Alexander Tan Limkakeng Jr.

Alexander Tan Limkakeng Jr.
Associate Professor of Surgery

My personal research interest is finding new ways to diagnose acute coronary syndrome. In particular, I am interested in novel biomarkers and systems biology approaches to this problem. As director of acute care research for the Duke Division of Emergency Medicine, I study a wide variety of conditions. The common theme is that they all have a time-sensitive component. We work with researchers from many fields. One of my related areas of interest is in empirical bioethics and trial enrollment.

Current Appointments & Affiliations

Associate Professor of Surgery, Surgery, Emergency Medicine, Surgery 2013

Contact Information

2301 Erwin Road, Box 3096, Durham, NC 27710
(919) 681-0196
Duke Emergency Medicine Research

Background
Education, Training, & Certifications
- M.H.S., Duke University 2012
- M.D., University of Pennsylvania 2001
Duke Appointment History
- Assistant Professor of Surgery, Surgery, Emergency Medicine, Surgery 2007 - 2013
- Instructor, Temporary in the Department of Surgery, Surgery, Emergency Medicine, Surgery 2006 - 2007
Recognition
In the News
- JUL 11, 2017 Bass Connections
  
  These Kits Will Save Lives, But There Is Much More Work Ahead to Stem the Opiate Epidemic
Awards & Honors
Expertise
Subject Headings
Research
Selected Grants
- Energize awarded by AstraZeneca AB 2018 - 2019
- Biomarkers for Acute Stroke Etilogy (BASE) awarded by Ischemia Care LLC 2016 - 2018
- SC2i awarded by Henry M. Jackson Foundation 2014 - 2018
- Abbott Stress-Delta Biomarkers for ACS Risk Stratification awarded by Abbott Laboratories 2014 - 2018
- Assessment of Clinical Performance of Troponin Assays awarded by Siemens AG 2014 - 2018
- Comparison of Dyspnea Measurement Instruments in Acute Heart Failure awarded by Heart Failure Society of America 2017 - 2018
- CCC for NHLBI Prevention and early Treatment of Acute Lung Injury PETAL Network - VIOLET awarded by Vanderbilt University Medical Center 2017 - 2018
- MultiCenter trial of Rivaroxban for Early Discharge of Pulmonary Embolism from the ER awarded by Janssen Scientific Affairs, LLC. 2016 - 2017
- ACS Collection Study for Serum Claim awarded by Roche Diagnostics 2014 - 2017
- ARCHITECT STAT High Sensitive Troponin-I Assay Clinical Evaluation for Specimen Storage in Varying Specimen Tube Types awarded by Abbott Laboratories 2013 - 2015
- D-Dimer DVT/PE Exclusionary Sample Collection Project awarded by Siemens AG 2013 - 2015
Publications & Artistic Works
Selected Publications
- Book Sections
  - Limkakeng AT, Kemnitz MG. Globe rupture. In: Rosen and Barkin's 5-Minute Emergency Medicine Consult: Fifth Edition. 2014 Jul 7.
- Conference Papers
  - Darrabie MD, Lee J, Cheeseman J, Limkakeng AT, Vaslef SN, Sullenger BA, Kirk AD. Toll-Like Receptor Signaling as a Prognostic Tool in Trauma Patients. 2016 Oct:S159-S160. Full Text
- Journal Articles
  - Peacock WF, Baumann BM, Bruton D, Davis TE, Handy B, Jones CW, Hollander JE, Limkakeng AT, Mehrotra A, Than M, Ziegler A, Dinkel C. Efficacy of High-Sensitivity Troponin T in Identifying Very-Low-Risk Patients With Possible Acute Coronary Syndrome. JAMA cardiology. 2018 Feb;3(2):104-111. PubMed PMID: 29238804. Full Text
  - de Oliveira LLH, Vissoci JRN, Machado WDL, Rodrigues CG, Limkakeng AT. Are Well-Informed Potential Trial Participants More Likely to Participate?. Journal of empirical research on human research ethics : JERHRE. 2017 Dec;12(5):363-371. PubMed PMID: 29073806. Full Text
  - Gaspari R, Weekes A, Adhikari S, Noble V, Nomura JT, Theodoro D, Woo M, Atkinson P, Blehar D, Brown S, Caffery T, Douglass E, Fraser J, Haines C, Lam S, Lanspa M, Lewis M, Liebmann O, Limkakeng A, Lopez F, Platz E, Mendoza M, Minnigan H, Moore C, Novik J, Rang L, Scruggs W, Raio C. A retrospective study of pulseless electrical activity, bedside ultrasound identifies interventions during resuscitation associated with improved survival to hospital admission. A REASON Study. Resuscitation. 2017 Nov;120:103-107. PubMed PMID: 28916478. Full Text
  - Boyd LR, Borawski J, Lairet J, Limkakeng AT. Critical Care Air Transport Team severe traumatic brain injury short-term outcomes during flight for Operation Iraqi Freedom/Operation Enduring Freedom. Journal of the Royal Army Medical Corps. 2017 Oct;163(5):342-346. PubMed PMID: 28385926. Full Text
  - Borawski JB, Graff LG, Limkakeng AT. Care of the Patient with Chest Pain in the Observation Unit. Emergency medicine clinics of North America. 2017 Aug;35(3):535-547. PubMed PMID: 28711123. (Review) Full Text
  - Gaspari R, Weekes A, Adhikari S, Noble VE, Nomura JT, Theodoro D, Woo M, Atkinson P, Blehar D, Brown SM, Caffery T, Douglass E, Fraser J, Haines C, Lam S, Lanspa M, Lewis M, Liebmann O, Limkakeng A, Lopez F, Platz E, Mendoza M, Minnigan H, Moore C, Novik J, Rang L, Scruggs W, Raio C. Reply to Letter: Letter to the Editor regarding Gaspari and colleague's "Emergency department point-of-care ultrasound in out-of-hospital and in-ED cardiac arrest". Resuscitation. 2017 May;114:e7-e8. PubMed PMID: 28219757. (Letter) Full Text
  - Beri N, Marston NA, Daniels LB, Nowak RM, Schreiber D, Mueller C, Jaffe A, Diercks DB, Wettersten N, DeFilippi C, Peacock WF, Limkakeng AT, Anand I, McCord J, Hollander JE, Wu AHB, Apple FS, Nagurney JT, Berardi C, Cannon CM, Clopton P, Neath S-X, Christenson RH, Hogan C, Vilke G, Maisel A. Necessity of hospitalization and stress testing in low risk chest pain patients. The American journal of emergency medicine. 2017 Feb;35(2):274-280. PubMed PMID: 27847253. Full Text
  - Mehta R, Nankivil D, Zielinski DJ, Waterman G, Keller B, Limkakeng AT, Kopper R, Izatt JA, Kuo AN. Wireless, Web-Based Interactive Control of Optical Coherence Tomography with Mobile Devices. Translational vision science & technology. 2017 Jan 20;6(1):5-. PubMed PMID: 28138415. Full Text Open Access Copy
  - Gaspari R, Weekes A, Adhikari S, Noble VE, Nomura JT, Theodoro D, Woo M, Atkinson P, Blehar D, Brown SM, Caffery T, Douglass E, Fraser J, Haines C, Lam S, Lanspa M, Lewis M, Liebmann O, Limkakeng A, Lopez F, Platz E, Mendoza M, Minnigan H, Moore C, Novik J, Rang L, Scruggs W, Raio C. Emergency department point-of-care ultrasound in out-of-hospital and in-ED cardiac arrest. Resuscitation. 2016 Dec;109:33-39. PubMed PMID: 27693280. Full Text
  - Limkakeng AT, Monte AA, Kabrhel C, Puskarich M, Heitsch L, Tsalik EL, Shapiro NI. Systematic Molecular Phenotyping: A Path Toward Precision Emergency Medicine?. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 2016 Oct;23(10):1097-1106. PubMed PMID: 27288269. (Review) Full Text Open Access Copy
  - Meyers HP, Jaffa E, Smith SW, Drake W, Limkakeng AT. Evaluation of T-Wave Morphology in Patients With Left Bundle Branch Block and Suspected Acute Coronary Syndrome. The Journal of emergency medicine. 2016 Sep;51(3):229-237. PubMed PMID: 27318856. Full Text
  - Broder JS, Bhat R, Boyd JP, Ogloblin IA, Limkakeng A, Hocker MB, Drake WG, Miller T, Harringa JB, Repplinger MD. Who explicitly requests the ordering of computed tomography for emergency department patients? A multicenter prospective study. Emergency radiology. 2016 Jun;23(3):221-227. PubMed PMID: 26873604. Full Text
  - Tsalik EL, Li Y, Hudson LL, Chu VH, Himmel T, Limkakeng AT, Katz JN, Glickman SW, McClain MT, Welty-Wolf KE, Fowler VG, Ginsburg GS, Woods CW, Reed SD. Potential Cost-effectiveness of Early Identification of Hospital-acquired Infection in Critically Ill Patients. Annals of the American Thoracic Society. 2016 Mar;13(3):401-413. PubMed PMID: 26700878. Full Text Open Access Copy
  - Marston NA, Shah KS, Mueller C, Neath S-X, Christenson RH, McCord J, Nowak RM, Daniels LB, Hollander JE, Apple F, Nagurney J, Schreiber D, deFilippi C, Diercks D, Limkakeng A, Anand IS, Wu AHB, Jaffe AS, Peacock WF, Maisel AS. Serial sampling of copeptin levels improves diagnosis and risk stratification in patients presenting with chest pain: results from the CHOPIN trial. Emergency medicine journal : EMJ. 2016 Jan;33(1):23-29. PubMed PMID: 26105583. Full Text
  - Hoffman K, Butt CM, Chen A, Limkakeng AT, Stapleton HM. High Exposure to Organophosphate Flame Retardants in Infants: Associations with Baby Products. Environmental science & technology. 2015 Dec;49(24):14554-14559. PubMed PMID: 26551726. Full Text
  - Meyers HP, Limkakeng AT, Jaffa EJ, Patel A, Theiling BJ, Rezaie SR, Stewart T, Zhuang C, Pera VK, Smith SW. Validation of the modified Sgarbossa criteria for acute coronary occlusion in the setting of left bundle branch block: A retrospective case-control study. American heart journal. 2015 Dec;170(6):1255-1264. PubMed PMID: 26678648. Full Text
  - Ranney ML, Limkakeng AT, Carr B, Zink B, Kaji AH, ACEP SAEM Research Committees (approved by ACEP-SAEM Board of Directors) . Improving the Emergency Care Research Investigator Pipeline: SAEM/ACEP Recommendations. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 2015 Jul;22(7):849-851. PubMed PMID: 26112275. Full Text
  - Shah KS, Marston NA, Mueller C, Neath S-X, Christenson RH, McCord J, Nowak RM, Vilke GM, Daniels LB, Hollander JE, Apple FS, Cannon CM, Nagurney J, Schreiber D, deFilippi C, Hogan CJ, Diercks DB, Limkakeng A, Anand IS, Wu AHB, Clopton P, Jaffe AS, Peacock WF, Maisel AS. Midregional proadrenomedullin predicts mortality and major adverse cardiac events in patients presenting with chest pain: results from the CHOPIN trial. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 2015 May;22(5):554-563. PubMed PMID: 25908114. Full Text
  - Limkakeng AT, de Oliveira LLH, Moreira T, Phadtare A, Garcia Rodrigues C, Hocker MB, McKinney R, Voils CI, Pietrobon R. Systematic review and metasummary of attitudes toward research in emergency medical conditions. J Med Ethics. 2014 Jun;40(6):401-408. PubMed PMID: 23665997. (Review) Full Text Open Access Copy Link to Item
  - Hertz JT, Reardon JM, Rodrigues CG, de Andrade L, Limkakeng AT, Bloomfield GS, Lynch CA. Acute myocardial infarction in sub-Saharan Africa: the need for data. PLoS ONE. 2014 Jan;9(5):e96688-. PubMed PMID: 24816222. (Review) Full Text
  - Chavez J, Srinivasan A, Ely S, Drake W, Freeman D, Borawski J, Chandra A, Limkakeng AT. Thrombolysis in myocardial infarction risk score in an observation unit setting. Crit Pathw Cardiol. 2013 Sep;12(3):137-140. PubMed PMID: 23892944. Full Text Open Access Copy Link to Item
  - Maisel A, Mueller C, Neath S-X, Christenson RH, Morgenthaler NG, McCord J, Nowak RM, Vilke G, Daniels LB, Hollander JE, Apple FS, Cannon C, Nagurney JT, Schreiber D, deFilippi C, Hogan C, Diercks DB, Stein JC, Headden G, Limkakeng AT, Anand I, Wu AHB, Papassotiriou J, Hartmann O, Ebmeyer S, Clopton P, Jaffe AS, Peacock WF. Copeptin helps in the early detection of patients with acute myocardial infarction: primary results of the CHOPIN trial (Copeptin Helps in the early detection Of Patients with acute myocardial INfarction). J Am Coll Cardiol. 2013 Jul 9;62(2):150-160. PubMed PMID: 23643595. Full Text Link to Item
  - Ely S, Chandra A, Mani G, Drake W, Freeman D, Limkakeng AT. Utility of observation units for young emergency department chest pain patients. J Emerg Med. 2013 Feb;44(2):306-312. PubMed PMID: 22975283. Full Text Open Access Copy Link to Item
  - Limkakeng A, Phadtare A, Shah J, Vaghasia M, Wei DY, Shah A, Pietrobon R. Willingness to participate in clinical trials among patients of Chinese heritage: a meta-synthesis. PLoS One. 2013;8(1):e51328-. PubMed PMID: 23349672. Full Text Link to Item
  - Hocker MB, Villani JJ, Borawski JB, Evans CS, Nelson SM, Gerardo CJ, Limkakeng AT. Dental visits to a North Carolina emergency department: a painful problem. N C Med J. 2012 Sep;73(5):346-351. PubMed PMID: 23189415. Link to Item
  - Limkakeng AT, Glickman SW, Shofer F, Mani G, Drake W, Freeman D, Ascher S, Pietrobon R, Cairns CB. Are patients with longer emergency department wait times less likely to consent to research?. Acad Emerg Med. 2012 Apr;19(4):396-401. PubMed PMID: 22506943. Full Text Open Access Copy Link to Item
  - Anderson KL, Limkakeng A, Damuth E, Chandra A. Cardiac evaluation for structural abnormalities may not be required in patients presenting with syncope and a normal ECG result in an observation unit setting. Annals of Emergency Medicine. 2012;60(4):478-484.e1. PubMed PMID: 22632775. Full Text
  - Limkakeng AT, Drake W, Mani G, Freeman D, Best R, Newby LK, Chandra A. Left ventricular dysfunction screening in hypertensive patients with N-terminal pro-B-type natriuretic peptide and electrocardiogram. Am J Emerg Med. 2012 Jan;30(1):214-217. PubMed PMID: 21185671. Full Text Open Access Copy Link to Item
  - Chandra A, Sieck S, Hocker M, Gerardo CJ, Villani J, Harrison D, Boardwine A, Limkakeng A. An observation unit may help improve an institution's Press Ganey satisfaction score. Crit Pathw Cardiol. 2011 Jun;10(2):104-106. PubMed PMID: 21988951. Full Text Link to Item
  - Chandra A, Nicks B, Maniago E, Nouh A, Limkakeng A. A multicenter analysis of the ED diagnosis of pneumonia. Am J Emerg Med. 2010 Oct;28(8):862-865. PubMed PMID: 20887906. Full Text Link to Item
  - Limkakeng AT, Chandra A. Impact of renal dysfunction on acute coronary syndrome evaluation in observation unit patients. Am J Emerg Med. 2010 Jul;28(6):658-662. PubMed PMID: 20637379. Full Text Open Access Copy Link to Item
  - Chandra A, Lindsell CJ, Limkakeng A, Diercks DB, Hoekstra JW, Hollander JE, Kirk JD, Peacock WF, Gibler WB, Pollack CV, EMCREG i*trACS Investigators . Emergency physician high pretest probability for acute coronary syndrome correlates with adverse cardiovascular outcomes. Acad Emerg Med. 2009 Aug;16(8):740-748. PubMed PMID: 19673712. Full Text Link to Item
  - Limkakeng AT, Glickman SW, Cairns CB, Chandra A. Unsuspected pulmonary embolism in observation unit patients. West J Emerg Med. 2009 Aug;10(3):130-134. PubMed PMID: 19718369. Link to Item
  - Takakuwa KM, Shofer FS, Limkakeng AT, Hollander JE. Preferences for cardiac tests and procedures may partially explain sex but not race disparities. Am J Emerg Med. 2008 Jun;26(5):545-550. PubMed PMID: 18534282. Full Text Link to Item
  - Limkakeng AT, Halpern E, Takakuwa KM. Sixty-four-slice multidetector computed tomography: the future of ED cardiac care. Am J Emerg Med. 2007 May;25(4):450-458. PubMed PMID: 17499666. (Review) Full Text Link to Item
  - Sherman SC, Limkakeng A. Xanthogranulomatous pyelonephritis with a nephrocutaneous fistula. J Emerg Med. 2005 Oct;29(3):337-338. PubMed PMID: 16183456. Full Text Link to Item
  - Limkakeng A, Gibler WB, Pollack C, Hoekstra JW, Sites F, Shofer FS, Tiffany B, Wilke E, Hollander JE. Combination of Goldman risk and initial cardiac troponin I for emergency department chest pain patient risk stratification. Acad Emerg Med. 2001 Jul;8(7):696-702. PubMed PMID: 11435183. Link to Item
- Other Articles
  - A Randomized Trial of Protocol-Based Care for Early Septic Shock. New England Journal of Medicine. 2014 May;370(18):1683-1693. Full Text Open Access Copy
  - Limkakeng A, Broder JS, Theiling BJ. Chicken or egg? Risks of misattribution of cause-effect relationships in studies of association. Acad Emerg Med. 2013 Sep;20(9):965-. PubMed PMID: 23981076. (Letter) Full Text Link to Item
  - Limkakeng AT. Emergency Medicine national conventions: a medical student's perspective. J Emerg Med. 2002 Aug;23(2):211-212. PubMed PMID: 12359299. Link to Item
Scholarly, Clinical, & Service Activities
Presentations & Appearances
Outreach & Engaged Scholarship
- Bass Connections Faculty Team Member . Stemming the Opiate Epidemic through Education and Outreach. August 2017 - May 2018 2017 - 2018
Service to the Profession
- Co-Director. American College of Emergency Physicians Scientific Assembly Research Forum. American College of Emergency Physicians. 2015 - 2017 2015 - 2017

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Education, Training, & Certifications

Duke Appointment History

In the News

Awards & Honors

Subject Headings

Selected Grants

Selected Publications

Book Sections

Conference Papers

Journal Articles

Other Articles

Presentations & Appearances

Outreach & Engaged Scholarship

Service to the Profession