June 2017
BACKGROUND: Most patients with acute heart failure (AHF) admitted to critical care units (CCUs) are low acuity and do not require CCU-specific therapies, suggesting that they could be managed in a lower-cost ward environment. This study identified the pred ...
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Journal ArticleJAMA · May 16, 2017
IMPORTANCE: Iron deficiency is present in approximately 50% of patients with heart failure with reduced left ventricular ejection fraction (HFrEF) and is an independent predictor of reduced functional capacity and mortality. However, the efficacy of inexpe ...
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Journal ArticleJ Am Heart Assoc · May 16, 2017
BACKGROUND: Pokémon GO is a location-based augmented reality game. Using GPS and the camera on a smartphone, the game requires players to travel in real world to capture animated creatures, called Pokémon. We examined the impact of Pokémon GO on physical a ...
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Journal ArticleAm Heart J · May 2017
BACKGROUND: EXSCEL is a randomized, double-blind, placebo-controlled trial examining the effect of exenatide once-weekly (EQW) versus placebo on time to the primary composite outcome (cardiovascular death, nonfatal myocardial infarction or nonfatal stroke) ...
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Journal ArticleJACC Heart Fail · May 2017
Acute heart failure (HF) is a major public health problem with substantial associated economic costs. Because most patients who present to hospitals are admitted irrespective of their level of risk, novel approaches to manage acute HF are needed, such as t ...
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Journal ArticleJACC Heart Fail · May 2017
OBJECTIVES: This study sought to ascertain the impact of heart failure (HF) guideline change on the number of patients eligible to undergo cardiac resynchronization therapy (CRT). BACKGROUND: The 2013 HF guideline of the American College of Cardiology Foun ...
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Journal ArticleCirculation. Heart failure · May 2017
Approximately half of patients with heart failure have preserved ejection fraction. There is no proven treatment that improves outcome. The pathophysiology of heart failure with preserved ejection fraction is complex and includes left ventricular systolic ...
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Journal ArticleJ Womens Health (Larchmt) · April 2017
BACKGROUND: Compared to ischemic stroke, sex differences in response to intracerebral hemorrhage (ICH) are largely unexplored, and their potential interactions with patient age have not been examined. This study hypothesized that risk for poor outcome is g ...
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Journal ArticleJACC Heart Fail · April 2017
OBJECTIVES: The aim of this study was to assess the prevalence and variation in angiotensin receptor/neprilysin inhibitor (ARNI) prescription among a real-world population with heart failure with reduced ejection fraction (HFrEF). BACKGROUND: The U.S. Food ...
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Journal ArticleAm J Cardiol · March 15, 2017
Implantable cardioverter defibrillators (ICD) and cardiac resynchronization therapy (CRT) reduce mortality in many patients with heart failure (HF), but the current use and effectiveness of ICD/CRT in patients with chronic kidney disease (CKD) are uncertai ...
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Journal ArticleCirculation · March 14, 2017
BACKGROUND: Intravenous rt-PA (recombinant tissue-type plasminogen activator) is effective in improving outcomes in ischemic stroke; however, there are few data on the use of rt-PA in patients who are receiving a non-vitamin K antagonist oral anticoagulant ...
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Journal ArticleJAMA · March 14, 2017
IMPORTANCE: Antithrombotic therapies are known to prevent stroke for patients with atrial fibrillation (AF) but are often underused in community practice. OBJECTIVES: To examine the prevalence of patients with acute ischemic stroke with known history of AF ...
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Journal ArticleAm Heart J · March 2017
BACKGROUND: The APEX trial assessed the safety and efficacy of extended-duration thromboprophylaxis using betrixaban versus standard dosing of enoxaparin among hospitalized, acutely ill medical patients. The 80-mg betrixaban dose was halved to 40 mg among ...
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Journal ArticleJACC Heart Fail · March 2017
Heart failure (HF) is a chronic syndrome characterized by acute exacerbations. There is significant overlap between respiratory infections and exacerbation of underlying HF. Vaccination against respiratory infections in patients with HF could serve as a po ...
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Journal ArticleCirculation · February 14, 2017
BACKGROUND: Stroke is a morbid and potentially mortal complication among patients hospitalized with acute medical illness. The potential of extended-duration thromboprophylaxis with the factor Xa inhibitor betrixaban to reduce the risk of stroke compared w ...
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Journal ArticleJ Am Heart Assoc · February 11, 2017
BACKGROUND: Guidelines recommend continuation or initiation of guideline-directed medical therapy, including angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEi/ARB), in hospitalized patients with heart failure with reduced ejec ...
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Journal ArticleJ Am Heart Assoc · February 3, 2017
BACKGROUND: Healthcare resources vary geographically, but associations between hospital-based resources and acute stroke quality and outcomes remain unclear. METHODS AND RESULTS: Using Get With The Guidelines-Stroke and Dartmouth Atlas of Health Care data, ...
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Journal ArticleJ Heart Lung Transplant · February 2017
BACKGROUND: Pre-transplant amiodarone use has been postulated as a risk factor for morbidity and mortality after orthotopic heart transplantation (OHT). We assessed pre-OHT amiodarone use and tested the hypothesis that it is associated with impaired post-O ...
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Journal ArticleEur J Heart Fail · February 2017
AIMS: Heart failure (HF) can be associated with a higher resting heart rate (HR), and an elevated HR is associated with adverse long-term events. However, the mechanistic and causal role of HR in HF is unclear. This study aimed to investigate changes in HR ...
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Journal ArticleJAMA Cardiol · February 1, 2017
IMPORTANCE: Increased resting heart rate is associated with worse outcomes in studies of mostly white populations, but its significance is not well established in African Americans persons whose cardiac comorbidities and structural abnormalities differ. OB ...
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Journal ArticleJAMA Cardiol · February 1, 2017
IMPORTANCE: Several attempts have been made at developing models to predict 30-day readmissions in patients with heart failure, but none have sufficient discriminatory capacity for clinical use. Machine-learning (ML) algorithms represent a novel approach a ...
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Journal ArticleJAMA Cardiol · February 1, 2017
IMPORTANCE: Elevated levels of cardiac troponins are associated with adverse clinical outcomes among patients with heart failure (HF) and reduced ejection fraction. However, the clinical significance of troponin elevation in the setting of decompensated HF ...
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Journal ArticleStroke · February 2017
BACKGROUND AND PURPOSE: Kidney disease is a frequent comorbidity in patients presenting with acute ischemic stroke. We evaluated whether the estimated glomerular filtration rate (eGFR) on admission is associated with poststroke in-hospital mortality or dis ...
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Journal ArticleJ Am Heart Assoc · January 21, 2017
BACKGROUND: In 2009, the Get With The Guidelines-Stroke (GWTG-Stroke) program offered additional recognition if hospitals performed well on certain stroke quality measures. We sought to determine whether quality of care for all hospitals participating in G ...
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Journal ArticleCirculation · January 10, 2017
BACKGROUND: Earlier tissue plasminogen activator treatment improves ischemic stroke outcome, but aspects of the time-benefit relationship still not well delineated are: (1) the degree of additional benefit accrued with treatment in the first 60 minutes aft ...
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Journal ArticleClin Cardiol · January 2017
BACKGROUND: Several diabetes mellitus (DM) therapies are associated with worse heart failure (HF) outcomes, yet limited data exist characterizing routine DM management based on HF status. HYPOTHESIS: DM medications prescribed for patients with HF will diff ...
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Journal ArticleJACC Heart Fail · January 2017
OBJECTIVES: This study sought to examine the relationships between in-hospital and post-discharge body weight changes and outcomes among patients hospitalized for acute heart failure (AHF). BACKGROUND: Body weight changes during and after hospitalization f ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · January 2017
BACKGROUND: Heart failure guidelines recommend routine monitoring of serum potassium, and renal function in patients treated with a mineralocorticoid receptor antagonist (MRA). How these recommendations are implemented in high-risk patients or according to ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · January 2017
BACKGROUND: The implementation of Target: Stroke Phase I, the first stage of the American Heart Association's national quality improvement initiative to accelerate door-to-needle (DTN) times, was associated with an average 15-minute reduction in DTN times. ...
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Conference · 2017
Introduction: Globalization of clinical trials fosters inclusion of patients from higher and lower income countries. The influence of enrolling country income level on heart failure (HF) trial performance is unclear.Methods: Associations between country in ...
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Journal ArticleJ Am Heart Assoc · December 7, 2016
BACKGROUND: In 2014, new hypertension guidelines liberalized blood pressure goals for persons 60 years and older. Little is known about the implications for blacks. METHODS AND RESULTS: Using data from 2000 through 2011 for 5280 participants in the Jackson ...
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ConferenceBlood · December 2, 2016
AbstractBackground: The exposure of all the currently licenced DOACs is increased in renal impairment and by certain drug interactions. The Acute Medically Ill VTE (Venous Thromboembolism) Prevention with Ex ...
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Journal ArticleAm Heart J · December 2016
BACKGROUND: The contribution of diabetes to the burden of heart failure (HF) remains largely undescribed. Assessing diabetes temporal trends among US patients hospitalized with HF and their relation with quality measures in real-world practice can help to ...
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Journal ArticleAm Heart J · December 2016
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs, dabigatran, rivaroxaban, apixaban, and edoxaban) have been increasingly used as alternatives to warfarin for stroke prophylaxis in patients with atrial fibrillation. Yet there is substantial ...
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Journal ArticleJACC Heart Fail · December 2016
OBJECTIVES: This study sought to determine whether processes of care and long-term clinical outcomes for heart failure (HF) admissions across Get With The Guidelines-Heart Failure (GWTG-HF) program participating centers differ according to HF-specific risk ...
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Journal ArticleJ Card Fail · November 2016
OBJECTIVE: To characterize a novel "worst"-symptom visual analogue scale (WS-VAS) versus the traditional dyspnea visual analogue scale (DVAS) in an acute heart failure (AHF) trial. BACKGROUND: AHF trials assess symptom relief as a pivotal endpoint with the ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · November 2016
BACKGROUND: Despite increasing awareness regarding evidence-based guidelines, considerable gaps exist for heart failure (HF) quality of care at teaching hospitals (TH) and nonteaching hospitals (NTH). We analyzed data from Get With The Guidelines (GWTG)-HF ...
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Journal ArticleJ Am Coll Cardiol · October 25, 2016
Large randomized clinical trials in cardiovascular disease have proliferated over the past 3 decades, with results that have influenced every aspect of cardiology practice. Despite these advances, there remains a substantial need for more high-quality evid ...
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Journal ArticleJ Am Heart Assoc · October 6, 2016
BACKGROUND: Timely reperfusion after ST-elevation myocardial infarction (STEMI) improves survival. Guidelines recommend primary percutaneous coronary intervention (PPCI) within 90 minutes of arrival at a PCI-capable hospital. The alternative is fibrinolysi ...
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ConferenceJ Card Fail · October 2016
BACKGROUND: Heart failure (HF) with preserved ejection fraction (HFpEF) is more common in women than in men; data characterizing sex differences in the management and outcomes of HFpEF patients presenting to the emergency department (ED) are limited. METHO ...
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Journal ArticleEur J Heart Fail · October 2016
AIMS: The combined neprilysin/renin-angiotensin system (RAS) inhibitor sacubitril/valsartan reduced cardiovascular death or heart failure hospitalization, cardiovascular death, and all-cause mortality in a large outcomes trial. While sacubitril/valsartan i ...
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Journal ArticleStroke · October 2016
BACKGROUND AND PURPOSE: Stroke survivors identify home-time as a high-priority outcome; there are limited data on factors influencing home-time and home-time variability among discharging hospitals. METHODS: We ascertained home-time (ie, time alive out of ...
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Journal ArticleJ Card Fail · September 2016
BACKGROUND: Though commonly noted in clinical practice, it is unknown if decongestion in acute heart failure (AHF) results in increased serum bicarbonate. METHODS AND RESULTS: For 678 AHF patients in the DOSE-AHF, CARRESS-HF, and ROSE-AHF trials, we assess ...
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Journal ArticleJ Card Fail · September 2016
BACKGROUND: Use of left ventricular assist devices (LVADs) for treatment of advanced heart failure has expanded significantly over the past decade. However, concomitant use of heart failure medical therapies after implant is poorly characterized. METHODS A ...
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Journal ArticleJAMA Cardiol · September 1, 2016
IMPORTANCE: Angiotensin receptor neprilysin inhibition (ARNI) therapy provided incremental survival benefit to patients with heart failure and reduced ejection fraction (HFrEF) in clinical trials. To date, estimation of the potential benefits that could be ...
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Journal ArticleAm Heart J · September 2016
BACKGROUND: Real-world use of traditional heart failure (HF) medications for patients with left ventricular assist devices (LVADs) is not well known. METHODS: We conducted a retrospective, observational analysis of 1,887 advanced HF patients with and witho ...
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Journal ArticleJACC Heart Fail · September 2016
Although therapy with mineralocorticoid receptor antagonists (MRAs) is recommended for patients with chronic heart failure (HF) with reduced ejection fraction and in post-infarction HF, it has not been studied well in acute HF (AHF) despite being commonly ...
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Journal ArticleCirc Heart Fail · September 2016
BACKGROUND: Most international acute heart failure trials have failed to show benefit with respect to key end points. The impact of site enrollment and protocol execution on trial performance is unclear. METHODS AND RESULTS: We assessed the impact of varyi ...
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Journal ArticleCirculation · August 16, 2016
BACKGROUND: Previous studies have found that women and black patients eligible for a primary prevention implantable cardioverter-defibrillator (ICD) are less likely than men or white patients to receive one. METHODS: We performed an observational analysis ...
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Journal ArticleN Engl J Med · August 11, 2016
BACKGROUND: Patients with acute medical illnesses are at prolonged risk for venous thrombosis. However, the appropriate duration of thromboprophylaxis remains unknown. METHODS: Patients who were hospitalized for acute medical illnesses were randomly assign ...
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Journal ArticleJAMA · August 2, 2016
IMPORTANCE: Abnormal cardiac metabolism contributes to the pathophysiology of advanced heart failure with reduced left ventricular ejection fraction (LVEF). Glucagon-like peptide 1 (GLP-1) agonists have shown cardioprotective effects in early clinical stud ...
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Journal ArticleJ Card Fail · August 2016
BACKGROUND: Higher rates of obesity and heart failure have been observed in African Americans, but associations with mortality are not well-described. We examined intermediate and long-term clinical implications of obesity in African Americans and associat ...
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Journal ArticleEndocr Pract · August 2016
OBJECTIVE: To summarize characteristics of Medicare beneficiaries with type 2 diabetes and to describe changing trends in care and outcomes. METHODS: We conducted a retrospective cohort study of a nationally representative 5% sample of fee-for-service Medi ...
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Journal ArticleJACC Heart Fail · August 2016
OBJECTIVES: The purpose of this study was to determine the temporal trends in the adherence to heart failure (HF)-related process of care measures and clinical outcomes among patients with acute decompensated HF with reduced ejection fraction (HFrEF) and e ...
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Journal ArticleCurr Cardiol Rep · August 2016
Coronary artery disease (CAD) is the underlying cause of death in one out of seven deaths in the USA. Aspirin therapy has been proven to decrease mortality and major adverse cardiovascular events in patients with CAD. Despite a plethora of studies showing ...
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Journal ArticleAm Heart J · August 2016
BACKGROUND: A subset of patients hospitalized with acute heart failure experiences in-hospital worsening heart failure, defined as persistent or worsening signs or symptoms requiring an escalation of therapy. METHODS: We analyzed data from the Acute Decomp ...
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Journal ArticleJ Am Heart Assoc · July 29, 2016
BACKGROUND: Metabolic impairment is an important contributor to heart failure (HF) pathogenesis and progression. Dysregulated metabolic pathways remain poorly characterized in patients with HF and preserved ejection fraction (HFpEF). We sought to determine ...
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Journal ArticleCirc Heart Fail · July 2016
BACKGROUND: Diabetes mellitus, heart failure (HF), and chronic kidney disease are common comorbidities, but overall use and safety of antihyperglycemic medications (AHMs) among patients with these comorbidities are poorly understood. METHODS AND RESULTS: U ...
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Journal ArticleEur J Heart Fail · June 2016
AIMS: It remains unclear if early administration of i.v. nesiritide in patients hospitalized with acute heart failure (AHF) is associated with improved clinical outcomes. METHODS AND RESULTS: We analysed data from 7007 patients enrolled in ASCEND-HF to exa ...
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Journal ArticleJ Card Fail · June 2016
BACKGROUND: Younger age as an independent predictor of death or all-cause rehospitalization at 30 days post-randomization for hospitalized heart failure (HF) patients has not been well described. METHODS AND RESULTS: ASCEND-HF enrolled 7141 hospitalized ac ...
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Journal ArticleAm J Cardiol · June 1, 2016
A growing number of countries and geographical regions are involved in major clinical trials. Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure is the largest trial in acutely decompensated heart failure (HF) with patients ...
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Journal ArticleJACC Heart Fail · June 2016
OBJECTIVES: This study assessed the comparative frequency of precipitating clinical factors leading to hospitalization among heart failure (HF) patients with reduced, borderline, and preserved ejection fraction (EF) BACKGROUND: There are few data assessing ...
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Journal ArticleCirc Heart Fail · June 2016
BACKGROUND: Atrial fibrillation is common in patients with heart failure, but outcomes of patients with both conditions who receive cardiac resynchronization therapy with defibrillator (CRT-D) compared with an implantable cardioverter-defibrillator (ICD) a ...
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Journal ArticleCirc Heart Fail · June 2016
BACKGROUND: Reducing hospital readmissions for patients with heart failure is a national priority, and quality improvement campaigns are targeting reductions of ≥20%. However, there are limited data on whether such targets have been met. METHODS AND RESULT ...
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Journal ArticleNephrol Dial Transplant · June 2016
BACKGROUND: Many patients who receive maintenance hemodialysis experience poor sleep. Uncontrolled studies suggest frequent hemodialysis improves sleep quality, which is a strong motivation for some patients to undertake the treatment. We studied the effec ...
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Journal ArticleJ Cardiovasc Pharmacol Ther · May 2016
Acute medical illnesses are associated with a prolonged elevation in inflammatory markers that predisposes patients to thrombosis beyond the duration of their hospital stay. In parallel, both observational and randomized data have demonstrated a rate of po ...
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Journal ArticleJ Heart Lung Transplant · May 2016
BACKGROUND: Heart transplantation is increasing in patients with adult congenital heart disease (ACHD). In this population, the association of pulmonary hypertension (PH) with post-transplant outcomes is not well-defined. METHODS: Using data from the Unite ...
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ConferenceJACC Heart Fail · May 2016
OBJECTIVES: The aim of this study was to assess temporal trends and factors associated with digoxin use at discharge among patients admitted with heart failure (HF). BACKGROUND: Digoxin has class IIa recommendations for treating HF with reduced ejection fr ...
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Journal ArticleStroke · May 2016
BACKGROUND AND PURPOSE: Get With The Guidelines (GWTG)-Stroke is a national, hospital-based quality improvement program developed by the American Heart Association. Although studies have suggested improved processes of care in GWTG-Stroke-participating hos ...
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Journal ArticleCirc Heart Fail · May 2016
UNLABELLED: : Iron deficiency is present in ≈50% of patients with heart failure and is an independent predictor of mortality. Despite growing recognition of the functional and prognostic significance of iron deficiency, randomized multicenter trials explor ...
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Journal ArticleEur J Heart Fail · April 2016
AIMS: We aimed to characterize abnormal liver function tests in patients with heart failure (HF), as they are commonly encountered yet poorly defined. METHODS AND RESULTS: We used data from ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in ...
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Journal ArticleAm Heart J · April 2016
Exenatide once-weekly is an extended release formulation of exenatide, a glucagon-like peptide-1 receptor agonist, which can improve glycemic control, body weight, blood pressure, and lipid levels in patients with type 2 diabetes mellitus (T2DM). The EXena ...
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Journal ArticleMed Care · April 2016
BACKGROUND: Readmission within 30 days after hospitalization for heart failure (HF) is a major public health problem. OBJECTIVE: To examine whether timing and type of post-discharge follow-up impacts risk of 30-day readmission in adults hospitalized for HF ...
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Journal ArticleBMJ Open · March 17, 2016
OBJECTIVES: Limited data exist assessing the relationship between ambulance versus self-presentation and outcomes in patients with acute heart failure (AHF). SETTING: Clinical trial sites in North America. PARTICIPANTS: 1068 patients enrolled in the Acute ...
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Journal ArticleAm J Cardiol · March 15, 2016
There are limited data describing outcomes associated with an elevated heart rate in patients with heart failure with reduced ejection fraction (HFrEF) in routine clinical practice. We identified patients with HFrEF at Duke University Hospital undergoing e ...
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Journal ArticleJ Heart Lung Transplant · March 2016
BACKGROUND: With increasing age of patients with heart failure, it is important to understand the potential role for orthotopic heart transplant (OHT) in elderly patients. We examined recipient and donor characteristics and long-term outcomes of older reci ...
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Journal ArticleEur J Heart Fail · March 2016
AIMS: A longitudinal and comprehensive analysis of health-related quality of life (HRQOL) was performed during hospitalization for heart failure (HF) or soon after discharge. METHODS AND RESULTS: A post-hoc analysis was performed of the ASCEND-HF trial. Th ...
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Journal ArticleEur J Heart Fail · March 2016
AIMS: Endothelin-1 (ET-1) is an endogenous vasoconstrictor implicated in pulmonary and systemic hypertension, as well as ventricular dysfunction, through effects on vascular smooth muscle, the kidneys, and cardiomyocytes. We aimed to determine the associat ...
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Journal ArticleAm Heart J · March 2016
BACKGROUND: Elevated heart rate of ≥70 beats/min despite β-blocker use may represent a new treatment target in patients in sinus rhythm with heart failure with reduced ejection fraction. However, little is known about the proportion of patients with elevat ...
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Journal ArticleStroke · March 2016
BACKGROUND AND PURPOSE: Stroke survivors have identified home-time as a meaningful outcome. We evaluated home-time as a patient-centered outcome in Medicare beneficiaries with ischemic stroke in comparison with modified Rankin Scale (mRS) score at 90 days ...
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Journal ArticleAm Heart J · March 2016
BACKGROUND: Clinical trial evidence suggests that statin therapy reduces adverse clinical events and provides even greater benefit at high-intensity doses in coronary artery disease (CAD) patients, yet few studies have examined this in clinical practice. M ...
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Journal ArticleJ Am Coll Cardiol · March 1, 2016
BACKGROUND: In 2009, the Centers for Medicare & Medicaid Services (CMS) began publicly reporting 30-day hospital readmission rates for patients discharged with acute myocardial infarction (MI), heart failure (HF), or pneumonia. OBJECTIVES: This study asses ...
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Journal ArticleCirculation · March 1, 2016
Randomized, clinical trials are commonly regarded as the highest level of evidence to support clinical decisions. Good Clinical Practice guidelines have been constructed to provide an ethical and scientific quality standard for trials that involve human su ...
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Journal ArticleJACC Heart Fail · March 2016
Patient-reported outcomes (PRO) are defined as reports coming directly from patients about how they feel or function in relation to a health condition and its therapy. Although there are numerous compelling reasons why PRO could be an important help in cli ...
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Journal ArticleAm J Cardiol · February 1, 2016
Furosemide is the most commonly used loop diuretic in patients with heart failure (HF) despite data suggesting potential pharmacologic and antifibrotic benefits with torsemide. We investigated patients with HF in Acute Study of Clinical Effectiveness of Ne ...
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Journal ArticleAm Heart J · February 2016
BACKGROUND: The acute heart failure (AHF) Syndromes International Working Group proposed that dyspnea be assessed under standardized, incrementally provocative maneuvers and called for studies to assess the feasibility of this approach. We sought to assess ...
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Journal ArticleCirc Heart Fail · February 2016
BACKGROUND: In clinical trials, hydralazine-isosorbide dinitrate (H-ISDN) for heart failure with reduced ejection fraction reduced morbidity and mortality among black patients and patients with intolerance to angiotensin-converting enzyme inhibitors or ang ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · February 2016
BACKGROUND: It is unclear to what extent cardiovascular health disparities exist and can be modified among sexes, racial/ethnic groups, and geographic regions in US hospitals. METHODS AND RESULTS: We conducted a cohort study of 49 358 patients aged 65 year ...
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Journal ArticleJ Card Fail · January 2016
BACKGROUND: Worsening renal function in heart failure may be related to increased venous congestion, decreased cardiac output, or both. Diuretics are universally used in acute decompensated heart failure, but they may be ineffective and may lead to azotemi ...
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Journal ArticleJAMA Neurol · January 2016
IMPORTANCE: Intravenous tissue plasminogen activator (tPA) is known to improve outcomes in ischemic stroke; however, many patients may have been receiving antiplatelet therapy before acute ischemic stroke and could face an increased risk for bleeding when ...
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Journal ArticleJACC Heart Fail · January 2016
OBJECTIVES: The study sought to investigate the association between soluble growth stimulation expressed gene 2 (sST2) level and adverse outcomes in acute heart failure (HF). BACKGROUND: Several studies have demonstrated the prognostic utility of sST2 leve ...
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Journal ArticleJACC Heart Fail · January 2016
OBJECTIVES: This study assessed the association between pulse pressure (PP) and adverse outcomes at 1 year in patients hospitalized for heart failure (HF). BACKGROUND: PP has been shown to be predictive of the development of HF. The value and utility of PP ...
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Journal ArticleCirc Heart Fail · January 2016
BACKGROUND: Clinical trials of implantable cardioverter defibrillators (ICDs) for primary prevention enrolled a limited number of women. We sought to examine clinical practice data to compare survival rates among women with heart failure with or without a ...
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Journal ArticleCirc Heart Fail · January 2016
BACKGROUND: Previous data demonstrate early follow-up (ie, within 7 days of discharge) after a hospitalization for heart failure is associated with a lower risk of readmission, yet is uncommon and varies widely across hospitals. Limited data exist on wheth ...
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Journal ArticleASAIO J · 2016
Left heart disease (LHD) represents the most common cause of pulmonary hypertension (PH), and is associated with worse prognosis compared with LHD without PH. In addition, PH due to LHD may prevent patients from receiving heart transplantation, because of ...
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Journal ArticlePLoS One · 2016
Given the emerging recognition of left atrial structure and function as an important marker of disease in heart failure with preserved ejection fraction (HF-pEF), we investigated the association between left atrial volume and function with markers of disea ...
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Journal ArticleJ Am Coll Cardiol · December 15, 2015
BACKGROUND: Patients with moderate-to-severe chronic kidney disease (CKD) are poorly represented in clinical trials of cardiac resynchronization therapy (CRT). OBJECTIVES: This study sought to assess the real-world comparative effectiveness of CRT with def ...
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Journal ArticleAm Heart J · December 2015
BACKGROUND: Patients hospitalized with acute heart failure may experience worsening symptoms requiring escalation of therapy. In-hospital worsening heart failure is associated with worse in-hospital and postdischarge outcomes, but associations between the ...
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Journal ArticleJACC Heart Fail · November 2015
OBJECTIVES: The authors sought to describe characteristics, treatments, and in-hospital outcomes of hospitalized heart failure (HF) patients stratified by etiology. BACKGROUND: Whether characteristics and outcomes of HF patients differ by cardiomyopathy et ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · November 2015
BACKGROUND: Most studies of depression and cardiovascular risk have been conducted in white populations. We investigated this association in a community-based cohort of blacks. METHODS AND RESULTS: We used data from the Jackson Heart Study to investigate a ...
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Journal ArticleCirculation · October 13, 2015
BACKGROUND: In patients with ischemic stroke, data on the real-world effectiveness of statin therapy for clinical and patient-centered outcomes are needed to better inform shared decision making. METHODS AND RESULTS: Patient-Centered Research Into Outcomes ...
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Journal ArticleCirculation · October 6, 2015
BACKGROUND: Guidelines for heart failure (HF) recommend prescription of guideline-directed medical therapy before hospital discharge; some of these therapies are included in publicly reported performance measures. The burden of new medications for individu ...
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Journal ArticleJACC Heart Fail · October 2015
OBJECTIVES: This study sought to determine the relationship of KIM-1 levels with adverse clinical outcomes in acute decompensated heart failure (ADHF). BACKGROUND: Kidney injury molecule (KIM)-1 is a biomarker expressed by the nephron in acute tubular inju ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · October 2015
BACKGROUND: Smoking is a potent risk factor for coronary artery disease (CAD) and acute ischemic stroke (AIS), but there are numerous reports of lower in-hospital mortality among smokers versus nonsmokers hospitalized for these events. METHODS AND RESULTS: ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · October 2015
BACKGROUND: Patients with transient ischemic attack (TIA) are at increased risk for ischemic stroke. We derived a prediction rule for 1-year ischemic stroke risk post-TIA, examining estimated risk, receipt of inpatient quality of care measures for TIA, and ...
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Journal ArticleJ Am Coll Cardiol · August 25, 2015
BACKGROUND: Current guidelines recommend cardiac rehabilitation (CR) in medically stable outpatients with heart failure (HF); however, temporal trends and factors associated with CR referral among these patients in real-world practice are not entirely know ...
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Journal ArticleJ Am Heart Assoc · August 24, 2015
BACKGROUND: Patients with acute heart failure (AHF) frequently have atrial fibrillation (AF), but how this affects patient-reported outcomes has not been well characterized. METHODS AND RESULTS: We examined dyspnea improvement and clinical outcomes in 7007 ...
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Journal ArticleAm J Cardiol · August 15, 2015
Alternatives have emerged for patients ineligible for cardiac transplantation under standard criteria. The purpose of our study was to compare outcomes in patients ineligible for cardiac transplantation under standard criteria, treated either with extended ...
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Journal ArticleJ Am Heart Assoc · August 6, 2015
BACKGROUND: Implantable cardioverter-defibrillator (ICD) therapy is associated with improved outcomes in patients with heart failure (HF), but whether this association holds among older patients with multiple comorbid illnesses and worse HF burden remains ...
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Journal ArticleHepatology · August 2015
UNLABELLED: Treatment for chronic hepatitis C virus (HCV) infection is evolving from interferon (IFN)-based therapy to direct-acting antiviral (DAA) agents, yet some safety concerns have arisen involving cardiac toxicity. In this study, we sought to better ...
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Journal ArticleJ Card Fail · August 2015
The presentation, natural history, clinical outcomes, and response to therapy in patients with heart failure differ in some ways across populations. Women, older adults, and non-Caucasian racial or ethnic groups compose a substantial proportion of the over ...
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Journal ArticleAm Heart J · August 2015
BACKGROUND: Despite initial in-hospital treatment of acute heart failure (HF), some patients experience worsening HF (WHF). There are limited data about the outcomes and characteristics of patients who experience in-hospital WHF. METHODS AND RESULTS: We as ...
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Journal ArticleAm Heart J · August 2015
BACKGROUND: Patients hospitalized for acute decompensated heart failure (ADHF) are at high risk for early mortality and rehospitalization. Risk stratification of ADHF using clinically available data on admission is increasingly important to integrate with ...
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Journal ArticleAm Heart J · August 2015
BACKGROUND: Diuretic unresponsiveness often occurs during hospital admission for acute heart failure (AHF) and is associated with adverse outcome. This study aims to investigate determinants, clinical outcome, and the effects of nesiritide on diuretic resp ...
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Journal ArticleBMJ · July 31, 2015
OBJECTIVE: To examine the association between warfarin treatment and longitudinal outcomes after ischemic stroke in patients with atrial fibrillation in community practice. DESIGN: Observational study. SETTING: Hospitals (n = 1487) participating in the Get ...
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Journal ArticleCirc Heart Fail · July 2015
BACKGROUND: Congestion is the most frequent cause for hospitalization in acute decompensated heart failure. Although decongestion is a major goal of acute therapy, it is unclear how the clinical components of congestion (eg, peripheral edema, orthopnea) co ...
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Journal ArticleAm Heart J · July 2015
BACKGROUND: Stroke is common and costly, annually depriving the lives and well-being of 800,000 Americans. Despite demonstrated efficacy in clinical trials, questions remain about the safety and clinical effectiveness of various treatment options given pat ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · July 2015
BACKGROUND: Novel oral anticoagulants (NOACs) have been shown to be at least as good as warfarin for preventing stroke or transient ischemic attack in patients with atrial fibrillation, yet diffusion of these therapies and patterns of use among atrial fibr ...
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Journal ArticleHeart Fail Clin · July 2015
Team-based or multidisciplinary care may be a potential way to positively impact outcomes for heart failure (HF) patients by improving clinical outcomes, managing patient symptoms, and reducing costs. The multidisciplinary team includes the HF cardiologist ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · July 2015
BACKGROUND: There is significant variation in the delivery of evidence-based care for patients with heart failure (HF), but there is limited evidence defining the best methods to improve the quality of care. METHODS AND RESULTS: We performed a cluster-rand ...
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Journal ArticleAm Heart J · June 2015
Recent developments have highlighted the challenges facing cardiovascular clinical research in global contemporary practice, particularly in North America, including shifting priorities for drug development targets, increasing regulatory requirements, and ...
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Journal ArticleJ Card Fail · June 2015
We propose that stage D advanced heart failure be defined as the presence of progressive and/or persistent severe signs and symptoms of heart failure despite optimized medical, surgical, and device therapy. Importantly, the progressive decline should be pr ...
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Journal ArticleJACC Heart Fail · June 2015
OBJECTIVES: This study sought to describe the use of CRT-D and its association with survival for older patients. BACKGROUND: Many patients who receive cardiac resynchronization therapy with defibrillator (CRT-D) in practice are older than those included in ...
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Journal ArticleCirculation · May 19, 2015
BACKGROUND: Oxidative stress may contribute to heart failure (HF) progression. Inhibiting xanthine oxidase in hyperuricemic HF patients may improve outcomes. METHODS AND RESULTS: We randomly assigned 253 patients with symptomatic HF, left ventricular eject ...
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Journal ArticleJ Am Coll Cardiol · May 12, 2015
BACKGROUND: Electronic health records (EHRs) may be key tools for improving the quality of health care, particularly for conditions for which guidelines are rapidly evolving and timely care is critical, such as ischemic stroke. OBJECTIVES: The goal of this ...
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Journal ArticleCirc Heart Fail · May 2015
BACKGROUND: An individual's socioeconomic status (SES) is associated with health outcomes and mortality, yet it is unknown whether accounting for SES can improve risk-adjustment models for 30-day outcomes among Centers for Medicare & Medicaid Services bene ...
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Journal ArticleJ Am Heart Assoc · April 22, 2015
BACKGROUND: Whether heart rate upon discharge following hospitalization for heart failure is associated with long-term adverse outcomes and whether this association differs between patients with sinus rhythm (SR) and atrial fibrillation (AF) have not been ...
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Journal ArticleAm J Med · April 2015
BACKGROUND: Prior studies have noted that in-hospital adherence to secondary prevention measures varied among patients undergoing coronary artery bypass graft surgery, percutaneous coronary revascularization, or no intervention. We sought to study contempo ...
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Journal ArticleStroke · April 2015
BACKGROUND AND PURPOSE: We sought to determine hospital and patient characteristics associated with the use of endovascular therapy for acute ischemic stroke and to analyze trends in clinical outcome. METHODS: Data were from Get With The Guidelines-Stroke ...
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Journal ArticleAm Heart J · April 2015
BACKGROUND: Poor adherence to evidence-based medications in heart failure (HF) is a major cause of avoidable hospitalizations, disability, and death. To test the feasibility of improving medication adherence, we performed a randomized proof-of-concept stud ...
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Journal ArticleAmerican Heart Journal · April 1, 2015
Background Poor adherence to evidence-based medications in heart failure (HF) is a major cause of avoidable hospitalizations, disability, and death. To test the feasibility of improving medication adherence, we performed a randomized proof-of-concept study ...
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ConferenceEur J Heart Fail · March 2015
AIMS: Loop diuretics are a cornerstone of heart failure (HF) treatment, but data regarding diuretic dose adjustments after a HF hospitalization and the association with subsequent outcomes are limited. This study was therefore conducted to determine these ...
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Journal ArticleCirc Heart Fail · March 2015
BACKGROUND: QRS prolongation is associated with adverse outcomes in mostly white populations, but its clinical significance is not well established for other groups. We investigated the association between QRS duration and mortality in African Americans. M ...
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Journal ArticleGlob Heart · March 2015
Diabetes and hypertension are chronic conditions that are growing in prevalence as major causal factors of cardiovascular disease (CVD). The need for chronic-illness surveillance, population-risk management, and successful treatment interventions are cruci ...
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Journal ArticleCirc Heart Fail · March 2015
In patients with heart failure (HF), use of 30-day rehospitalization as a healthcare metric and increased pressure to provide value-based care compel healthcare providers to improve efficiency and to use an integrated care approach. Transition programs are ...
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Journal ArticleJACC Heart Fail · February 2015
OBJECTIVES: The purpose of this study was to assess the relationship between biomarkers of renin-angiotensin-aldosterone system (RAAS) activation and decongestion strategies, worsening renal function, and clinical outcomes. BACKGROUND: High-dose diuretic t ...
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Journal ArticleJACC Heart Fail · February 2015
OBJECTIVES: The purpose of this study was to assess the benefit of primary prevention implantable cardioverter defibrillators (ICDs) in women. BACKGROUND: Clinical trials of primary prevention ICDs enrolled a limited number of women. METHODS: Using a prope ...
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Journal ArticleJ Thromb Thrombolysis · January 2015
D-Dimer is a biomarker of fibrin formation and degradation. While a D-dimer within normal limits is used to rule out the diagnosis of deep venous thrombosis and pulmonary embolism among patients with a low clinical probability of venous thromboembolism (VT ...
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Journal ArticleAm J Cardiol · January 1, 2015
Hospitalization for heart failure (HF) is frequently related to dyspnea, yet associations among dyspnea severity, outcomes, and health care costs are unknown. The aim of this study was to describe the characteristics of patients hospitalized for acute HF b ...
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Journal ArticleJACC Heart Fail · January 2015
OBJECTIVES: The purpose of this study was to examine changes in a broad panel of biomarkers following left ventricular assist device (LVAD) support in advanced heart failure (HF). BACKGROUND: LVAD therapy mechanically unloads the failing heart and may resu ...
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Journal ArticleJACC Heart Fail · January 2015
OBJECTIVES: The purpose of this study was to investigate the predictive values of baseline and changes in cystatin C (CysC) and its derived equations for short-term adverse outcomes and the effect of nesiritide therapy on CysC in acute decompensated heart ...
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Journal ArticleAm Heart J · January 2015
BACKGROUND: There is limited information about the association between diabetes, its treatment, and long-term angiographic and clinical outcomes in patients undergoing coronary artery bypass graft surgery (CABG). We evaluated the association of diabetes an ...
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Journal ArticleInt J Cardiol · 2015
BACKGROUND: Because little was previously known about Asian-American patients with heart failure (HF), we compared clinical profiles, quality of care, and outcomes between Asian-American and non-Hispanic white HF patients using data from the American Heart ...
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Journal ArticleInt J Cardiol · December 20, 2014
INTRODUCTION: Given the rising prevalence of heart failure (HF), our objective is to explore the relationships between meteorological events and acute HF (AHF) globally. METHODS: We used data from 30 countries participating in the ASCEND-HF trial. Paramete ...
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Journal ArticleInt J Cardiol · December 20, 2014
BACKGROUND: Little is known about global patterns of critical care unit (CCU) care and the relationship with outcomes in patients with acute decompensated heart failure (ADHF). Whether a ward or a CCU admission is associated with better outcomes is unclear ...
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Journal ArticleAm Heart J · December 2014
BACKGROUND: Transient and persistent worsening renal function (WRF) may be associated with different risks during hospitalization for acute heart failure. We compared outcomes of patients hospitalized for acute heart failure with transient, persistent, or ...
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ConferenceCirc Heart Fail · November 2014
BACKGROUND: Cardiac resynchronization therapy with defibrillator (CRT-D) reduces morbidity and mortality among selected patients with heart failure in clinical trials. The effectiveness of this therapy in clinical practice has not been well studied. METHOD ...
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Journal ArticleAm Heart J · November 2014
BACKGROUND: Studies on outcomes among patients with heart failure (HF) with preserved left ventricular ejection fraction (HFpEF), borderline left ventricular ejection fraction (HFbEF), and reduced left ventricular ejection fraction (HFrEF) remain limited. ...
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Journal ArticleStroke · November 2014
BACKGROUND AND PURPOSE: Although racial/ethnic differences in care are pervasive in many areas of medicine, little is known whether intracerebral hemorrhage (ICH) care processes or outcomes differ by race/ethnicity. METHODS: We analyzed 123 623 patients wi ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · November 2014
BACKGROUND: The safety of intravenous thrombolysis in ischemic stroke (IS) patients with chronic kidney disease (CKD) is uncertain. We assessed whether CKD is associated with bleeding complications after intravenous tissue-type plasminogen activator admini ...
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Journal ArticleCirc Heart Fail · November 2014
BACKGROUND: Outcomes associated with episodes of hypotension while hospitalized with acute decompensated heart failure are not well understood. METHODS AND RESULTS: Using data from Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart ...
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Journal ArticleStroke · November 2014
BACKGROUND AND PURPOSE: Limited information is available on stroke prevention in high-risk patients with preexisting cardiovascular disease. Our aim was to use admission low-density lipoprotein (LDL) values to evaluate differences in the attainment of Nati ...
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Journal ArticleJ Am Heart Assoc · October 16, 2014
BACKGROUND: The degree to which outcomes following hospitalization for acute heart failure (HF) vary by racial and ethnic groups is poorly characterized. We sought to compare 30-day and 1-year rehospitalization and mortality rates for HF among 4 race/ethni ...
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Journal ArticleJ Am Coll Cardiol · October 14, 2014
BACKGROUND: Little is known about mode of death after acute heart failure (AHF) hospitalization. In the RELAX-AHF (Efficacy and Safety of Relaxin for the Treatment of Acute Heart Failure) study, serelaxin, the recombinant form of human relaxin-2, reduced p ...
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Journal ArticleJ Stroke Cerebrovasc Dis · October 2014
BACKGROUND: There is a paucity of information on clinical characteristics, care patterns, and clinical outcomes for hospitalized intracerebral hemorrhage (ICH) patients with chronic kidney disease (CKD). We assessed characteristics, care processes, and in- ...
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Journal ArticleAm J Cardiol · October 1, 2014
There are limited data integrating findings on right-sided cardiac catheterization and cardiopulmonary exercise testing in ambulatory patients with heart failure. In this study, 187 outpatients with HF referred to the Duke Medical Center for consideration ...
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Journal ArticleCirculation · September 16, 2014
BACKGROUND: Contradictory results have been reported on the effects of nesiritide on renal function in patients with acute decompensated heart failure. We studied the effects of nesiritide on renal function during hospitalization for acute decompensated he ...
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Journal ArticleJ Am Heart Assoc · September 10, 2014
BACKGROUND: In 2009, the Get With The Guidelines-Heart Failure program enhanced the standard recognition of hospitals by offering additional recognition if hospitals performed well on certain quality measures. We sought to determine whether initiation of t ...
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Journal ArticleAm Heart J · September 2014
BACKGROUND: Million Hearts is a national initiative to prevent 1 million heart attacks and strokes over 5 years. The degree to which outpatient providers are controlling risk factors has not been fully described. METHODS: We examined adherence to the Milli ...
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Journal ArticleStroke · September 2014
BACKGROUND AND PURPOSE: The American Heart Association/American Stroke Association guidelines recommend intravenous tissue-type plasminogen activator (tPA) treatment 3 to 4.5 hours from symptom onset according to criteria used in the Third European Coopera ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · September 2014
BACKGROUND: Patients with heart failure and atrial fibrillation are at higher risk of thromboembolic events than patients with heart failure alone. Yet, the use of anticoagulation therapy varies in clinical practice, especially among older patients, for wh ...
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Journal ArticleJ Am Coll Cardiol · August 12, 2014
BACKGROUND: The RELAX (Phosphodiesterase-5 Inhibition to Improve Clinical Status and Exercise Capacity in Heart Failure with Preserved Ejection Fraction) study was a multicenter, randomized trial of sildenafil versus placebo in heart failure with preserved ...
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Journal ArticleJ Am Heart Assoc · July 11, 2014
BACKGROUND: A subset of patients hospitalized with acute heart failure experiences worsening clinical status and requires escalation of therapy. Worsening heart failure is an end point in many clinical trials, but little is known about its prevalence in cl ...
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Journal ArticleCirc Heart Fail · July 2014
BACKGROUND: Exercise intolerance is a hallmark of heart failure, but factors associated with impaired exercise capacity in heart failure with preserved ejection fraction are unclear. We hypothesized that in heart failure with preserved ejection fraction, t ...
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Journal ArticleJ Am Heart Assoc · June 5, 2014
BACKGROUND: Relatively little is known about the quality of care and outcomes for hospitalized ischemic stroke patients with chronic kidney disease (CKD). We examined quality of care and in-hospital prognoses among patients with CKD in the Get With The Gui ...
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Journal ArticleJAMA · June 4, 2014
IMPORTANCE: Clinical trials of prophylactic implantable cardioverter-defibrillators (ICDs) have included a minority of patients with a left ventricular ejection fraction (LVEF) between 30% and 35%. Because a large number of ICDs in the United States are im ...
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Journal ArticleAm Heart J · June 2014
BACKGROUND: Guidelines recommend noninvasive tests (NITs) to risk stratify and identify patients with higher likelihood of coronary artery disease (CAD) prior to elective coronary angiography. However, a high percentage of patients are found to have nonobs ...
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Journal ArticleAnn Intern Med · May 6, 2014
BACKGROUND: Trials comparing implantable cardioverter-defibrillator (ICD) therapy with cardiac resynchronization therapy with a defibrillator (CRT-D) are limited to selected patients treated at centers with extensive experience. OBJECTIVE: To compare outco ...
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Journal ArticleJ Card Fail · May 2014
BACKGROUND: Inflammation is associated with progression of chronic heart failure (HF). Few data exist on high-sensitivity C-reactive protein (hsCRP) levels and their importance in acute HF. METHODS AND RESULTS: In this biomarker substudy of the ASCEND-HF t ...
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Journal ArticleStroke · May 2014
BACKGROUND AND PURPOSE: The benefits of intravenous tissue-type plasminogen activator in acute ischemic stroke are time dependent, and several strategies have been reported to be associated with more rapid door-to-needle (DTN) times. However, the extent to ...
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Journal ArticleClin Cardiol · May 2014
BACKGROUND: Revascularization availability at US hospitals varies and may impact care quality for acute coronary syndrome patients. HYPOTHESIS: The hypothesis of this study was that there would be differences in care quality at Get With The Guidelines-Coro ...
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Journal ArticleJAMA · April 23, 2014
IMPORTANCE: The benefits of intravenous tissue plasminogen activator (tPA) in patients with acute ischemic stroke (AIS) are time dependent and guidelines recommend a door-to-needle (DTN) time of 60 minutes or less. However, studies have found that less tha ...
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Journal ArticleJ Am Coll Cardiol · April 15, 2014
OBJECTIVES: This study sought to examine trends in mortality, readmission, and costs among Medicare beneficiaries receiving ventricular assist devices (VADs) and associations between hospital-level procedure volume and outcomes. BACKGROUND: VADs are an opt ...
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Journal ArticleAm Heart J · April 2014
BACKGROUND: Recent initiatives have focused on primary prevention to delay time to first myocardial infarction (MI). The aim of this study was to evaluate the change in risk factor profile over time in patients without known cardiovascular disease presenti ...
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Journal ArticleClin Cardiol · March 2014
BACKGROUND: Although atrial fibrillation (AF) occurs frequently in patients hospitalized with acute coronary syndrome (ACS), strategies for prevention of thromboembolic complications are poorly characterized. HYPOTHESIS: We sought to examine exposure to wa ...
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Journal ArticleAm Heart J · March 2014
Randomized clinical trials have identified a population of acute medically ill patients who remain at risk for venous thromboembolism (VTE) beyond the standard duration of therapy and hospital discharge. The aim of the APEX study is to determine whether ex ...
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Journal ArticleEur J Heart Fail · March 2014
AIM: Acute decompensated heart failure (ADHF) is associated with significant morbidity and mortality but the relationship between LVEF and outcomes is unclear. We explored the association between LVEF and 30 and 180 day mortality in 7007 ADHF patients enro ...
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Journal ArticleAm Heart J · March 2014
BACKGROUND: The relative impact of atrial fibrillation on early outcomes of patients with heart failure with reduced or preserved ejection fraction (EF) is unknown. METHODS: We conducted a retrospective cohort study of clinical registry data linked to Medi ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · March 2014
BACKGROUND: The Relaxin for the Treatment of Acute Heart Failure (RELAX-AHF) trial enrolled 1161 patients admitted to the hospital for acute heart failure (AHF) to evaluate the therapeutic efficacy of serelaxin, a recombinant form of human relaxin-2. We ch ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · March 2014
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) initiated after myocardial infarction (MI) reduce mortality and are American College of Cardiology/American Heart Association guideline recommended. Yet the ...
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Journal ArticleCirc Heart Fail · March 1, 2014
BACKGROUND: Prior claims analyses suggest that the use of intravenous inotropic therapy for patients hospitalized with heart failure varies substantially by hospital. Whether differences in the clinical characteristics of the patients explain observed diff ...
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Journal ArticleJ Card Fail · February 2014
BACKGROUND: Despite chronic systemic anticoagulation, advanced heart failure patients treated with a continuous-flow left ventricular assist device (LVAD) remain at risk for pump thrombosis. Pump thrombosis may initially be suspected in the setting of clin ...
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Journal ArticleJACC Heart Fail · February 2014
OBJECTIVES: This study sought to examine the long-term outcomes of patients hospitalized with heart failure and atrial fibrillation. BACKGROUND: Atrial fibrillation is common among patients hospitalized with heart failure. Associations of pre-existing and ...
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Journal ArticleJ Stroke Cerebrovasc Dis · February 2014
BACKGROUND: [corrected] Few studies have examined associations among insurance status, treatment, and outcomes in patients hospitalized for intracerebral hemorrhage (ICH). METHODS: Through retrospective analyses of the Get With The Guidelines (GWTG)-Stroke ...
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Journal ArticleJ Card Fail · January 2014
BACKGROUND: Postdischarge adherence and long-term persistence in the use of warfarin among patients with heart failure and atrial fibrillation without contraindications have not been fully described. METHODS AND RESULTS: We identified patients with heart f ...
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Journal ArticleEur Heart J · January 2014
AIMS: Atrial fibrillation increases the risks of stroke, heart failure, and death, and anticoagulation therapy increases the risk of gastrointestinal haemorrhage. However, the relative event rates for these outcomes are not well described. We sought to def ...
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Journal ArticleClin Cardiol · January 2014
BACKGROUND: Postoperative atrial fibrillation (POAF) is a well-recognized complication of cardiac surgery; however, its management remains a challenge, and the implementation and outcomes of various strategies in clinical practice remain unclear. HYPOTHESI ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · January 2014
BACKGROUND: Despite mild reductions in rates of lower extremity amputation over the past decade, few data exist on the use of arterial testing in patients before amputation. METHODS AND RESULTS: Using Medicare claims from 2000 through 2010, we examined rat ...
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Journal ArticleCirc Heart Fail · January 2014
Patients with advanced HF and coexisting VHD who undergo LVAD implantation constitute a growing population and pose unique challenges in clinical and surgical management. Contemporary continuous-flow LVADs alter blood flow dynamics and cardiovascular physi ...
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Journal ArticleCirc Heart Fail · January 2014
BACKGROUND: Atrial fibrillation (AF) is common among patients with heart failure and preserved ejection fraction (HFpEF), but its clinical profile and impact on exercise capacity remain unclear. RELAX (Phosphodiesterase-5 Inhibition to Improve Clinical Sta ...
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Journal ArticleAmerican heart journal · 2014
The relative impact of atrial fibrillation on early outcomes of patients with heart failure with reduced or preserved ejection fraction (EF) is unknown. We conducted a retrospective cohort study of clinical registry data linked to Medicare claims for patie ...
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Journal ArticleJAMA · December 18, 2013
IMPORTANCE: Small studies suggest that low-dose dopamine or low-dose nesiritide may enhance decongestion and preserve renal function in patients with acute heart failure and renal dysfunction; however, neither strategy has been rigorously tested. OBJECTIVE ...
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Journal ArticleJACC Heart Fail · December 2013
OBJECTIVES: The aim of this study was to compare clinical outcomes, resource utilization, and health-related quality of life between Canadian and U.S. patients enrolled in ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Hear ...
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Journal ArticleJournal of Atrial Fibrillation · December 1, 2013
The risks and benefits of anticoagulation for patients with both heart failure and atrial fibrillation are unclear. We hypothesized that anticoagulation was associated with improved clinical outcomes of heart failure patients with atrial fibrillation indep ...
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Journal ArticleJ Atr Fibrillation · December 2013
The risks and benefits of anticoagulation for patients with both heart failure and atrial fibrillation are unclear. We hypothesized that anticoagulation was associated with improved clinical outcomes of heart failure patients with atrial fibrillation indep ...
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Journal ArticleClin Cardiol · December 2013
BACKGROUND: Effective warfarin thromboprophylaxis requires maintaining anticoagulation within the recommended international normalized ratio (INR) range. INR testing rates and associations between testing and outcomes are not well understood. HYPOTHESIS: I ...
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Journal ArticleClin Cardiol · December 2013
BACKGROUND: Prior studies have described racial/ethnic disparities in door-to-balloon (DTB) time for patients undergoing primary percutaneous coronary intervention (PCI). We sought to compare DTB time between different racial/ethnic groups undergoing prima ...
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Journal ArticleAm Heart J · December 2013
BACKGROUND: In heart failure (HF), there are known differences in plasma B-type natriuretic peptide (BNP) levels between reduced and preserved ejection fraction (EF), but few HF studies have explored sex differences. We sought to evaluate the relationship ...
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Journal ArticleJ Stroke Cerebrovasc Dis · November 2013
BACKGROUND: National guidelines recommend dysphagia screening (DS) before oral intake in stroke patients to reduce hospital-acquired pneumonia (HAP). We examined the relationship between DS and HAP after ischemic stroke. METHODS: Get with the Guidelines-St ...
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Journal ArticleCirc Heart Fail · November 2013
BACKGROUND: Extended criteria cardiac transplant (ECCT) programs expand the transplant pool by matching donors and recipients typically excluded from the transplant process because of age or comorbidity. There is a paucity of data examining long-term outco ...
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Journal ArticleJ Am Heart Assoc · October 14, 2013
BACKGROUND: Hospital certification and recognition programs represent 2 independent but commonly used systems to distinguish hospitals, yet they have not been directly compared. This study assessed acute ischemic stroke quality of care measure conformity b ...
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Journal ArticleEur J Heart Fail · October 2013
Endpoint selection is a critically important step in clinical trial design. It poses major challenges for investigators, regulators, and study sponsors, and it also has important clinical and practical implications for physicians and patients. Clinical out ...
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Journal ArticleAm J Cardiol · October 1, 2013
Risk of atrial fibrillation (AF) after coronary artery bypass grafting (CABG) is high, yet the effectiveness of guideline-recommended preoperative prophylaxis in clinical practice remains uncertain. We determined the utilization and variation of preoperati ...
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Journal ArticleJACC Heart Fail · October 2013
OBJECTIVES: This study sought to examine the associations of hospitalist and cardiologist care of patients with heart failure with outcomes and adherence to quality measures. BACKGROUND: The hospitalist model of inpatient care has grown nationally, but its ...
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Journal ArticleJ Am Heart Assoc · September 26, 2013
BACKGROUND: The intersection of heart failure (HF) and atrial fibrillation (AF) is common, but the burden of AF among black patients with HF is poorly characterized. We sought to determine the prevalence of AF, characteristics, in-hospital outcomes, and wa ...
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Journal ArticleJ Am Coll Cardiol · September 24, 2013
OBJECTIVES: This study sought to determine if nesiritide increases diuresis in congestive heart failure patients. BACKGROUND: In the ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide and Decompensated Heart Failure), 7,141 patients hospitalize ...
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Journal ArticleJ Am Heart Assoc · September 11, 2013
BACKGROUND: Dispensing data from Medicare Part D standalone prescription drug plans are now available, but characteristics of enrollees with heart failure have not been well described. METHODS AND RESULTS: We identified 81 874 patients with prevalent heart ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · September 1, 2013
BACKGROUND: Translation of evidence-based heart failure (HF) therapies to clinical practice is incomplete and may vary internationally. We examined common measures of quality of care in patients enrolled in the international Acute Study of Clinical Effecti ...
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Journal ArticleJ Card Fail · September 2013
BACKGROUND: The Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure (ASCEND-HF) randomly assigned 7,141 participants to nesiritide or placebo. Dyspnea improvement was more often reported in the nesiritide group, but there wer ...
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Journal ArticleJ Am Heart Assoc · August 21, 2013
BACKGROUND: Hydralazine-isosorbide dinitrate (H-ISDN) therapy is recommended for African American patients with moderate to severe heart failure with reduced ejection fraction (<40%) (HFrEF), but use, temporal trends, and clinical characteristics associate ...
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Journal ArticleJAMA · August 14, 2013
IMPORTANCE: The benefits of cardiac resynchronization therapy (CRT) in clinical trials were greater among patients with left bundle-branch block (LBBB) or longer QRS duration. OBJECTIVE: To measure associations between QRS duration and morphology and outco ...
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Journal ArticleAm Heart J · August 2013
BACKGROUND: Timing of initial treatment for acute decompensated heart failure (ADHF) varies across hospitals and its impact on outcomes remains poorly defined. We examined the association between time to first intravenous (IV) heart failure (HF) therapy an ...
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Journal ArticleJACC Heart Fail · August 2013
OBJECTIVES: This study sought to determine if there were differences in B-type natriuretic peptide (BNP) levels across racial/ethnic groups and in their association with quality of care and in-hospital outcomes among patients with heart failure (HF). BACKG ...
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Journal ArticleEur J Heart Fail · July 2013
Anti-beta-1-adrenergic receptor antibodies (anti-β1AR Abs) have long been implicated in the pathogenesis of dilated cardiomyopathy (DCM). It is believed that these autoantibodies bind to and constitutively stimulate the β1AR to promote pathological cardiac ...
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Journal ArticleCirc Heart Fail · July 2013
BACKGROUND: Hospital readmission is an important clinical outcome of patients with heart failure. Its relation to length of stay for the initial hospitalization is not clear. METHODS AND RESULTS: We used hierarchical modeling of data from a clinical trial ...
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Journal ArticleJAMA · June 19, 2013
IMPORTANCE: Randomized clinical trials suggest the benefit of intravenous tissue-type plasminogen activator (tPA) in acute ischemic stroke is time dependent. However, modest sample sizes have limited characterization of the extent to which onset to treatme ...
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Journal ArticleJ Am Coll Cardiol · June 18, 2013
Heart failure (HF) is a major public health problem leading to frequent hospitalizations, impaired quality of life, and shortened life expectancy. Heart failure leads to a chronic inability to meet metabolic requirements of end organs or skeletal muscle. C ...
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Journal ArticleEur J Cardiovasc Nurs · June 2013
BACKGROUND: The purpose of this study was to explore the theoretical linkages between symptom experiences and meaning associated with medication adherence. The specific objectives were to evaluate the key constructs of Meaning-Response theory for understan ...
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Journal ArticleJ Cardiovasc Electrophysiol · June 2013
INTRODUCTION: Practice guidelines recommend the use of ICDs in patients with heart failure (HF) and a left ventricular ejection fraction (LVEF) of ≤ 35% in the absence of contraindications. METHODS AND RESULTS: We performed an analysis of ICD use among pat ...
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Journal ArticleAm Heart J · June 2013
Sudden cardiac arrest (SCA) is one of the most impactful public health problems in the United States. Despite the progress made in reducing the number of cardiac deaths, the incidence of sudden cardiac death remains high. Studies of life-saving interventio ...
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Journal ArticleAm Heart J · June 2013
BACKGROUND: Aldosterone antagonist therapy is recommended for selected patients with heart failure and reduced ejection fraction. Adherence to therapy in the transition from hospital to home is not well understood. METHODS: We identified patients with hear ...
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Journal ArticleAm Heart J · June 2013
BACKGROUND: Hospitals are challenged to reduce length of stay (LOS), yet simultaneously reduce readmissions for patients with heart failure (HF). This study investigates whether 30-day rehospitalization or an alternative measure of total inpatient days ove ...
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Journal ArticleJ Card Fail · June 2013
BACKGROUND: Patients with heart failure are at higher risk for thromboembolic events, even in the absence of atrial fibrillation, but the effect of anticoagulation therapy on outcomes is uncertain. METHODS AND RESULTS: With data from a clinical registry li ...
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Journal ArticleJACC Heart Fail · June 2013
OBJECTIVES: The study sought to derive and validate risk-prediction tools from a large nationwide registry linked with Medicare claims data. BACKGROUND: Few clinical models have been developed utilizing data elements readily available in electronic health ...
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Journal ArticleJ Card Fail · June 2013
Acute decompensated heart failure (ADHF) is a complex clinical event associated with excess morbidity and mortality. Managing ADHF patients is challenging because of the lack of effective treatments that both reduce symptoms and improve clinical outcomes. ...
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ConferenceAm J Transplant · May 2013
The Food and Drug Administration (FDA) held an open public workshop in September 2011 to discuss the current state of science related to the effects of ischemia reperfusion injury (IRI) on outcomes in kidney transplantation. Topics included the development ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · May 1, 2013
BACKGROUND: Prior studies found that only about half of stroke patients arrived at hospitals via emergency medical services (EMSs), yet since then, there have been efforts to increase public awareness that time is brain. Using contemporary Get With the Gui ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · May 1, 2013
BACKGROUND: Little is known as to whether long-term outcomes of acute ischemic stroke (AIS) vary by race/ethnicity. Using the American Heart Association Get With The Guidelines-Stroke registry linked with Medicare claims data set, we examined whether 30-da ...
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Journal ArticleEur J Heart Fail · April 2013
AIMS: To examine the characteristics associated with early dyspnoea relief during acute heart failure (HF) hospitalization, and its association with 30-day outcomes. METHODS AND RESULTS: ASCEND-HF was a randomized trial of nesiritide vs. placebo in 7141 pa ...
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Journal ArticleAm Heart J · April 2013
BACKGROUND: Prior studies have suggested an association between higher heart rate and higher mortality, particularly in chronic heart failure (HF). Whether this relationship holds true in patients hospitalized with HF and differs between patients in sinus ...
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Journal ArticleJACC Heart Fail · April 2013
OBJECTIVES: The purpose of this study was to determine whether exercise training is associated with an increased risk of implantable cardioverter-defibrillator (ICD) therapy in patients with heart failure (HF). BACKGROUND: Few data are available regarding ...
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Journal ArticleJAMA · March 27, 2013
IMPORTANCE: Studies in experimental and human heart failure suggest that phosphodiesterase-5 inhibitors may enhance cardiovascular function and thus exercise capacity in heart failure with preserved ejection fraction (HFPEF). OBJECTIVE: To determine the ef ...
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Journal Article · March 21, 2013
Cardiac sarcoidosis can present as ventricular ectopy, sustained ventricular arrhythmias, asymptomatic ventricular dysfunction, heart failure, or sudden death. Although 25% of patients with sarcoidosis have evidence of cardiac involvement autopsy, only 5% ...
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Journal ArticleCirc Heart Fail · March 2013
BACKGROUND: Congestion is a primary driver of symptoms in patients with acute heart failure, and relief of congestion is a critical goal of therapy. Monitoring of response to therapy through the assessment of daily weights and net fluid loss is the current ...
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Journal ArticleCirc Heart Fail · March 2013
BACKGROUND: Impaired glucose tolerance and metabolic syndrome are associated with increased risk of heart failure (HF). However, predictors associated with the increased risk of incident HF have not been well characterized. We aimed to identify independent ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · March 1, 2013
BACKGROUND: Comparative effectiveness reviews offer a systematic method to critically appraise existing research and to identify unaddressed clinical areas in cardiovascular disease where significant morbidity, mortality, and variation in the use of resour ...
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Journal ArticleJ Am Heart Assoc · January 28, 2013
BACKGROUND: We aimed to derive and validate a single risk score for predicting death from ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH). METHODS AND RESULTS: Data from 333 865 stroke patients (IS, 82.4%; ICH, 11.2% ...
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Journal ArticleJ Am Coll Cardiol · January 8, 2013
OBJECTIVES: This study explored temporal trends in the use of aldosterone antagonist therapy among eligible patients with post-acute myocardial infarction (AMI) and reduced ejection fraction and characteristics associated with use in clinical practice. BAC ...
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Journal ArticleAm J Med · January 2013
BACKGROUND: There have been substantial improvements in the use of evidence-based, guideline-recommended therapies for patients with acute myocardial infarction. Nevertheless, some gaps, disparities, and variations in use remain. To understand how such gap ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · January 1, 2013
BACKGROUND: Secondary prevention therapies improve longitudinal outcomes in patients with coronary artery disease. Previous studies showed that teaching hospitals (THs) more consistently use evidence-based secondary prevention therapies than non-THs (NTHs) ...
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Journal ArticleASAIO J · 2013
A 69-year-old man with advanced heart failure treated with a continuous-flow left ventricular assist device presented for evaluation of dark urine and severe dysphagia. Because of evidence of ongoing intravascular hemolysis with device dysfunction, there w ...
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Journal ArticleASAIO J · 2013
Primary adrenal insufficiency or Addison's disease is a rare disorder often difficult to diagnose on presentation by the nature of its associated nonspecific symptoms, such as nausea or weakness. Cardiovascular complications of the condition are usually li ...
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Journal ArticleN Engl J Med · December 27, 2012
BACKGROUND: Disorders of mineral metabolism, including secondary hyperparathyroidism, are thought to contribute to extraskeletal (including vascular) calcification among patients with chronic kidney disease. It has been hypothesized that treatment with the ...
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Journal ArticleN Engl J Med · December 13, 2012
BACKGROUND: Ultrafiltration is an alternative strategy to diuretic therapy for the treatment of patients with acute decompensated heart failure. Little is known about the efficacy and safety of ultrafiltration in patients with acute decompensated heart fai ...
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Journal ArticleJAMA · November 28, 2012
CONTEXT: Aldosterone antagonist therapy for heart failure and reduced ejection fraction has been highly efficacious in randomized trials. However, questions remain regarding the effectiveness and safety of the therapy in clinical practice. OBJECTIVE: To ex ...
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Journal ArticleArch Intern Med · November 12, 2012
BACKGROUND: Although certain drugs that target the renin- angiotensin-aldosterone system are linked to an increased risk for angioedema, data on their absolute and comparative risks are limited. We assessed the risk for angioedema associated with the use o ...
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Journal ArticleEur J Heart Fail · November 2012
AIMS: We examined the prognostic importance of cardiac troponin I (cTnI) in a cohort of patients enrolled in the ASCEND-HF study of nesiritide in acute decompensated heart failure (ADHF). Circulating troponins are a prognostic marker in patients with ADHF. ...
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Journal ArticleClin Cardiol · November 2012
BACKGROUND: Warfarin use and associated outcomes in patients with heart failure and atrial fibrillation and a cardiovascular implantable electronic device have not been described previously. HYPOTHESIS: We hypothesized that warfarin is underused and is ass ...
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Journal ArticleCirc Heart Fail · November 2012
BACKGROUND: Reducing 30-day heart failure readmission rates is a national priority. Yet, little is known about how hospitals address the problem and whether hospital-based processes of care are associated with reductions in readmission rates. METHODS AND R ...
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Journal ArticleCirc Heart Fail · November 2012
BACKGROUND: Randomized controlled trials (RCT) are limited by their generalizability to the broader nontrial population. To provide a context for Acute Study of Nesiritide in Decompensated Heart Failure (ASCEND-HF) trial, we designed a complementary regist ...
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Journal ArticleCirculation · October 30, 2012
BACKGROUND: Atrial fibrillation is common among older persons. Catheter ablation is increasingly used in patients for whom medical therapy has failed. METHODS AND RESULTS: We conducted a retrospective cohort study of all fee-for-service Medicare beneficiar ...
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Journal ArticleClin Cardiol · October 2012
BACKGROUND: Data regarding reperfusion strategies, adherence to national guidelines, and in-hospital mortality in ST-elevation myocardial infarction (STEMI) patients age ≥80 years are limited. The aim of this study was to determine current reperfusion tren ...
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Journal ArticleAm J Med · October 2012
BACKGROUND: Young patients (aged≤45 years) presenting with ST-segment elevation myocardial infarction present unique challenges. The quality of care and in-hospital outcomes may differ from their older counterparts. METHODS: A total of 31,544 patients pres ...
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Journal ArticleClin Cardiol · October 2012
BACKGROUND: Guidelines recommend evaluation of cardiac function, valvular and ischemic heart disease, and thyroid, kidney, and liver function on initial diagnosis of atrial fibrillation (AF). HYPOTHESIS: We hypothesized that initial workup of patients with ...
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Journal ArticleHeart Rhythm · September 2012
BACKGROUND: There are limited data regarding national patterns of pharmacotherapy for atrial fibrillation (AF) among older patients. Drug exposure data are now captured for Medicare beneficiaries enrolled in prescription drug plans. OBJECTIVE: To describe ...
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Journal ArticleClin Cardiol · September 2012
BACKGROUND: Many patients admitted for acute myocardial infarction (AMI) have chronic renal insufficiency. We studied the impact of chronic renal insufficiency on mortality and quality of inpatient care for AMI from the American Heart Association's Get Wit ...
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Journal ArticleStroke · September 2012
BACKGROUND AND PURPOSE: There are few validated models for prediction of risk of symptomatic intracranial hemorrhage (sICH) after intravenous tissue-type plasminogen activator treatment for ischemic stroke. We used data from Get With The Guidelines-Stroke ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · September 1, 2012
BACKGROUND: Clinical guidelines recommend similar medical therapy for patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation MI (NSTEMI). METHODS AND RESULTS: Using the Get with the Guidelines-Coronary Artery Disease ...
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Journal ArticleCirc Heart Fail · September 1, 2012
Heart failure (HF) with preserved ejection fraction (HFpEF) or “diastolic HF” accounts for approximately half of HF cases. To date, neurohumoral antagonists have failed to show a significant benefit on clinical outcomes in HFpEF. While our understanding of ...
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Journal ArticleJ Am Heart Assoc · August 2012
BACKGROUND: An analysis of the changes in the clinical and demographic characteristics of patients with acute myocardial infarction could identify successes and failures of risk factor identification and treatment of patients at increased risk for cardiova ...
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Journal ArticleJ Am Heart Assoc · August 2012
BACKGROUND#ENTITYSTARTX02014;: Emergency medical services (EMS) hospital prenotification of an incoming stroke patient is guideline recommended as a means of increasing the timeliness with which stroke patients are evaluated and treated. Still, data are li ...
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Journal ArticleJAMA · July 18, 2012
CONTEXT: There is increasing interest in reporting risk-standardized outcomes for Medicare beneficiaries hospitalized with acute ischemic stroke, but whether it is necessary to include adjustment for initial stroke severity has not been well studied. OBJEC ...
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Journal ArticleCirculation · July 3, 2012
BACKGROUND: Heart failure with preserved ejection fraction (EF) is a common syndrome, but trends in treatments and outcomes are lacking. METHODS AND RESULTS: We analyzed data from 275 hospitals in Get With the Guidelines-Heart Failure from January 2005 to ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · July 1, 2012
BACKGROUND: The benefits of intravenous tissue-plasminogen activator (tPA) in acute ischemic stroke are time-dependent. Emergency medical services (EMS) hospital prenotification of an incoming patient with potential stroke may provide a means of reducing e ...
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Journal ArticleStroke · July 2012
BACKGROUND AND PURPOSE: Time from symptom onset to hospital arrival is the most important factor in determining eligibility for intravenous tissue-type plasminogen activator. We used data from a large contemporary nationwide study to determine temporal tre ...
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Journal ArticleJAMA · June 27, 2012
CONTEXT: Intravenous tissue plasminogen activator (tPA) is known to improve outcomes in ischemic stroke; however, patients receiving long-term chronic warfarin therapy may face an increased risk for intracranial hemorrhage when treated with tPA. Although c ...
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Journal ArticleJ Card Fail · June 2012
BACKGROUND: Guidelines recommend hospice care as a treatment option for end-stage heart failure (HF) patients. Little is known regarding utilization of hospice care in a contemporary cohort of patients hospitalized with HF and how this may vary by estimate ...
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Journal ArticleAm Heart J · June 2012
BACKGROUND: Patients hospitalized with heart failure (HF) have elevated B-type natriuretic peptide (BNP) levels and increased risk for thromboembolic events. Associations between BNP level and thromboembolic events in patients with HF without atrial fibril ...
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Journal ArticleAm Heart J · June 2012
BACKGROUND: Despite demonstrated efficacy in randomized trials, aldosterone antagonist therapy is not used in many eligible patients with heart failure. Questions remain about its clinical effectiveness and safety for patients who are underrepresented in r ...
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Journal ArticleAm Heart J · May 2012
BACKGROUND: We sought to characterize patient factors and regional variations associated with vitamin K antagonist (VKA) use in patients with heart failure (HF) and atrial fibrillation (AF) in areas outside the United States and Europe. METHODS: The ADHERE ...
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Journal ArticleJ Am Coll Cardiol · April 17, 2012
OBJECTIVES: This study hypothesized that peak expiratory flow rate (PEFR) would increase with acute heart failure (AHF) treatment over the first 24 h, related to a Dyspnea Index (DI) change and treatment effect. BACKGROUND: Dyspnea is a key symptom and cli ...
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Journal ArticleJ Card Fail · April 2012
Aldosterone antagonists (or mineralocorticoid receptor antagonists [MRAs]) are guideline-recommended therapy for patients with moderate to severe heart failure (HF) symptoms and reduced left ventricular ejection fraction (LVEF), and in postmyocardial infar ...
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Journal ArticleCirculation · March 6, 2012
BACKGROUND: Prior studies have demonstrated low use of implantable cardioverter defibrillators (ICDs) as primary prevention, particularly among women and blacks. The degree to which the overall use of ICD therapy and disparities in use have changed is uncl ...
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Journal ArticleAm J Cardiol · March 1, 2012
Disease management programs that target patients with the highest risk of subsequent costs may help payers and providers control health care costs, but identifying these patients prospectively is challenging. We hypothesized that medical history and clinic ...
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Journal ArticleAm Heart J · March 2012
BACKGROUND: Get With The Guidelines (GWTG)-Stroke is a national stroke registry and quality improvement program. We examined the accuracy and reliability of data entered in GWTG-Stroke. METHODS: Data entered by sites in the GWTG-Stroke database were compar ...
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Journal ArticleAm Heart J · March 2012
BACKGROUND: There are no sex-specific survival comparisons between patients with heart failure (HF) with reduced and those with preserved ejection fraction. Large registries noting women have better survival than men combined HF patients with reduced and p ...
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Journal ArticleCirc Heart Fail · March 1, 2012
BACKGROUND: It is unclear if the presence of atrial fibrillation (AF) on admission is associated with worse in-hospital outcomes in patients hospitalized with heart failure (HF). This study evaluated the clinical characteristics, management, length of stay ...
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Journal ArticleCirc Heart Fail · March 1, 2012
BACKGROUND: Although individuals of Hispanic ethnicity are at high risk for developing heart failure (HF), little is known about differences between Hispanic HF patients stratified by left ventricular ejection fraction (EF). We compared characteristics, qu ...
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Journal ArticleJ Am Heart Assoc · February 2012
BACKGROUND: The National Institutes of Health Stroke Scale (NIHSS), a well-validated tool for assessing initial stroke severity, has previously been shown to be associated with mortality in acute ischemic stroke. However, the relationship, optimal categori ...
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Journal ArticleAm Heart J · February 2012
BACKGROUND: The purpose of this study was to determine patient and hospital characteristics associated with 4 measures of quality of inpatient heart failure care used by both the primary payer of heart failure care in the United States (Center for Medicare ...
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Journal ArticleJ Card Fail · February 2012
Cardiac resynchronization therapy (CRT) improves survival, symptoms, quality of life, exercise capacity, and cardiac structure and function in patients with New York Heart Association (NYHA) functional class II or ambulatory class IV heart failure (HF) wit ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · January 2012
BACKGROUND: Atrial fibrillation (AF) is a common and costly problem among older persons. The frequency of AF increases with age, but representative national data about incidence and prevalence are limited. We examined the annual incidence, prevalence, and ...
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Journal ArticleStroke · January 2012
BACKGROUND AND PURPOSE: Get With The Guidelines (GWTG)-Stroke is a large quality improvement-based registry of acute stroke; however, its generalizability is unclear. We used fee-for-service Medicare claims to ascertain the representativeness of ischemic s ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · January 2012
BACKGROUND: Asian-Americans represent an important United States minority population, yet there are limited data regarding the clinical care and outcomes of Asian-Americans following acute myocardial infarction (AMI). Using data from the American Heart Ass ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · January 2012
BACKGROUND: Hospitals enrolled in the American Heart Association's Get With The Guidelines Program for heart failure (GWTG-HF) have improved their process of care. However, it is unclear if process of care and outcomes are better in the GWTG-HF hospitals c ...
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Journal ArticleClin Cardiol · 2012
BACKGROUND: Successful smoking cessation in stroke and coronary artery disease (CAD) patients is important, as smoking contributes to significant morbidity and mortality. The American Heart Association developed Get With The Guidelines (GWTG) to improve co ...
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Journal ArticleJ Card Fail · January 2012
BACKGROUND: Heart failure (HF) is a leading cause of hospitalization. Although a number of multicenter international HF hospital registries have been published, there are limited data for the Asia Pacific region. METHODS: ADHERE (ie, Acute Decompensated He ...
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Journal ArticleAm Heart J · December 2011
BACKGROUND: Although Hispanics constitute the largest minority in the United States, it is unknown whether regional differences in quality of care and outcomes exist among Hispanic patients hospitalized with acute myocardial infarction (MI). METHODS: Using ...
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Journal ArticleClin Cardiol · November 2011
BACKGROUND: Hospitalized medically ill patients are at greater risk for venous thromboembolism (VTE). Although pharmacologic prophylaxis regimens have reduced VTE risk in medically ill patients, associations with early postdischarge adverse clinical outcom ...
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Journal ArticleJ Card Surg · November 2011
BACKGROUND/AIM: Limited clinical data exist to guide practice patterns and evidence-based use of inotropes and vasopressors following coronary artery bypass grafting (CABG). METHODS: Contemporary Analysis of Perioperative Cardiovascular Surgical Care (CAPS ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · November 1, 2011
BACKGROUND: Composite indices of health care performance are an aggregation of underlying individual performance measures and are increasingly being used to rank hospitals. We sought to conduct an observational analysis to determine the influence of the op ...
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Journal ArticleCirc Heart Fail · November 2011
Axial-flow LVADs have become an integral tool in the management of end-stage heart failure. Consequently, nonsurgical bleeding has emerged as a major source of morbidity and mortality in this fragile population. The mechanisms responsible for these adverse ...
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Journal ArticleStroke · November 2011
BACKGROUND AND PURPOSE: Mild or rapidly improving stroke is a frequently cited reason for not giving intravenous recombinant tissue-type plasminogen activator (rtPA), but some of these patients may have poor outcomes. We used data from a large nationwide s ...
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Journal ArticleJ Am Coll Cardiol · October 18, 2011
OBJECTIVES: The goals of this analysis were to determine: 1) whether guideline-based care during hospitalization for a myocardial infarction (MI) varied as a function of patients' baseline risk; and 2) whether temporal improvements in guideline adherence o ...
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Journal ArticleStroke · October 2011
BACKGROUND AND PURPOSE: The benefits of intravenous tissue-type plasminogen activator (tPA) in acute ischemic stroke are time-dependent, and guidelines recommend a door-to-needle time of ≤60 minutes. However, fewer than one third of acute ischemic stroke p ...
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Journal ArticleAm J Cardiol · October 1, 2011
Early physician follow-up after a heart failure (HF) hospitalization is associated with lower risk of readmission. However, factors associated with early physician follow-up are not well understood. We identified 30,136 patients with HF ≥65 years at 225 ho ...
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Journal ArticleAm Heart J · October 2011
BACKGROUND: Anticoagulation therapy reduces thromboembolic events in patients with atrial fibrillation (AF) and has a class I indication for ischemic stroke patients with AF and no contraindications. We determined the patient and hospital level characteris ...
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Journal ArticleJ Am Coll Cardiol · September 27, 2011
OBJECTIVES: The aim of this study was to analyze the relationship between payment source and quality of care and outcomes in heart failure (HF). BACKGROUND: HF is a major cause of morbidity and mortality. There is a lack of studies assessing the associatio ...
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Journal ArticleEur J Heart Fail · September 2011
AIMS: To characterize geographic differences in clinical characteristics and care of patients hospitalized with heart failure and preserved ejection fraction (HF-PEF). METHODS AND RESULTS: Using data on 61 182 admissions in 307 US hospitals from March 2004 ...
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Journal ArticleCirc Heart Fail · September 2011
BACKGROUND: B-type natriuretic peptide (BNP) has been associated with short- and long-term postdischarge prognosis among hospitalized patients with heart failure. It is unknown if admission, discharge, or change from admission to discharge BNP measure is t ...
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Journal ArticleCirc Heart Fail · September 2011
BACKGROUND: Although women account for a significant proportion of heart failure (HF) hospitalizations, data on the quality of care and in-hospital outcomes in women are limited. METHODS AND RESULTS: We examined The Joint Commission performance measures, o ...
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Journal ArticleAm Heart J · September 2011
BACKGROUND: Diabetes mellitus is frequently comorbid with heart failure (HF). It is unclear if comorbid diabetes is associated with quality of care and in-hospital mortality. METHODS: We analyzed 133,971 HF admissions from 431 hospitals between January 200 ...
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Journal ArticleJ Am Coll Cardiol · August 23, 2011
Heart failure (HF) and chronic kidney disease (CKD) both carry significant risk for sudden cardiac death, hospitalization, and mortality; when combined, however, they markedly increase the risk of morbidity and mortality. Device therapies such as implantab ...
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Journal ArticleCirculation · August 9, 2011
BACKGROUND: Process and outcome measures are often used to quantify quality of care in hospitals. Whether these quality measures correlate with one another and the degree to which hospital provider rankings shift on the basis of the performance metric is u ...
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Journal ArticleJ Am Coll Cardiol · August 2, 2011
OBJECTIVES: This study examined the degree to which hospital performance for acute myocardial infarction (AMI) and heart failure (HF) care processes are correlated. BACKGROUND: Although AMI and HF care processes may be amenable to similar quality improveme ...
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Journal ArticleJ Card Fail · August 2011
BACKGROUND: This study was undertaken to identify predictors of hospital length of stay (LOS) for heart failure (HF) patients using clinical variables available at the time of admission and hospital characteristics. METHODS AND RESULTS: A cohort of 70,094 ...
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Journal ArticleAm Heart J · August 2011
Sudden cardiac arrest (SCA) is the most common cause of death in the United States. Despite national guidelines, patients at risk for SCA often fail to receive evidence-based therapies. Racial and ethnic minorities and women are at particularly high risk f ...
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Journal ArticleAm Heart J · August 2011
OBJECTIVES: To determine the adherence to national guidelines and in-hospital mortality of older patients with acute myocardial infarction (AMI) using a national database. BACKGROUND: Prior studies have demonstrated that older patients are less likely to r ...
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Journal ArticleN Engl J Med · July 7, 2011
BACKGROUND: Nesiritide is approved in the United States for early relief of dyspnea in patients with acute heart failure. Previous meta-analyses have raised questions regarding renal toxicity and the mortality associated with this agent. METHODS: We random ...
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Journal ArticleAm J Cardiol · June 15, 2011
Hospitalized patients with heart failure and decreased ejection fraction are at substantial risk for mortality and rehospitalization, yet no acute therapies are proven to decrease this risk. Therefore, in-hospital use of medications proved to decrease long ...
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Journal ArticleAm Heart J · June 2011
BACKGROUND: Although multiple therapies have been shown to lower mortality in patients with heart failure (HF) and reduced left ventricular ejection fraction, their application in clinical practice has been less than ideal. To date, empiric estimation of t ...
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ConferenceAm J Transplant · May 2011
The Food and Drug Administration (FDA) held an open public workshop in June 2010 to discuss the current state of science related to antibody-mediated rejection (AMR) in kidney transplantation. Desensitization, acute AMR and chronic AMR (CAMR) were consider ...
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Journal ArticleJ Card Fail · May 2011
BACKGROUND: Heart failure disease management (HFDM) may be beneficial in heart failure (HF) patients at risk for readmission or post-discharge mortality. However, characteristics of hospitalized HF patients referred to HFDM are not known. METHODS AND RESUL ...
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Journal ArticleCirc Heart Fail · May 2011
BACKGROUND: Heart failure (HF) is the leading cause of hospitalization among older Americans. Subsequent discharge to skilled nursing facilities (SNF) is not well described. METHODS AND RESULTS: We performed an observational analysis of Medicare beneficiar ...
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Journal ArticleAm Heart J · May 2011
BACKGROUND: Policy makers have proposed bundling payments for all heart failure (HF) care within 30 days of an HF hospitalization in an effort to reduce costs. Disease management (DM) programs can reduce costly HF readmissions but have not been economicall ...
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Journal ArticleAm Heart J · April 2011
BACKGROUND: Black and Hispanic populations are at increased risk for developing heart failure (HF) at a younger age and experience differential morbidity and possibly differential mortality compared with whites. Yet, there have been insufficient data chara ...
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Journal ArticleN Engl J Med · March 3, 2011
BACKGROUND: Loop diuretics are an essential component of therapy for patients with acute decompensated heart failure, but there are few prospective data to guide their use. METHODS: In a prospective, double-blind, randomized trial, we assigned 308 patients ...
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Journal ArticleCirculation · February 22, 2011
BACKGROUND: The benefits of intravenous tissue-type plasminogen activator (tPA) in acute ischemic stroke are time dependent, and guidelines recommend an arrival to treatment initiation (door-to-needle) time of ≤60 minutes. METHODS AND RESULTS: Data from ac ...
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Journal ArticleJ Am Coll Cardiol · February 15, 2011
The need for consistent and current data describing the true incidence of sudden cardiac arrest (SCA) and/or sudden cardiac death (SCD) was highlighted during the most recent Sudden Cardiac Arrest Thought Leadership Alliance's (SCATLA) Think Tank meeting o ...
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Journal ArticleArch Intern Med · February 14, 2011
BACKGROUND: Heart failure is a common cause of death among Medicare beneficiaries, but little is known about health care resource use at the end of life. METHODS: In a retrospective cohort study of 229,543 Medicare beneficiaries with heart failure who died ...
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Journal ArticleAm Heart J · February 2011
OBJECTIVES: The study aimed to analyze the use of intensive lipid-lowering therapy (I-LLT) at discharge in a broad population of patients hospitalized with acute coronary syndrome (ACS). BACKGROUND: Early and intensive statin therapy in ACS has been shown ...
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Journal ArticleJAMA · January 5, 2011
CONTEXT: Practice guidelines do not recommend use of an implantable cardioverter-defibrillator (ICD) for primary prevention in patients recovering from a myocardial infarction or coronary artery bypass graft surgery and those with severe heart failure symp ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · January 1, 2011
BACKGROUND: Administrative claims data are used routinely for risk adjustment and hospital profiling for heart failure outcomes. As clinical data become more readily available, the incremental value of adding clinical data to claims-based models of mortali ...
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Journal ArticleStroke · January 2011
BACKGROUND AND PURPOSE: stroke is the second leading cause of hospital admission among older adults in the United States. However, little is known regarding contemporary ischemic stroke mortality and rehospitalization rates for Medicare beneficiaries and h ...
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Journal ArticleJ Urol · December 2010
PURPOSE: The C-index is a morphometric descriptor of renal masses that incorporates tumor size and site. We examined associations of the C-index with kidney function after laparoscopic partial nephrectomy. MATERIALS AND METHODS: We retrospectively reviewed ...
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Journal ArticleAm Heart J · December 2010
OBJECTIVES: The study aimed to analyze the use of intensive lipid-lowering therapy (LLT) at discharge in a broad population of patients hospitalized with acute coronary syndrome (ACS). BACKGROUND: Early and intensive statin therapy in ACS was shown to redu ...
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Journal ArticleJ Am Coll Cardiol · November 2, 2010
Volume overload is an important clinical target in heart failure management, typically addressed using loop diuretics. An important and challenging subset of heart failure patients exhibit fluid overload despite significant doses of loop diuretics. One app ...
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Journal ArticleAm Heart J · November 2010
BACKGROUND: Clinical registries are used increasingly to analyze quality and outcomes, but the generalizability of findings from registries is unclear. METHODS: We linked data from the Acute Decompensated Heart Failure National Registry (ADHERE) to 100% fe ...
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Journal ArticleCirculation · October 12, 2010
BACKGROUND: There are few validated models for prediction of in-hospital mortality after ischemic stroke. We used Get With the Guidelines-Stroke Program data to derive and validate prediction models for a patient's risk of in-hospital ischemic stroke morta ...
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Journal ArticleAm Heart J · October 2010
Sudden cardiac arrest (SCA) is the most common cause of death in the Unites States. Despite its major impact on public health, significant challenges exist at the patient, provider, public, and policy levels with respect to raising more widespread awarenes ...
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Journal ArticleStroke · October 2010
BACKGROUND AND PURPOSE: Many patients hospitalized with intracerebral hemorrhage are at high future risk for ischemic events and may benefit from stain therapy. However, little is known about patterns of statin prescription among patients with intracerebra ...
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Journal ArticleJ Urol · September 2010
PURPOSE: We evaluated renal functional and oncological outcomes after sequential partial nephrectomy and radical nephrectomy in patients with bilateral synchronous kidney tumors. MATERIALS AND METHODS: A total of 220 patients treated from June 1994 to July ...
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Journal ArticleStroke · September 2010
BACKGROUND AND PURPOSE: Physician prescribing patterns change slowly despite published randomized trials and consensus guidelines. We measure the effect of Management of Atherothrombosis With Clopidogrel in High-Risk Patients (MATCH) trial on discharge pre ...
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Journal ArticleAm Heart J · August 2010
In acute heart failure syndrome (AHFS), dyspnea is one of the most common but least understood presenting symptoms for hospitalization. For this reason, dyspnea relief is increasingly becoming a focus in the development of therapies for the treatment of AH ...
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Journal ArticleClin Cardiol · July 2010
BACKGROUND: Most information about the use of guideline-recommended therapies for heart failure reflects what occurred at discharge after an inpatient stay. HYPOTHESIS: Using a nationally representative, community-dwelling sample of elderly Medicare benefi ...
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Journal ArticleAm Heart J · July 2010
BACKGROUND: Kidney disease is common among patients with heart failure, but relationships between worsening renal function (WRF) and outcomes after hospitalization for heart failure are poorly understood, especially among patients with preserved systolic f ...
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Journal ArticleStroke · July 2010
BACKGROUND AND PURPOSE: The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial showed statins reduce vascular risk among patients with atherosclerotic stroke or transient ischemic attack. In this study, we assessed recent nation ...
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Journal ArticleAm J Cardiol · June 15, 2010
We examined whether worsening renal function (RF) was associated with long-term mortality, readmission, and inpatient costs in Medicare beneficiaries hospitalized with heart failure (HF). Baseline renal insufficiency in patients hospitalized for HF is asso ...
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Journal ArticleCirculation · June 1, 2010
BACKGROUND: Racial/ethnic differences in cardiovascular care have been well documented. We sought to determine whether racial/ethnic differences in evidence-based acute myocardial infarction care persist among hospitals participating in a national quality ...
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Journal ArticleAm Heart J · June 2010
BACKGROUND: Prior studies have documented that patients' health insurance status can impact use of guideline-based care as well as acute outcomes for coronary artery disease. Whether insurance status remains a contemporary influence among centers participa ...
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Journal ArticleJAMA · May 5, 2010
CONTEXT: Readmission after hospitalization for heart failure is common. Early outpatient follow-up after hospitalization has been proposed as a means of reducing readmission rates. However, there are limited data describing patterns of follow-up after hear ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · May 2010
BACKGROUND: Although the absolute benefits of an intervention are proportional to patients' underlying risk, studies in heart failure have noted a paradoxical inverse relationship between treatment and risk. The extent to which this reflects higher rates o ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · May 2010
BACKGROUND: Stroke results in substantial death and disability. To address this burden, Get With The Guideline (GWTG)-Stroke was developed to facilitate the measurement, tracking, and improvement in quality of care and outcomes for acute stroke and transie ...
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Journal ArticleAnn Thorac Surg · April 2010
BACKGROUND: End-stage heart failure is a growing problem associated with a high mortality using conventional medical care. Although cardiac transplantation is an excellent treatment option, it is a limited resource and most patients are ineligible for card ...
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Journal ArticleCrit Pathw Cardiol · March 2010
BACKGROUND: Geographic differences in the delivery of guideline-driven care following acute myocardial infarction have been described. The effect of hospital participation in a national performance improvement program on regional variation in quality of ca ...
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Journal ArticleMed Care · March 2010
BACKGROUND: Recent efforts to improve care for patients hospitalized with heart failure have focused on process-based performance measures. Data supporting the link between current process measures and patient outcomes are sparse. OBJECTIVE: To examine the ...
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Journal ArticleAm Heart J · March 2010
BACKGROUND: Previous studies have not confirmed associations between some current performance measures for inpatient heart failure processes of care and postdischarge outcomes. It is unknown if alternative measures are associated with outcomes. METHODS: Us ...
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Journal ArticleAm Heart J · February 2010
BACKGROUND: Previous reports have demonstrated that participation in GWTG-CAD, a national quality initiative of the American Heart Association, is associated with improved guideline adherence for patients hospitalized with CAD. We sought to establish wheth ...
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Journal ArticleKidney Int · February 2010
The CHOIR trial in anemic patients with chronic kidney disease compared epoetin-alfa treatment with low (11.3 g/l) and high (13.5 g/l) hemoglobin targets on the composite end point of death, hospitalization for heart failure, stroke, and myocardial infarct ...
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Journal ArticleExpert Rev Cardiovasc Ther · February 2010
Acute decompensated heart failure is a common clinical problem with associated poor outcomes. Over the last decade, attention to this area has greatly increased, with a focus on medical therapies that may safely offer improvement in acute symptoms and earl ...
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Journal ArticleAm J Cardiol · January 15, 2010
Previous studies have suggested that patients with coronary artery disease (CAD) in rural areas may have worse outcomes due to limited availability of specialists, fewer resources, and less institutional funding. Data were collected from hospitals particip ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · January 2010
BACKGROUND: Effective risk stratification can inform clinical decision-making. Our objective was to derive and validate a risk score for in-hospital mortality in patients hospitalized with heart failure using American Heart Association Get With the Guideli ...
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Journal ArticleCirc Heart Fail · January 2010
BACKGROUND: The clinical effectiveness of implantable cardioverter-defibrillators (ICDs) in older patients with heart failure has not been established, and older patients have been underrepresented in previous studies. METHODS AND RESULTS: We identified pa ...
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Journal ArticleHeart Fail Rev · December 2009
In this review we investigate the role of particulate and soluble guanylate cyclase (pGC and sGC, respectively) pathways in heart failure, and several novel drugs that modify guanylate cyclase. Nesiritide and ularitide/urodilatin are natriuretic peptides w ...
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Journal ArticleAnn Thorac Surg · November 2009
BACKGROUND: Bridge to heart transplantation with a left ventricular assist device (LVAD) can be a promising therapy for patients who are not effectively stabilized with conservative measures. However, referral for LVAD therapy may be limited secondary to r ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · November 2009
BACKGROUND: Significant disparities have been reported in the application of evidence-based guidelines in the treatment of coronary artery disease (CAD) in women and the elderly. We hypothesized that participation in a quality-improvement program could imp ...
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Journal ArticleJAMA · October 21, 2009
CONTEXT: Aldosterone antagonists are recommended for patients with moderate to severe heart failure (HF) and systolic dysfunction. Prior studies suggest underuse of aldosterone antagonists in eligible patients as well as overuse in settings in which therap ...
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Journal ArticleAm Heart J · October 2009
BACKGROUND: Medication and dietary nonadherence are precipitating factors for heart failure (HF) hospitalization; however, the characteristics, outcomes, and quality of care of patients with nonadherence are unknown. Recognizing features of nonadherent pat ...
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Journal ArticleJ Am Coll Cardiol · September 29, 2009
OBJECTIVES: This study sought to examine quality of care and warfarin use at discharge in patients with atrial fibrillation (AF) and heart failure (HF). BACKGROUND: Atrial fibrillation is common in HF, and national guidelines recommend discharge on warfari ...
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Journal ArticleAm Heart J · September 2009
BACKGROUND: Although hospital admissions during weekends have been associated with worse quality of care and worse outcomes in some but not all medical conditions, the impact of weekend versus weekday admission and discharge for heart failure (HF) has not ...
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Journal ArticleAm Heart J · September 2009
BACKGROUND: Measurement of circulating natriuretic peptides has been shown to play an important role in diagnosis and prognosis in patients with chronic heart failure. Whether serial natriuretic peptide measurements to aid in the titration of therapy can i ...
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Journal ArticleNeurology · September 1, 2009
OBJECTIVE: Little is known about in-hospital care for hemorrhagic stroke. We examined quality of care in intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) admissions in the national Get With The Guidelines-Stroke (GWTG-Stroke) database, and ...
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Journal ArticleCirculation · August 18, 2009
BACKGROUND: Patients with prior atherosclerosis in 1 or more vascular territories (coronary, cerebrovascular, or peripheral arterial) who present with acute coronary syndromes have high cardiovascular risk and may benefit significantly from evidence-based ...
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Journal ArticleArch Intern Med · August 10, 2009
BACKGROUND: Recent initiatives have focused on reducing door-to-balloon (DTB) times among patients with acute myocardial infarction undergoing primary percutaneous coronary intervention. However, DTB time is only one of several important AMI care processes ...
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Journal ArticleJ Am Coll Cardiol · August 4, 2009
OBJECTIVES: Our purpose was to determine factors independently associated with cardiac rehabilitation referral, which are currently not well described at a national level. BACKGROUND: Substantial numbers of eligible patients are not referred to cardiac reh ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · July 2009
BACKGROUND: Participation in clinical registries is nonrandom, so participants may differ in important ways from nonparticipants. The extent to which findings from clinical registries can be generalized to broader populations is unclear. METHODS AND RESULT ...
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Journal ArticleAm Heart J · July 2009
BACKGROUND: The appropriate use of vasoactive cardiovascular drugs in high-risk coronary artery bypass grafting (CABG) patients has not been well characterized. METHODS: We performed a detailed chart analysis on 2,390 randomly selected patients undergoing ...
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Journal ArticleJ Am Coll Cardiol · June 16, 2009
Acute heart failure syndromes (AHFS) remain a major cause of morbidity and mortality, in part because the development of new therapies for these disorders has been marked by frequent failure and little success. The heterogeneity of current approaches to AH ...
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Journal ArticleAm Heart J · June 2009
BACKGROUND: Inpatient clinical registries generally have limited ability to provide a longitudinal perspective on care beyond the acute episode. We present a method to link hospitalization records from registries with Medicare inpatient claims data, withou ...
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Journal ArticleAm J Cardiol · June 1, 2009
Beta blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) are evidence-based medications for chronic heart failure, but little is known about the persistent use and clinical effectiveness of these medications. We ...
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Journal ArticleAm Heart J · June 2009
BACKGROUND: Heart failure (HF) is common among elderly adults. Although multiple studies demonstrate age-related declines in the utilization of evidence-based therapies for coronary artery disease, there are few analyses of HF patients to distinguish possi ...
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Journal ArticleAm J Cardiol · April 15, 2009
To improve hospital performance in door-to-balloon (DTB) times nationally, the American College of Cardiology D2B Alliance recently enrolled approximately 1,000 hospitals that perform percutaneous coronary intervention (PCI) across the United States in a l ...
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Journal ArticleJ Am Coll Cardiol · February 3, 2009
OBJECTIVES: The aim of this study was to describe hospital variation and factors associated with adherence to guidelines for implantable cardioverter-defibrillator (ICD) therapy. BACKGROUND: Studies have shown incomplete application of ICD therapy in eligi ...
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Journal ArticleStroke · February 2009
BACKGROUND AND PURPOSE: Previous reports have shown higher in-hospital mortality for patients with acute stroke who arrived on weekends compared with regular workdays. We analyzed the effect of presenting during off-hours, defined as weekends and weeknight ...
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Journal ArticleAm J Cardiol · February 1, 2009
Beta blockers have a proven benefit in the management of patients with acute coronary syndromes (ACS) and for secondary prevention of coronary events. Current guidelines list such reactive airway diseases (RADs) such as asthma and chronic obstructive pulmo ...
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Journal ArticleAm Heart J · February 2009
BACKGROUND: Acute decompensated heart failure (ADHF) is a major public health burden with significant mortality and morbidity. Nesiritide is a recombinantly produced intravenous formulation of human B-type natriuretic peptide that promotes vasodilation and ...
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Journal ArticleAm Heart J · February 2009
Acute decompensated heart failure (ADHF) is a major public health issue and remains a heterogeneous, complex, and difficult condition to manage. Although novel acute therapies are being tested in large randomized clinical trials, opportunities exist to imp ...
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Journal ArticleJ Am Coll Cardiol · January 13, 2009
OBJECTIVES: We sought to examine associations between initiation of beta-blocker therapy and outcomes among elderly patients hospitalized for heart failure. BACKGROUND: Beta-blockers are guideline-recommended therapy for heart failure, but their clinical e ...
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Journal ArticleAm Heart J · January 2009
BACKGROUND: Lipid levels among contemporary patients hospitalized with coronary artery disease (CAD) have not been well studied. This study aimed to analyze admission lipid levels in a broad contemporary population of patients hospitalized with CAD. METHOD ...
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Journal ArticleCirculation · December 16, 2008
BACKGROUND: Women receive less evidence-based medical care than men and have higher rates of death after acute myocardial infarction (AMI). It is unclear whether efforts undertaken to improve AMI care have mitigated these sex disparities in the current era ...
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Journal ArticleAm J Cardiol · December 15, 2008
Adherence to treatment guidelines during hospital admissions for heart failure impacts readmissions and mortality. However, the relation between guideline adherence and heart failure hospital length of stay (LOS) has not been well studied. Whether quality ...
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Journal ArticleArch Intern Med · December 8, 2008
BACKGROUND: The treatment of chronic heart failure has improved during the past 2 decades, but little is known about whether the improvements are reflected in trends in early and long-term mortality and hospital readmission. METHODS: In a retrospective coh ...
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Journal ArticleArch Intern Med · December 8, 2008
BACKGROUND: Whether beta-blockers (BBs) other than carvedilol, metoprolol succinate, and bisoprolol fumarate (evidence-based beta-blockers [EBBBs]) improve survival in patients with heart failure (HF) is unknown. We compared the effectiveness of EBBBs vs n ...
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Journal ArticleAm Heart J · December 2008
BACKGROUND: In chronic heart failure (HF), lower total cholesterol (TC) levels have been associated with increased mortality. However, the relationship between lipid levels and outcomes in acute HF has not been studied. This study investigates the relation ...
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Journal ArticleJAMA · November 26, 2008
CONTEXT: In 2003, Medicare expanded coverage of ventricular assist devices as destination, or permanent, therapy for end-stage heart failure. Little is known about the long-term outcomes and costs associated with these devices. OBJECTIVE: To examine the ac ...
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Journal ArticleJ Heart Lung Transplant · November 2008
BACKGROUND: We have previously shown that extended criteria heart transplant recipient mortality is higher than standard list mortality, but this is not associated with an increased incidence of either primary graft dysfunction or acute rejection. We hypot ...
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Journal ArticleJAMA · October 22, 2008
CONTEXT: While most comparisons of hospital outcomes adjust for patient characteristics, process performance comparisons typically do not. OBJECTIVE: To evaluate the degree to which hospital process performance ratings and eligibility for financial incenti ...
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Journal ArticleAm Heart J · October 2008
BACKGROUND: Both heart failure (HF) and chronic kidney disease (CKD) are highly prevalent conditions that often coexist; however, the quality of care received by hospitalized patients with both is not known. METHODS: The Get With the Guidelines - HF regist ...
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Journal ArticleCirc Arrhythm Electrophysiol · October 2008
BACKGROUND: Little is known about factors that influence survival and complications after implantable cardioverter-defibrillator (ICD) implantation in routine clinical practice. We examined patient and implanting physician factors associated with outcomes ...
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Journal ArticleAm J Cardiol · September 15, 2008
Most hospitals have reduced medical staff on weekends. Furthermore, a recent study on acute myocardial infarction suggested that weekend admissions were associated with higher mortality compared with weekday admissions. We sought to determine if compliance ...
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Journal ArticleCirculation · August 26, 2008
BACKGROUND: The frequency and characterization of patients receiving cardiac resynchronization therapy (CRT) are largely unknown since the publication of pivotal clinical trials and subsequent incorporation of CRT into the American College of Cardiology/Am ...
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Journal ArticleAm Heart J · June 2008
BACKGROUND: The speed of reperfusion (door-to-balloon [D2B] time) is a well established performance metric for patients with ST-elevation myocardial infarction. Although preferably D2B times should be
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Journal ArticleAnesthesiology · April 2008
BACKGROUND: Changes in the demographics and epidemiology of patients with cardiovascular comorbidities who undergo major noncardiac surgery require an updated assessment of which patients are at greater risk of mortality or readmission. The authors evaluat ...
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Journal ArticleHeart Fail Clin · April 2008
Heart failure is a common and serious disorder affecting more than 5 million patients in the United States. Although clinical trials have shown that several therapies improve outcomes, translation of evidence into practice is imperfect. This "quality chasm ...
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Journal ArticleArch Intern Med · February 25, 2008
BACKGROUND: Recent analyses have presented conflicting evidence regarding the incidence and prevalence of heart failure in the United States. We sought to estimate the annual incidence and prevalence of heart failure and associated survival in elderly pers ...
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Journal ArticleAm J Cardiol · December 15, 2007
Elevated B-type natriuretic peptide (BNP) levels are associated with increased risk for mortality in patients with non-ST-segment-elevation (NSTE) acute coronary syndromes (ACS). However, the optimal use of BNP measurement for the risk stratification of th ...
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Journal ArticleAm J Cardiol · November 1, 2007
Previous studies of hospitalized patients have suggested an "obesity paradox" with lower short-term mortality as weight increases. We hypothesized that some of this difference might be related to more aggressive management. To evaluate the effect of body m ...
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Journal ArticleJAMA · October 3, 2007
CONTEXT: Previous studies of sex differences in the use of implantable cardioverter-defibrillators (ICDs) predate recent expansions in Medicare coverage and did not provide patient follow-up over multiple years. OBJECTIVE: To examine sex differences in ICD ...
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Journal ArticleJAMA · October 3, 2007
CONTEXT: Practice guidelines recommend implantable cardioverter-defibrillator (ICD) therapy for patients with heart failure and left ventricular ejection fraction of 30% or less. The influence of sex and race on ICD use among eligible patients is unknown. ...
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Journal ArticleCirculation · August 7, 2007
BACKGROUND: Previous studies showed 75% mortality before hospital discharge in patients with a ventricular assist device (VAD) placed for post-cardiac surgery shock. We examined a large national clinical database to assess trends in the incidence of post-c ...
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Journal ArticleAm J Cardiol · May 15, 2007
Previous studies of non-ST-segment elevation acute coronary syndromes (NSTE ACSs) complicated by heart failure (HF) have focused primarily on patients with left ventricular systolic dysfunction defined by an ejection fraction (EF) <40%. Little is known abo ...
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Journal ArticleAm Heart J · September 2006
BACKGROUND: Surgical ventricular restoration (SVR) is an operation that demonstrates promise to improve outcomes for patients with left ventricular dysfunction. Current use and operative outcomes of SVR have come from centers of expertise, and operative ri ...
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Journal ArticleJ Heart Lung Transplant · September 2006
Cardiac transplant recipients often anticipate and suffer varying degrees of discomfort during surveillance endomyocardial biopsy (EMBx). We performed a randomized, blinded, placebo-controlled trial to determine whether topical anesthetic was associated wi ...
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Journal ArticleN C Med J · 2006
INTRODUCTION: Recently, the Food and Drug Administration approved implantable left ventricular assist devices (LVAD) as destination therapy (DT) for end-stage heart failure patients who are ineligible for cardiac transplantation. OBJECTIVE AND STUDY DESIGN ...
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Journal ArticleJ Heart Lung Transplant · November 2005
We present the case of a young man who received a left ventricular assist device (LVAD) as a bridge to transplantation for end-stage heart failure, in whom the diagnosis of sarcoid cardiomyopathy was made at the time of LVAD implantation. He subsequently u ...
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Journal ArticleJ Heart Lung Transplant · November 2005
BACKGROUND: Heart transplantation (HT) is an effective therapy for end-stage heart failure, but its impact is limited by the scarcity of donor organs and stringent selection criteria for both donors and recipients. The creation of an alternate list to matc ...
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Journal ArticleArch Intern Med · October 10, 2005
BACKGROUND: How often echocardiography and cardiac catheterization are used to evaluate left ventricular (LV) function in patients with myocardial infarction (MI) and how they are associated with quality of care is unknown. METHODS: Patients with MI in the ...
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Chapter · January 1, 2005
Acute heart failure (AHF) is the most common reason for hospital admission in patients over the age of 65, accounting for 1 000 000 admissions, over 6 000 000 hospital days, and $12 billion in costs.1, 2 The prognosis of patients admitted with AHF is disma ...
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Chapter · January 1, 2005
The major source of plasma BNP is the cardiac ventricles. This is unlike ANP, whose major storage sites include both the atria and ventricles.3 Unlike ANP, which is mainly released from its storage granules in response to atrial wall tension, BNP (as the n ...
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Journal ArticleJ Am Coll Cardiol · October 6, 2004
OBJECTIVES: The purpose of this study was to evaluate mortality and readmission rates of heart failure (HF) patients after major noncardiac surgery. BACKGROUND: There is a lack of generalizable outcome data on HF patients undergoing major noncardiac surger ...
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Journal ArticleArch Intern Med · September 13, 2004
The number of patients undergoing major noncardiac surgery has steadily increased over the last decade. Cardiovascular complications are important and often feared by patients, surgeons, and anesthesiologists. Although preoperative risk assessment has impr ...
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Journal ArticleClin Transpl · 2004
Since beginning cardiac transplantation in 1985, Duke University Medical Center has performed 485 de novo heart transplants in adult recipients. Our program has broadened the access of patients to transplantation through the aggressive use of ventricular a ...
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