Skip to main content

Michael August Blazing

Associate Professor of Medicine
Medicine, Cardiology
Duke Box 3126, Durham, NC 27710
7412HOSP North, Durham, NC 27710

Selected Publications


Effects of statin therapy on diagnoses of new-onset diabetes and worsening glycaemia in large-scale randomised blinded statin trials: an individual participant data meta-analysis.

Journal Article The lancet. Diabetes & endocrinology · May 2024 BackgroundPrevious meta-analyses of summary data from randomised controlled trials have shown that statin therapy increases the risk of diabetes, but less is known about the size or timing of this effect, or who is at greatest risk. We aimed to ad ... Full text Cite

In-Hospital Virtual Peer-to-Peer Consultation to Increase Guideline-Directed Medical Therapy for Heart Failure: A Pilot Randomized Trial.

Journal Article Circ Heart Fail · February 2023 BACKGROUND: Guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) improves clinical outcomes and quality of life. Optimizing GDMT in the hospital is associated with greater long-term use in HFrEF. This study aim ... Full text Link to item Cite

Growth differentiation factor 15 and cardiovascular risk: individual patient meta-analysis.

Journal Article Eur Heart J · January 21, 2023 AIMS: Levels of growth differentiation factor 15 (GDF-15), a cytokine secreted in response to cellular stress and inflammation, have been associated with multiple types of cardiovascular (CV) events. However, its comparative prognostic performance across d ... Full text Link to item Cite

Association of Serial High-Sensitivity Cardiac Troponin T With Subsequent Cardiovascular Events in Patients Stabilized After Acute Coronary Syndrome: A Secondary Analysis From IMPROVE-IT.

Journal Article JAMA Cardiol · December 1, 2022 IMPORTANCE: Studies have demonstrated an association between single measures of high-sensitivity troponin (hsTn) and future cardiovascular events in patients with chronic coronary syndromes. However, limited data exist regarding the association between cha ... Full text Link to item Cite

Effect of statin therapy on muscle symptoms: an individual participant data meta-analysis of large-scale, randomised, double-blind trials.

Journal Article Lancet · September 10, 2022 BACKGROUND: Statin therapy is effective for the prevention of atherosclerotic cardiovascular disease and is widely prescribed, but there are persisting concerns that statin therapy might frequently cause muscle pain or weakness. We aimed to address these t ... Full text Link to item Cite

Association of Apolipoprotein B-Containing Lipoproteins and Risk of Myocardial Infarction in Individuals With and Without Atherosclerosis: Distinguishing Between Particle Concentration, Type, and Content.

Journal Article JAMA Cardiol · March 1, 2022 IMPORTANCE: Lipid management typically focuses on levels of low-density lipoprotein cholesterol (LDL-C) and, to a lesser extent, triglycerides (TG). However, animal models and genetic studies suggest that the atherogenic particle subpopulations (LDL and ve ... Full text Link to item Cite

Cardiovascular Events and Long-Term Risk of Sudden Death Among Stabilized Patients After Acute Coronary Syndrome: Insights From IMPROVE-IT.

Journal Article J Am Heart Assoc · February 15, 2022 Background Unlike patients with low ejection fraction after an acute coronary syndrome (ACS), little is known about the long-term incidence and influence of cardiovascular events before sudden death among stabilized patients after ACS. Methods and Results ... Full text Link to item Cite

Baseline Low-Density Lipoprotein Cholesterol and Clinical Outcomes of Combining Ezetimibe With Statin Therapy in IMPROVE-IT.

Journal Article J Am Coll Cardiol · October 12, 2021 BACKGROUND: The 2018 U.S. cholesterol management guideline recommends additional lipid-lowering therapy with ezetimibe for secondary prevention in very high-risk patients with low-density lipoprotein cholesterol (LDL-C) ≥70 mg/dL despite maximally tolerate ... Full text Link to item Cite

Assessment of North American Clinical Research Site Performance During the Start-up of Large Cardiovascular Clinical Trials.

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

Prospective Evaluation of Malignancy in 17,708 Patients Randomized to Ezetimibe Versus Placebo: Analysis From IMPROVE-IT.

Journal Article JACC CardioOncol · September 2020 BACKGROUND: An increased risk of malignancy was reported with simvastatin/ezetimibe in 1,873 patients in the SEAS (Simvastatin and Ezetimibe in Aortic Stenosis) trial. OBJECTIVES: The purpose of this study was to clarify this unexpected finding in a larger ... Full text Link to item Cite

Lipoprotein (a): An Update on a Marker of Residual Risk and Associated Clinical Manifestations.

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

A care pathway for the cardiovascular complications of COVID-19: Insights from an institutional response.

Journal Article Am Heart J · July 2020 The infection caused by severe acute respiratory syndrome coronavirus-2, or COVID-19, can result in myocardial injury, heart failure, and arrhythmias. In addition to the viral infection itself, investigational therapies for the infection can interact with ... Full text Link to item Cite

Effect of Simvastatin-Ezetimibe Compared With Simvastatin Monotherapy After Acute Coronary Syndrome Among Patients 75 Years or Older: A Secondary Analysis of a Randomized Clinical Trial.

Journal Article JAMA Cardiol · September 1, 2019 IMPORTANCE: Limited evidence is available regarding the benefit and hazard of higher-intensity treatment to lower lipid levels among patients 75 years or older. As a result, guideline recommendations differ for this age group compared with younger patients ... Full text Link to item Cite

Biomarkers and Clinical Cardiovascular Outcomes With Ezetimibe in the IMPROVE-IT Trial.

Journal Article J Am Coll Cardiol · August 27, 2019 BACKGROUND: Addition of ezetimibe to statin therapy reduces the risk of recurrent cardiovascular (CV) events in patients with prior acute coronary syndrome (ACS). The role of biomarkers in identifying subsets of patients who may derive greater clinical ben ... Full text Link to item Cite

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

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

Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials.

Journal Article Lancet · February 2, 2019 BACKGROUND: Statin therapy has been shown to reduce major vascular events and vascular mortality in a wide range of individuals, but there is uncertainty about its efficacy and safety among older people. We undertook a meta-analysis of data from all large ... Full text Link to item Cite

Medication Discontinuation in the IMPROVE-IT Trial.

Journal Article Circ Cardiovasc Qual Outcomes · January 2019 BACKGROUND: Although cholesterol-lowering medications can reduce the risk of recurrent cardiovascular events, premature discontinuation limits effectiveness. Discontinuation rates have not been systematically reported for lipid-lowering trials. METHODS AND ... Full text Link to item Cite

Polyvascular disease, type 2 diabetes, and long-term vascular risk: a secondary analysis of the IMPROVE-IT trial.

Journal Article Lancet Diabetes Endocrinol · December 2018 BACKGROUND: Polyvascular disease and type 2 diabetes are each associated with increased cardiovascular risk, but whether these risks are additive is unknown. In this exploratory analysis of a randomised trial, we explored the long-term cardiovascular risk ... Full text Link to item Cite

The nonalcoholic fatty liver disease (NAFLD) fibrosis score, cardiovascular risk stratification and a strategy for secondary prevention with ezetimibe.

Journal Article Int J Cardiol · November 1, 2018 OBJECTIVE: The nonalcoholic fatty liver disease fibrosis score (NFS) is comprised of unique metabolic risk indicators that may accurately predict residual cardiovascular (CV) risk in patients with established coronary disease and metabolic dysfunction. MET ... Full text Link to item Cite

Natural History of Patients Postacute Coronary Syndrome Based on Heart Failure Status.

Journal Article Am J Cardiol · November 1, 2018 The natural history of patients hospitalized for acute coronary syndrome (ACS) with pre-existing versus (vs) de novo heart failure (HF) has not been previously reported over an extended duration of follow-up. The IMPROVE-IT trial enrolled 18,144 patients h ... Full text Link to item Cite

Modeling survival distribution as a function of time to treatment discontinuation: A dynamic treatment regime approach.

Journal Article Biometrics · September 2018 We consider estimating the effect that discontinuing a beneficial treatment will have on the distribution of a time to event clinical outcome, and in particular assessing whether there is a period of time over which the beneficial effect may continue after ... Full text Link to item Cite

Benefit of Adding Ezetimibe to Statin Therapy on Cardiovascular Outcomes and Safety in Patients With Versus Without Diabetes Mellitus: Results From IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial).

Journal Article Circulation · April 10, 2018 BACKGROUND: Ezetimibe, when added to simvastatin, reduces cardiovascular events after acute coronary syndrome. We explored outcomes stratified by diabetes mellitus (DM). METHODS: In IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International ... Full text Link to item Cite

Prevention of Stroke with the Addition of Ezetimibe to Statin Therapy in Patients With Acute Coronary Syndrome in IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial).

Journal Article Circulation · December 19, 2017 BACKGROUND: Patients who experience an acute coronary syndrome are at heightened risk of recurrent ischemic events, including stroke. Ezetimibe improved cardiovascular outcomes when added to statin therapy in patients stabilized after acute coronary syndro ... Full text Link to item Cite

Efficacy and Safety of Adding Ezetimibe to Statin Therapy Among Women and Men: Insight From IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial).

Journal Article J Am Heart Assoc · November 18, 2017 BACKGROUND: IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial) showed that adding the nonstatin ezetimibe to statin therapy further reduced cardiovascular events in patients after an acute coronary syndrome. In a prespecified ... Full text Link to item Cite

Benefit of Ezetimibe Added to Simvastatin in Reduced Kidney Function.

Journal Article J Am Soc Nephrol · October 2017 Efficacy of statin-based therapies in reducing cardiovascular mortality in individuals with CKD seems to diminish as eGFR declines. The strongest evidence supporting the cardiovascular benefit of statins in individuals with CKD was shown with ezetimibe plu ... Full text Open Access Link to item Cite

Competing Risks of Cardiovascular Versus Noncardiovascular Death During Long-Term Follow-Up After Acute Coronary Syndromes.

Journal Article J Am Heart Assoc · September 18, 2017 BACKGROUND: Understanding the relative risk of cardiovascular versus noncardiovascular death is important for designing clinical trials. These risks may differ depending on patient age, sex, and type of acute coronary syndrome (ACS). METHODS AND RESULTS: I ... Full text Link to item Cite

Long-term Safety and Efficacy of Achieving Very Low Levels of Low-Density Lipoprotein Cholesterol : A Prespecified Analysis of the IMPROVE-IT Trial.

Journal Article JAMA Cardiol · May 1, 2017 IMPORTANCE: In the Improved Reduction of Outcomes: Vytorin Efficacy International Trial, intensive low-density lipoprotein cholesterol (LDL-C)-reducing therapy with ezetimibe/simvastatin compared with simvastatin alone was associated with a significant red ... Full text Link to item Cite

Impact of Ezetimibe on the Rate of Cardiovascular-Related Hospitalizations and Associated Costs Among Patients With a Recent Acute Coronary Syndrome: Results From the IMPROVE-IT Trial (Improved Reduction of Outcomes: Vytorin Efficacy International Trial).

Journal Article Circ Cardiovasc Qual Outcomes · May 2017 BACKGROUND: Ezetimibe, when added to simvastatin therapy, reduces cardiovascular events after recent acute coronary syndrome. However, the impact of ezetimibe on cardiovascular-related hospitalizations and associated costs is unknown. METHODS AND RESULTS: ... Full text Link to item Cite

Atherothrombotic Risk Stratification and Ezetimibe for Secondary Prevention.

Journal Article J Am Coll Cardiol · February 28, 2017 BACKGROUND: Ezetimibe improves cardiovascular (CV) outcomes in patients stabilized after acute coronary syndrome (ACS) when added to statin therapy. After ACS, patients vary considerably in their risk for recurrent CV events. OBJECTIVES: This study tested ... Full text Link to item Cite

The benefit of adding ezetimibe to statin therapy in patients with prior coronary artery bypass graft surgery and acute coronary syndrome in the IMPROVE-IT trial.

Journal Article Eur Heart J · December 21, 2016 AIMS: To examine the efficacy and safety of ezetimibe added to statin in patients with prior coronary artery bypass graft surgery (CABG) following hospitalization for an acute coronary syndrome (ACS). METHODS AND RESULTS: In the IMPROVE-IT trial, post-ACS ... Full text Link to item Cite

On-treatment analysis of the Improved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT).

Journal Article Am Heart J · December 2016 BACKGROUND: We aimed to determine the efficacy and safety of adding ezetimibe (Ez) to simvastatin (S) in a post-acute coronary syndrome (ACS) population in a prespecified on-treatment analysis. METHODS: We evaluated 17,706 post-ACS patients from the IMPROV ... Full text Link to item Cite

Efficacy and Tolerability of Evolocumab vs Ezetimibe in Patients With Muscle-Related Statin Intolerance: The GAUSS-3 Randomized Clinical Trial.

Journal Article JAMA · April 19, 2016 IMPORTANCE: Muscle-related statin intolerance is reported by 5% to 20% of patients. OBJECTIVE: To identify patients with muscle symptoms confirmed by statin rechallenge and compare lipid-lowering efficacy for 2 nonstatin therapies, ezetimibe and evolocumab ... Full text Link to item Cite

Reduction in Total Cardiovascular Events With Ezetimibe/Simvastatin Post-Acute Coronary Syndrome: The IMPROVE-IT Trial.

Journal Article J Am Coll Cardiol · February 2, 2016 BACKGROUND: Intensive low-density lipoprotein cholesterol therapy with ezetimibe/simvastatin in IMPROVE-IT (IMProved Reduction of Outcomes: Vytorin Efficacy International Trial) significantly reduced the first primary endpoint (PEP) in patients post-acute ... Full text Link to item Cite

Achievement of dual low-density lipoprotein cholesterol and high-sensitivity C-reactive protein targets more frequent with the addition of ezetimibe to simvastatin and associated with better outcomes in IMPROVE-IT.

Journal Article Circulation · September 29, 2015 BACKGROUND: Statins lower low-density lipoprotein cholesterol (LDL-C) and high-sensitivity C-reactive protein (hs-CRP); addition of ezetimibe to statins further reduces LDL-C and hs-CRP. An analysis of the relationship between achieved LDL-C and hs-CRP tar ... Full text Link to item Cite

Infusion of Reconstituted High-Density Lipoprotein, CSL112, in Patients With Atherosclerosis: Safety and Pharmacokinetic Results From a Phase 2a Randomized Clinical Trial.

Journal Article J Am Heart Assoc · August 25, 2015 BACKGROUND: CSL112 is a new formulation of human apolipoprotein A-I (apoA-I) being developed to reduce cardiovascular events following acute coronary syndrome. This phase 2a, randomized, double-blind, multicenter, dose-ranging trial represents the first cl ... Full text Open Access Link to item Cite

Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes.

Journal Article N Engl J Med · June 18, 2015 BACKGROUND: Statin therapy reduces low-density lipoprotein (LDL) cholesterol levels and the risk of cardiovascular events, but whether the addition of ezetimibe, a nonstatin drug that reduces intestinal cholesterol absorption, can reduce the rate of cardio ... Full text Link to item Cite

Efficacy and safety of LDL-lowering therapy among men and women: meta-analysis of individual data from 174,000 participants in 27 randomised trials.

Journal Article Lancet · April 11, 2015 BACKGROUND: Whether statin therapy is as effective in women as in men is debated, especially for primary prevention. We undertook a meta-analysis of statin trials in the Cholesterol Treatment Trialists' (CTT) Collaboration database to compare the effects o ... Full text Link to item Cite

Evaluating cardiovascular event reduction with ezetimibe as an adjunct to simvastatin in 18,144 patients after acute coronary syndromes: final baseline characteristics of the IMPROVE-IT study population.

Journal Article Am Heart J · August 2014 BACKGROUND: The IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) is evaluating the potential benefit for reduction in major cardiovascular (CV) events from the addition of ezetimibe versus placebo to 40 mg/d of simvastatin ... Full text Link to item Cite

Inflammation and atherosclerosis: disease modulating therapies.

Journal Article Curr Treat Options Cardiovasc Med · December 2013 Advances in the mechanistic understanding of atheroma initiation, repair, progression, and rupture have solidified the pivotal role played by the immune system in the pathophysiology of atherosclerotic vascular disease. These mechanistic findings have been ... Full text Link to item Cite

The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials.

Journal Article Lancet · August 11, 2012 BACKGROUND: Statins reduce LDL cholesterol and prevent vascular events, but their net effects in people at low risk of vascular events remain uncertain. METHODS: This meta-analysis included individual participant data from 22 trials of statin versus contro ... Full text Link to item Cite

Lack of effect of lowering LDL cholesterol on cancer: meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapy.

Journal Article PLoS One · 2012 BACKGROUND: Statin therapy reduces the risk of occlusive vascular events, but uncertainty remains about potential effects on cancer. We sought to provide a detailed assessment of any effects on cancer of lowering LDL cholesterol (LDL-C) with a statin using ... Full text Link to item Cite

Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis.

Journal Article JAMA · June 22, 2011 CONTEXT: A recent meta-analysis demonstrated that statin therapy is associated with excess risk of developing diabetes mellitus. OBJECTIVE: To investigate whether intensive-dose statin therapy is associated with increased risk of new-onset diabetes compare ... Full text Link to item Cite

Effects of coping skills training and sertraline in patients with non-cardiac chest pain: a randomized controlled study.

Journal Article Pain · April 2011 Non-cardiac chest pain (NCCP) is a common and distressing condition. Prior studies suggest that psychotropic medication or pain coping skills training (CST) may benefit NCCP patients. To our knowledge, no clinical trials have examined the separate and comb ... Full text Link to item Cite

Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials.

Journal Article Lancet · November 13, 2010 BACKGROUND: Lowering of LDL cholesterol with standard statin regimens reduces the risk of occlusive vascular events in a wide range of individuals. We aimed to assess the safety and efficacy of more intensive lowering of LDL cholesterol with statin therapy ... Full text Link to item Cite

The heart of the athlete

Chapter · November 2, 2010 Cite

Is rhythm-control superior to rate-control in patients with atrial fibrillation and diastolic heart failure?

Journal Article Ann Noninvasive Electrocardiol · July 2010 BACKGROUND: Although no clinical trial data exist on the optimal management of atrial fibrillation (AF) in patients with diastolic heart failure, it has been hypothesized that rhythm-control is more advantageous than rate-control due to the dependence of t ... Full text Link to item Cite

Statins--is there potential for uncovering new benefits (or detriments)?

Journal Article Cardiovasc Ther · April 2010 Despite over 20 years of clinical use and 15 years of clinical trial data, we still do not have a complete understanding of the mechanisms of action or full utility of statins as a class of drugs. The possibility of their use as a treatment for prevention ... Full text Link to item Cite

Acute decline in renal function, inflammation, and cardiovascular risk after an acute coronary syndrome.

Journal Article Clin J Am Soc Nephrol · November 2009 BACKGROUND AND OBJECTIVES: Chronic kidney disease is associated with a higher risk of cardiovascular outcomes. The prognostic significance of worsening renal function has also been shown in various cohorts of cardiac disease; however, the predictors of wor ... Full text Link to item Cite

Pain catastrophizing in patients with noncardiac chest pain: relationships with pain, anxiety, and disability.

Journal Article Psychosom Med · October 2009 OBJECTIVE: To examine the contributions of chest pain, anxiety, and pain catastrophizing to disability in 97 patients with noncardiac chest pain (NCCP) and to test whether chest pain and anxiety were related indirectly to greater disability via pain catast ... Full text Link to item Cite

Management of hyperlipidemia in older adults.

Journal Article J Cardiovasc Pharmacol Ther · March 2009 Cardiovascular disease is the leading cause of death in men and women older than 65 years; therefore, its prevention is an important public health priority. Although cardiovascular risk is multifactorial, elevated low-density lipoprotein cholesterol levels ... Full text Link to item Cite

Rationale and design of IMPROVE-IT (IMProved Reduction of Outcomes: Vytorin Efficacy International Trial): comparison of ezetimbe/simvastatin versus simvastatin monotherapy on cardiovascular outcomes in patients with acute coronary syndromes.

Journal Article Am Heart J · November 2008 BACKGROUND: Reduction in low-density lipoprotein cholesterol (LDL-C) improves clinical outcomes in patients with chronic coronary artery disease and acute coronary syndromes (ACSs). The combination of ezetimibe/simvastatin produces greater reductions in LD ... Full text Link to item Cite

Outcomes of patients with acute coronary syndrome and previous coronary artery bypass grafting (from the Pravastatin or Atorvastatin Evaluation and Infection Therapy [PROVE IT-TIMI 22] and the Aggrastat to Zocor [A to Z] trials).

Journal Article Am J Cardiol · September 1, 2008 We examined the effects of intensive statin therapy in patients with acute coronary syndromes (ACSs) and previous coronary artery bypass graft surgery (CABG) participating in the Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis In ... Full text Link to item Cite

Estimated glomerular filtration rate, inflammation, and cardiovascular events after an acute coronary syndrome.

Journal Article Am Heart J · April 2008 UNLABELLED: Both renal dysfunction and elevated levels of high-sensitivity C-reactive protein (CRP) are associated with a higher risk of cardiovascular (CV) outcomes. However, it remains to be established whether the prognostic value of impaired estimated ... Full text Link to item Cite

Effect of statin dose on incidence of atrial fibrillation: data from the Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 (PROVE IT-TIMI 22) and Aggrastat to Zocor (A to Z) trials.

Journal Article Am Heart J · February 2008 BACKGROUND: Inflammation has been suggested as a factor in the initiation and maintenance of atrial fibrillation (AF). Several observational studies have suggested that statins, presumably through their anti-inflammatory properties, decrease the risk of AF ... Full text Link to item Cite

Serial measurement of monocyte chemoattractant protein-1 after acute coronary syndromes: results from the A to Z trial.

Journal Article J Am Coll Cardiol · November 27, 2007 OBJECTIVES: This study sought to determine whether the novel biomarker monocyte chemoattractant protein (MCP)-1 adds prognostic value to standard risk assessment tools and biomarkers after acute coronary syndromes (ACS). BACKGROUND: Monocyte chemoattractan ... Full text Link to item Cite

Prospective assessment of radiotherapy-associated cardiac toxicity in breast cancer patients: analysis of data 3 to 6 years after treatment.

Journal Article Cancer · October 15, 2007 BACKGROUND: Radiation therapy (RT) to the left breast/chest wall has been linked with cardiac dysfunction. Previously, the authors identified cardiac perfusion defects in approximately 50% to 60% of patients 0.5 to 2 years post-RT. In the current study, th ... Full text Link to item Cite

Effect of intensive lipid-lowering therapy on mortality after acute coronary syndrome (a patient-level analysis of the Aggrastat to Zocor and Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 trials).

Journal Article Am J Cardiol · October 1, 2007 Compared with moderate lipid lowering with standard-dose statin therapy, intensive lipid lowering with high-dose statin therapy after acute coronary syndromes (ACS) significantly reduces cardiovascular events. However, the 2 trials of high-dose versus stan ... Full text Link to item Cite

Small cell lung cancer presenting as a paraneoplastic syndrome characterized by recurrent episodic hypotension and bradycardia: case report.

Journal Article Chest · January 2007 A 56-year-old man presenting with a 6-month history of recurrent episodic hypotension and bradycardia was found to have limited-stage small cell lung cancer. During both quiescence and episodes of hemodynamic embarrassment, extensive evaluations were condu ... Full text Link to item Cite

Impact of patient-specific factors, irradiated left ventricular volume, and treatment set-up errors on the development of myocardial perfusion defects after radiation therapy for left-sided breast cancer.

Journal Article Int J Radiat Oncol Biol Phys · November 15, 2006 PURPOSE: The aim of this study was to assess the impact of patient-specific factors, left ventricle (LV) volume, and treatment set-up errors on the rate of perfusion defects 6 to 60 months post-radiation therapy (RT) in patients receiving tangential RT for ... Full text Link to item Cite

Evaluation of the National Cholesterol Education Program Adult Treatment Panel III algorithm for selecting candidates for statin therapy: insights from the A to Z trial.

Journal Article Am J Cardiol · September 15, 2006 The National Cholesterol Education Program Adult Treatment Panel III recommends an algorithm to integrate iterative risk-stratification information with low-density lipoprotein (LDL) cholesterol levels to identify candidates for statin therapy. We used the ... Full text Link to item Cite

Clinical relevance of C-reactive protein during follow-up of patients with acute coronary syndromes in the Aggrastat-to-Zocor Trial.

Journal Article Circulation · July 25, 2006 BACKGROUND: Elevated levels of high-sensitivity C-reactive protein (hsCRP) are associated with higher risk of adverse outcomes in patients at risk for or with established coronary artery disease. Retrospective analyses suggest that this risk may be modifie ... Full text Link to item Cite

Effects of early treatment with statins on short-term clinical outcomes in acute coronary syndromes: a meta-analysis of randomized controlled trials.

Journal Article JAMA · May 3, 2006 CONTEXT: The short-term effects of early treatment with statins in patients after the onset of acute coronary syndromes (ACS) for the outcomes of death, myocardial infarction (MI), and stroke are unclear. OBJECTIVE: To evaluate relevant outcomes of patient ... Full text Link to item Cite

A tale of two trials: a comparison of the post-acute coronary syndrome lipid-lowering trials A to Z and PROVE IT-TIMI 22.

Journal Article Circulation · March 21, 2006 BACKGROUND: The Aggrastat to Zocor (A to Z) and Pravastatin or Atorvastatin Evaluation and Infection Therapy (PROVE IT) trials compared intensive and moderate statin therapy after acute coronary syndromes, with seemingly disparate results. We analyzed the ... Full text Link to item Cite

SU‐FF‐T‐119: Cardiac Dose Heterogeneity and Relationship to Tumor Location in Patients Receiving Radiation for Lung Cancer

Conference Medical Physics · January 1, 2006 Purpose: To assess dose heterogeneity to subregions of the heart (e.g. four chambers), and its relationship to tumor location in patients irradiated for lung cancer. Methods and Materials: 236 patients receiving 3D‐planned radiotherapy for lung cancer from ... Full text Cite

SU‐FF‐J‐131: Is There a Relationship Between Body Mass Index, Treatment Set‐Up Errors, and the Development of Myocardial Perfusion Defects Following Radiation Therapy for Left‐Sided Breast Cancer?

Conference Medical Physics · January 1, 2006 Purpose: To assess whether body mass index (BMI) affects the rate of “deep” set‐up errors (i.e. those that increase the volume of heart irradiated), resulting in an increased risk of RT‐induced myocardial perfusion defects (PD) 6–60 months post‐RT. Materia ... Full text Cite

Prognostic value of serial B-type natriuretic peptide testing during follow-up of patients with unstable coronary artery disease.

Journal Article JAMA · December 14, 2005 CONTEXT: Elevated concentrations of B-type natriuretic peptide (BNP) at presentation in patients with acute coronary syndrome (ACS) are associated with long-term mortality. Few data exist regarding serial assessment of BNP levels during follow-up. OBJECTIV ... Full text Link to item Cite

The incidence and functional consequences of RT-associated cardiac perfusion defects.

Journal Article Int J Radiat Oncol Biol Phys · September 1, 2005 PURPOSE: Radiation therapy (RT) for left-sided breast cancer has been associated with cardiac dysfunction. We herein assess the temporal nature and volume dependence of RT-induced left ventricular perfusion defects and whether these perfusion defects are r ... Full text Link to item Cite

Predicting radiotherapy-induced cardiac perfusion defects.

Journal Article Med Phys · January 2005 The purpose of this work is to compare the efficacy of mathematical models in predicting the occurrence of radiotherapy-induced left ventricular perfusion defects assessed using single-photon emission computed tomography (SPECT). The basis of this study is ... Full text Link to item Cite

Early intensive simvastatin may reduce CVD morbidity and mortality

Journal Article Journal of Family Practice · December 1, 2004 Early initiation of statin therapy with high-dose atorvastatin following an acute coronary syndrome event reduces major cardiovascular events. It is uncertain whether this benefit extends to other statin drugs. The investigators randomized 4497 patients wi ... Cite

Prognostic value of anxiety and depression in patients with chronic heart failure.

Journal Article Circulation · November 30, 2004 BACKGROUND: Anxiety is often present with depression and may be one of its manifestations. Although the adverse effects of depression in patients with chronic heart failure (CHF) have been well studied, the relation between anxiety and CHF prognosis has no ... Full text Link to item Cite

Enoxaparin versus unfractionated heparin in patients treated with tirofiban, aspirin and an early conservative initial management strategy: results from the A phase of the A-to-Z trial.

Journal Article Eur Heart J · October 2004 AIMS: In high risk patients with non-ST elevation acute coronary syndromes (ACS), enoxaparin is generally preferred to unfractionated heparin (UFH). However, less is known about the relative merits of these two forms of heparin in patients receiving concom ... Full text Link to item Cite

Early intensive vs a delayed conservative simvastatin strategy in patients with acute coronary syndromes: phase Z of the A to Z trial.

Journal Article JAMA · September 15, 2004 CONTEXT: Limited data are available evaluating how the timing and intensity of statin therapy following an acute coronary syndrome (ACS) event affect clinical outcome. OBJECTIVE: To compare early initiation of an intensive statin regimen with delayed initi ... Full text Link to item Cite

The association between depression and chronic kidney disease and mortality among patients hospitalized with congestive heart failure.

Journal Article Am J Kidney Dis · August 2004 BACKGROUND: The point prevalence of depression and its relationship to poor outcomes among patients with chronic kidney disease (CKD) has not been fully characterized. METHODS: We performed a secondary analysis of a prospective cohort of 374 patients admit ... Full text Link to item Cite

Safety and efficacy of enoxaparin vs unfractionated heparin in patients with non-ST-segment elevation acute coronary syndromes who receive tirofiban and aspirin: a randomized controlled trial.

Journal Article JAMA · July 7, 2004 CONTEXT: Enoxaparin or the combination of glycoprotein IIb/IIIa inhibitor tirofiban with unfractionated heparin independently have shown superior efficacy over unfractionated heparin alone in patients with non-ST-elevation acute coronary syndromes (ACS). I ... Full text Link to item Cite

Efficacy and bleeding complications among patients randomized to enoxaparin or unfractionated heparin for antithrombin therapy in non-ST-Segment elevation acute coronary syndromes: a systematic overview.

Journal Article JAMA · July 7, 2004 CONTEXT: Antithrombin therapy has become a guidelines-recommended standard of care in the treatment of acute coronary syndromes (ACS), but recent trials comparing use of enoxaparin and unfractionated heparin in ACS have yielded less robust efficacy and saf ... Full text Link to item Cite

Efficacy and safety of ezetimibe co-administered with simvastatin compared with atorvastatin in adults with hypercholesterolemia.

Journal Article Am J Cardiol · June 15, 2004 This study compared the efficacy and safety of co-administered ezetimibe + simvastatin with atorvastatin monotherapy in adults with hypercholesterolemia. Seven hundred eighty-eight patients were randomized 1:1:1 to 3 treatment groups; each group was force- ... Full text Link to item Cite

Making two wrongs right - Case of using a patient's diabetes insipidus to treat his heart failure: Experience with vasopressin antagonists from animal studies and clinical trials

Journal Article HeartDrug · December 8, 2003 The precise control of body water and solute concentrations is a function of several hormones acting on both the kidneys and circulatory system, with arginine vasopressin (AVP) playing a key role in this homeostatic process. Vasopressin, also known as anti ... Full text Cite

Effect on high-density lipoprotein cholesterol of maximum dose simvastatin and atorvastatin in patients with hypercholesterolemia: results of the Comparative HDL Efficacy and Safety Study (CHESS).

Journal Article Am Heart J · November 2003 BACKGROUND: Previous studies have shown that effects on high-density lipoprotein cholesterol (HDL-C) may differ among statins. METHODS: A multicenter, randomized, double-blind, parallel-dose study was conducted in 917 hypercholesterolemic patients to compa ... Full text Link to item Cite

Symptomatic cardiac events following radiation therapy for left-sided breast cancer: possible association with radiation therapy-induced changes in regional perfusion.

Journal Article Clin Breast Cancer · August 2003 Our group has demonstrated that tangential radiation therapy (RT) to the left breast or chest wall can cause perfusion changes in the anterior myocardium. We assess if RT-induced perfusion changes are associated with the development of symptoms consistent ... Link to item Cite

Targeting cardiovascular risk associated with both low density and high density lipoproteins using statin–niacin combination therapy

Journal Article European Journal of Cardiovascular Prevention & Rehabilitation · January 1, 2002 Background Cardiovascular risk might be reduced by targeted changes in both low density and high density lipoprotein cholesterol (LDL-C and HDL-C). This dual strategy will require a well tolerated, effective regimen, as well as a better understanding of ho ... Full text Cite

Doxorubicin-based chemotherapy and radiation increase cardiac perfusion changes in patients treated for left-sided breast cancer

Journal Article Breast Cancer Research and Treatment · December 1, 2001 Purpose: To determine the incidence/severity of regional cardiac perfusion abnormalities in patients treated with radiation therapy (RT) to the left breast/chest wall +/- chemotherapy (CTx). Methods: 80 patients with left-sided breast cancer underwent rest ... Cite

The benefit of implementing a heart failure disease management program.

Journal Article Arch Intern Med · October 8, 2001 BACKGROUND: To handle the increasing complexity of congestive heart failure (CHF) care, several new models for the care of patients with CHF have been developed to replace traditional strategies. We undertook this study to evaluate the potential benefit of ... Full text Link to item Cite

Relationship of depression to increased risk of mortality and rehospitalization in patients with congestive heart failure.

Journal Article Arch Intern Med · August 13, 2001 BACKGROUND: Patients with congestive heart failure (CHF) may have a high prevalence of depression, which may increase the risk of adverse outcomes. OBJECTIVE: To determine the prevalence and relationship of depression to outcomes of patients hospitalized w ... Full text Link to item Cite

The A-to-Z Trial: Methods and rationale for a single trial investigating combined use of low-molecular-weight heparin with the glycoprotein IIb/IIIa inhibitor tirofiban and defining the efficacy of early aggressive simvastatin therapy.

Journal Article Am Heart J · August 2001 BACKGROUND: The A-to-Z Trial is an ongoing international, multicenter, randomized study designed to investigate 2 issues concerning contemporary care of patients with acute coronary syndromes (ACS). The first issue is whether the use of low-molecular-weigh ... Full text Link to item Cite

Extended-release niacin vs gemfibrozil for the treatment of low levels of high-density lipoprotein cholesterol. Niaspan-Gemfibrozil Study Group.

Journal Article Arch Intern Med · April 24, 2000 OBJECTIVE: To provide a direct comparison of agents that raise plasma levels of high-density lipoprotein cholesterol (HDL-C) to help devise strategies for coronary risk reduction. METHODS: In a multicenter, randomized, double-blind trial, we compared the e ... Full text Link to item Cite

Advances in the approach to acute coronary syndromes.

Journal Article Hosp Pract (1995) · April 15, 2000 Acute coronary syndromes is a new term that encompasses the many permutations of acute ischemic heart disease. Management guidelines can help steer clinicians through diagnosis and facilitate rational selection of therapy from the myriad of available treat ... Full text Link to item Cite

Evidence supporting secondary prevention strategies.

Journal Article Curr Opin Cardiol · July 1999 Currently 14 million individuals in the United States have coronary disease. Within the next 2 decades, this number is expected to increase to 21 million persons. To minimize the excessive risk of recurrent cardiac events in these people, evidence-based, c ... Full text Link to item Cite

The health care burden of unstable angina.

Journal Article Cardiol Clin · May 1999 Worldwide, UA represents a significant allocation of resources. UA represents a syndrome where not only do many therapies exist, but considerable clinical trial evidence has accumulated. Universal application of effective practice patterns is warranted if ... Full text Link to item Cite

In vivo gene transfer of nitric oxide synthase enhances vasomotor function in carotid arteries from normal and cholesterol-Fed rabbits.

Journal Article Circulation · November 3, 1998 BACKGROUND: The vascular endothelium is anatomically intact but functionally abnormal in preatherosclerotic states, and an early deficit in the bioavailability of nitric oxide (NO) or related molecules has been described in both humans and animal models. W ... Full text Link to item Cite

Acute host-mediated endothelial injury after adenoviral gene transfer in normal rabbit arteries: impact on transgene expression and endothelial function.

Journal Article Circ Res · June 29, 1998 Acute injury after adenoviral vascular gene transfer remains incompletely characterized. Here, we describe the early response (< or =days) in 52 New Zealand White rabbits undergoing gene transfer (beta-galactosidase or empty vector) or sham procedures to b ... Full text Link to item Cite

Nitric oxide synthase gene transfer corrects deficient endothelial vasmotor function in hypercholesterolaemic rabbits

Journal Article Heart · May 1, 1998 Background: The vascular endothelium is anatomically intact but functionally abnormal in preatherosclerotic states. In particular, nitric oxide (NO) bioavailability is reduced and may play a role in disease progression. We investigated whether targeted vas ... Cite

Neuronal nitric-oxide synthase interaction with calmodulin-troponin C chimeras.

Journal Article J Biol Chem · March 6, 1998 Calmodulin (CaM) binding activates neuronal nitric-oxide synthase (nNOS) catalytic functions and also up-regulates electron transfer into its flavin and heme centers. Here, we utilized seven tight binding CaM-troponin C chimeras, which variably activate nN ... Full text Link to item Cite

Neuronal no synthase interaction with calmodulintroponin C chimeras: Divergent activation of catalytic functions and its relationship to reduction of flavin or heme centers

Journal Article FASEB Journal · December 1, 1997 Calmodulin (CaM) activates neuronal nitric oxide synthase (nNOS) catalytic functions and upregulates electron transfer into its flavin and heme centers. We utilized CaM-troponin C chimeras which variably activate nNOS NO synthesis to examine the relationsh ... Cite

Efficient adenoviral gene transfer to early venous bypass grafts: comparison with native vessels.

Journal Article Cardiovasc Res · September 1997 OBJECTIVES: Gene therapy may provide new approaches to reduce vein graft failure following coronary or peripheral bypass surgery. The aim of this study was to investigate the relative efficacy of intraoperative adenoviral gene transfer to vein grafts, comp ... Full text Link to item Cite

Optimising adenoviral vascular gene transfer in vivo: Impact of early acute inflammation on transgene expression and vasomotor function

Journal Article Heart · May 1, 1997 Recombinant adenoviruses are attractive vectors for in-vivo vascular gene therapy, although chronic inflammation and transgene loss results from host immunity to viral proteins. However, early acute effects of adenovirus may also have important implication ... Cite

In vivo adenoviral gene transfer of nitric oxide synthase augments or restores vascular no production

Journal Article Heart · May 1, 1997 Nitric oxide (NO) has key regulatory roles in the cardiovascular system. NO production is defective in injured or diseased vessels and restoration of NO production inhibits the sequelae of vessel injury. The nitric oxide synthase (NOS) isoforms are therefo ... Cite

In vivo pulmonary artery adenoviral gene transfer of nitric oxide synthase enhances pulmonary nitric oxide production

Journal Article Heart · May 1, 1997 Nitric oxide (NO), generated by nitric oxide synthase (NOS), has key regulatory roles in the normal pulmonary circulation, and also inhibits pathological processes such as platelet aggregation, neutrophil adhesion and smooth muscle cell proliferation. NO p ... Cite

Alteration of Arterial Vasomotor Function in Vitro by Gene Transfer with a Replication-Deficient Adenovirus

Journal Article Vascular and Endovascular Surgery · January 1, 1997 Gene transfer technologies offer great potential both to investigate and alter the course of vessel wall pathophysiology. Replication-deficient adenovirus vectors appear particu larly useful for the transfection of blood vessels, because of their ability t ... Full text Cite

Adenoviral gene transfer of nitric oxide synthase: high level expression in human vascular cells.

Journal Article Cardiovasc Res · November 1996 OBJECTIVES: Nitric oxide synthases (NOS) generate nitric oxide (NO), a second messenger with key regulatory roles. In the cardiovascular system, deficient endothelial NO production is an early, persistent feature of atherosclerosis and vascular injury. Acc ... Link to item Cite

Vascular gene transfer.

Journal Article Heart · March 1996 Full text Link to item Cite

In-vivo vs. ex-vivo adenoviral gene transfer to rabbit carotid artery: A comparative study of transgene expression

Journal Article Journal of Investigative Medicine · January 1, 1996 Recombinant adenovtruses have emerged as a promising vehicle for in-vlvo gene therapy. One major limitation of this method Is decreased recombinant gene expression due to host Immunity. To assess the relative Importance of host factors In reducing transgen ... Cite

Adenoviral gene transfer to intact and denuded arteries: A quantitative, comparative study

Journal Article Journal of Investigative Medicine · January 1, 1996 Adenoviral gene transfer to the arterial wall is a promising therapeutic strategy for gene therapy of various cardiovascular diseases. Because endothelial loss is an common feature of vascular Injury states, we quantitatively compared the relative efficien ... Cite

The calmodulin-nitric oxide synthase interaction. Critical role of the calmodulin latch domain in enzyme activation.

Journal Article J Biol Chem · December 8, 1995 The neuronal isoform of nitric oxide synthase (nNOS) requires calmodulin for nitric oxide producing activity. Calmodulin functions as a molecular switch, allowing electron transport from the carboxyl-terminal reductase domain of nitric oxide synthase to it ... Full text Link to item Cite

Expression of the E2F1 transcription factor overcomes type beta transforming growth factor-mediated growth suppression.

Journal Article Proc Natl Acad Sci U S A · January 17, 1995 Inhibition of cell growth by type beta transforming growth factor (TGF-beta) occurs in mid-G1 and is associated with decreased G1 cyclin-dependent kinase activity and maintenance of the retinoblastoma tumor suppressor protein Rb in an underphosphorylated, ... Full text Link to item Cite

Atrial fibrillation: conventional wisdom reappraised.

Journal Article Heart Dis Stroke · 1992 For years the conventional approach to treatment of atrial fibrillation has centered around use of digoxin for rate control and type IA agents for conversion to normal sinus rhythm and has avoided use of anticoagulation therapy for most patients. Current d ... Link to item Cite

Ethical dilemmas in emergency practice

Journal Article Topics in Emergency Medicine · January 1, 1991 Cite