Scholars@Duke
Chiara Melloni

Chiara Melloni

Adjunct Associate Professor in the Department of Medicine
Medicine, Cardiology
chiara.melloni@duke.edu
Duke Box 3850, Durham, NC 27710
2400 Pratt St, Durham, NC 27710

Selected Publications

Medicare coverage gap status, adherence to oral anticoagulation, and stroke rates in patients with atrial fibrillation.

Journal Article Am Heart J · January 2026 BACKGROUND: Prior to 2025, Medicare Part D included a coverage gap during which beneficiaries were responsible for substantially higher portions of medication costs. The impact of this on oral anticoagulant (OAC) prescription fills and subsequent stroke in ... Full text Link to item Cite

Aficamten Treatment for Symptomatic Obstructive Hypertrophic Cardiomyopathy: 48-Week Results From FOREST-HCM.

Journal Article JACC Heart Fail · August 2025 BACKGROUND: Long-term safety and efficacy data for aficamten in symptomatic obstructive hypertrophic cardiomyopathy are needed. OBJECTIVES: This study aims to evaluate 48-week experience from the ongoing FOREST-HCM (A Follow-Up, Open-Label, Research Evalua ... Full text Link to item Cite

Concomitant Aficamten and Disopyramide in Symptomatic Obstructive Hypertrophic Cardiomyopathy.

Journal Article JACC Heart Fail · April 2, 2025 BACKGROUND: Disopyramide, used in obstructive hypertrophic cardiomyopathy (oHCM) for its negative inotropic properties mediated by its reduction in cytosolic calcium, has been recommended for decades as an option to relieve resistant obstruction. Aficamten ... Full text Link to item Cite

Standard-of-Care Medication Withdrawal in Patients With Obstructive Hypertrophic Cardiomyopathy Receiving Aficamten in FOREST-HCM.

Journal Article J Am Coll Cardiol · November 5, 2024 BACKGROUND: Standard-of-care (SoC) medications for the treatment of obstructive hypertrophic cardiomyopathy (oHCM) are recommended as first-line therapy despite the lack of evidence from controlled clinical trials and well known off-target side effects. OB ... Full text Link to item Cite

Safety and efficacy of aficamten in patients with non-obstructive hypertrophic cardiomyopathy: A 36-week analysis from FOREST-HCM.

Journal Article Eur J Heart Fail · September 2024 AIMS: The aim of this study was to report safety and efficacy of aficamten in patients with non-obstructive hypertrophic cardiomyopathy (nHCM) over 36 weeks in the ongoing FOREST-HCM trial. METHODS AND RESULTS: Patients were started on aficamten 5 mg daily ... Full text Link to item Cite

Use of physiologically-based pharmacokinetic modeling to inform dosing of the opioid analgesics fentanyl and methadone in children with obesity.

Journal Article CPT Pharmacometrics Syst Pharmacol · June 2022 Obesity is an increasingly alarming public health threat, with nearly 20% of children classified as obese in the United States today. Children with obesity are commonly prescribed the opioids fentanyl and methadone, and accurate dosing is critical to reduc ... Full text Link to item Cite

Cardiovascular Safety of Degarelix Versus Leuprolide in Patients With Prostate Cancer: The Primary Results of the PRONOUNCE Randomized Trial.

Journal Article Circulation · October 19, 2021 BACKGROUND: The relative cardiovascular safety of gonadotropin-releasing hormone (GnRH) antagonists compared with GnRH agonists in men with prostate cancer and known atherosclerotic cardiovascular disease remains controversial. METHODS: In this internation ... Full text Link to item Cite

Pharmacokinetics of Hydrochlorothiazide in Children: A Potential Surrogate for Renal Secretion Maturation.

Journal Article J Clin Pharmacol · March 2021 Hydrochlorothiazide (HCTZ) is a thiazide diuretic used in adults and children for the treatment of hypertension and edema. The pharmacokinetic (PK) properties of HCTZ in children are not well characterized, particularly among children with obesity who freq ... Full text Link to item Cite

Cardiac Myosin Activation with Omecamtiv Mecarbil in Systolic Heart Failure.

Journal Article N Engl J Med · January 14, 2021 BACKGROUND: The selective cardiac myosin activator omecamtiv mecarbil has been shown to improve cardiac function in patients with heart failure with a reduced ejection fraction. Its effect on cardiovascular outcomes is unknown. METHODS: We randomly assigne ... Full text Link to item Cite

Cardiovascular Health

Chapter · January 1, 2021 As cancer survival improves, a better understanding of the long-term impact of cancer therapy is needed, particularly with regard to cardiovascular (CV) complications. CV risk factors (e.g., smoking, hypertension, dyslipidemia, diabetes, and obesity) left ... Full text Cite

Population Pharmacokinetics of Metoclopramide in Infants, Children, and Adolescents.

Journal Article Clin Transl Sci · November 2020 Metoclopramide is commonly used for gastroesophageal reflux. The aims of the present study were to develop a pediatric population pharmacokinetic (PopPK) model, which was applied to simulate the metoclopramide exposure following dosing used in clinical pra ... Full text Link to item Cite

Management of Cancer-Associated Thrombosis

Journal Article Current Treatment Options in Cardiovascular Medicine · November 1, 2020 Purpose of review: Low molecular weight heparin (LMWH) has been the standard of care for patients with cancer-associated thrombosis (CAT) for over 10 years; however, its adoption has been limited. The appearance of direct acting oral anticoagulants (DOACs) ... Full text Cite

Effect of Androgen Deprivation Therapy on Metabolic Complications and Cardiovascular Risk.

Journal Article J Cardiovasc Transl Res · June 2020 Androgen deprivation therapy (ADT) has been the cornerstone of prostate cancer treatment. ADT delays cancer progression, alleviates cancer-related symptoms, and is associated with survival gains. Despite these established benefits, the extended duration of ... Full text Link to item Cite

Dosing of Continuous Fentanyl Infusions in Obese Children: A Population Pharmacokinetic Analysis.

Journal Article J Clin Pharmacol · May 2020 Differences in fentanyl pharmacokinetics (PK) between obese and nonobese adults have previously been reported; however, the impact of childhood obesity on fentanyl PK is relatively unknown. We developed a population pharmacokinetic (PopPK) model using oppo ... Full text Link to item Cite

Methods for safety and endpoint ascertainment: identification of adverse events through scrutiny of negatively adjudicated events.

Journal Article Trials · April 9, 2020 BACKGROUND: The primary goal of phase 2 and 3 clinical trials is to evaluate the safety and effectiveness of therapeutic interventions, and efficient and reproducible ascertainment of important clinical events, either as clinical outcome events (COEs) or a ... Full text Link to item Cite

Cardiovascular Safety of Degarelix Versus Leuprolide for Advanced Prostate Cancer: The PRONOUNCE Trial Study Design.

Journal Article JACC CardioOncol · March 2020 OBJECTIVES: This study will compare the incidence of major adverse cardiovascular events (MACEs) with androgen deprivation therapy (ADT) among men with advanced prostate cancer who are being treated with a gonadotropin-releasing hormone (GnRH) antagonist v ... Full text Link to item Cite

Androgen deprivation therapy and cardiovascular disease.

Journal Article Urol Oncol · February 2020 Prostate cancer (PCa) is the most common cancer among men. Advances in early detection and successful treatments have improved cancer-specific survival. With prolonged survival, PCa patients now suffer from the effects of aging and are at increasing risk f ... Full text Link to item Cite

Population Pharmacokinetics of Milrinone in Infants, Children, and Adolescents.

Journal Article J Clin Pharmacol · December 2019 Milrinone is a type 3 phosphodiesterase inhibitor used to improve cardiac output in critically ill infants and children. Milrinone is primarily excreted unchanged in the urine, raising concerns for toxic accumulation in the setting of renal dysfunction of ... Full text Link to item Cite

Proceedings From the Global Cardio-Oncology Summit: The Top 10 Priorities to Actualize for CardioOncology.

Journal Article JACC CardioOncol · December 2019 The discipline of cardio-oncology has expanded at a remarkable pace. Recent developments and challenges to clinicians who practice cardio-oncology were presented at the Global Cardio-Oncology Summit on October 3 to 4, 2019, in São Paulo, Brazil. Here, we p ... Full text Link to item Cite

Population Pharmacokinetics of Doxycycline in Children.

Journal Article Antimicrob Agents Chemother · September 9, 2019 Doxycycline is a tetracycline-class antimicrobial labeled by the United States (U.S.) Food and Drug Administration for children >8 years of age for many common childhood infections. Doxycycline is not labeled for children ≤8 years of age, due to the associ ... Full text Link to item Cite

Cardiotoxicities of Modern Treatments in Breast Cancer.

Journal Article Curr Treat Options Cardiovasc Med · June 15, 2019 PURPOSE OF REVIEW: This paper will focus on novel breast cancer therapies used in clinical practice today, as well as review our understanding of standard therapies and their potential impact on cardiovascular health. RECENT FINDINGS: Established and novel ... Full text Link to item Cite

Efficacy and safety of rivaroxaban vs. warfarin in patients with non-valvular atrial fibrillation and a history of cancer: observations from ROCKET AF.

Journal Article Eur Heart J Qual Care Clin Outcomes · April 1, 2019 AIMS: The management of anticoagulation therapy in patients with atrial fibrillation (AF) and cancer is challenging due to increased thrombotic and bleeding risks. We sought to determine the safety and efficacy of rivaroxaban in patients with AF and a hist ... Full text Link to item Cite

Frequency, Regional Variation, and Predictors of Undetermined Cause of Death in Cardiometabolic Clinical Trials: A Pooled Analysis of 9259 Deaths in 9 Trials.

Journal Article Circulation · February 12, 2019 BACKGROUND: Modern cardiometabolic clinical trials often include cardiovascular death as a component of a composite primary outcome, requiring central adjudication by a clinical events committee to classify cause of death. However, sometimes the cause of d ... Full text Link to item Cite

Unmet Needs in Managing Myocardial Infarction in Patients With Malignancy.

Journal Article Front Cardiovasc Med · 2019 Patients with cancer face a high short-term risk of arterial thromboembolism. One of the most fatal manifestations of arterial thromboembolism is myocardial infarction (MI), and patients with cancer face a 3-fold greater risk of MI than patients without ca ... Full text Link to item Cite

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

Journal Article J Am Heart Assoc · December 18, 2018 Background Vorapaxar, a protease-activated receptor-1 antagonist, is approved for secondary prevention of cardiovascular events but is associated with increased intracranial hemorrhage. Methods and Results TRACER (Thrombin Receptor Antagonist for Clinical ... Full text Link to item Cite

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial.

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

Population Pharmacokinetics of Intramuscular and Intravenous Ketamine in Children.

Journal Article J Clin Pharmacol · August 2018 Ketamine is an N-methyl D-aspartate receptor antagonist used off-label to facilitate dissociative anesthesia in children undergoing invasive procedures. Available for both intravenous and intramuscular administration, ketamine is commonly used when vascula ... Full text Link to item Cite

A pharmacokinetic model for amiodarone in infants developed from an opportunistic sampling trial and published literature data.

Journal Article J Pharmacokinet Pharmacodyn · June 2018 Amiodarone is a first-line antiarrhythmic for life-threatening ventricular fibrillation or ventricular tachycardia in children, yet little is known about its pharmacokinetics (PK) in this population. We developed a population PK (PopPK) model using samples ... Full text Link to item Cite

UNDETERMINED CAUSE OF DEATH: A POOLED ANALYSIS OF 9,307 DEATHS ACROSS 9 CARDIOVASCULAR TRIALS

Conference Journal of the American College of Cardiology · March 2018 Full text Cite

Androgen deprivation therapy (ADT) and cardiovascular mortality (CVD) in men with early-stage prostate cancer (PC) receiving curative radiation therapy (RT).

Conference Journal of Clinical Oncology · March 1, 2018 127 Background: Combined with RT, ADT is a highly effective and utilized treatment for men with localized PC, but some studies suggest that use of ADT leads to increased CVD. We explored the association between ADT and CVD in men ... Full text Cite

A multicenter, randomized, controlled trial comparing the occurrence of major adverse cardiovascular events (MACEs) in patients (pts) with prostate cancer (pc) and cardiovascular disease (CVD) receiving degarelix (GnRH receptor antagonist) or leuprolide (GnRH receptor agonist).

Conference Journal of Clinical Oncology · February 20, 2018 TPS395 Background: Epidemiological studies showed an association between GnRH agonists and a long-term increased risk of CVD, early after treatment initiation and with a higher risk seen in pts with pre-existing CVD. Retrospectiv ... Full text Cite

Comparative Analysis of Ampicillin Plasma and Dried Blood Spot Pharmacokinetics in Neonates.

Journal Article Ther Drug Monit · February 2018 BACKGROUND: Dried blood spot (DBS) is a practical sampling strategy for pharmacokinetic studies in neonates. The utility of DBS to determine the population pharmacokinetics (pop-PK) of ampicillin, as well as accuracy versus plasma samples, was evaluated. M ... Full text Link to item Cite

Population Pharmacokinetics of Trimethoprim-Sulfamethoxazole in Infants and Children.

Journal Article Antimicrob Agents Chemother · January 2018 Trimethoprim (TMP)-sulfamethoxazole (SMX) is used to treat various types of infections, including community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) and Pneumocystis jirovecii infections in children. Pharmacokinetic (PK) data for infa ... Full text Link to item Cite

Efficacy and Safety of Apixaban Versus Warfarin in Patients with Atrial Fibrillation and a History of Cancer: Insights from the ARISTOTLE Trial.

Conference Am J Med · December 2017 BACKGROUND: Cancer is associated with a prothrombotic state and increases the risk of thrombotic events in patients with atrial fibrillation. We described the clinical characteristics and outcomes and assessed the safety and efficacy of apixaban versus war ... Full text Link to item Cite

Concomitant use of proton pump inhibitors and dual antiplatelet therapy for cardiovascular outcomes.

Journal Article Minerva Endocrinol · September 2017 INTRODUCTION: The aim of this review is to discuss the consequences of potential pharmacokinetic interactions between proton pump inhibitors (PPIs) and antiplatelet therapy on cardiovascular (CV) outcomes and provide guidance on the management of concomita ... Full text Link to item Cite

Management and outcomes of patients with atrial fibrillation and a history of cancer: the ORBIT-AF registry.

Journal Article Eur Heart J Qual Care Clin Outcomes · July 1, 2017 AIMS: The presence of cancer can complicate treatment choices for patients with atrial fibrillation (AF) increasing both the risk of thrombotic and bleeding events. METHODS AND RESULTS: Using data from Outcomes Registry for Better Informed Treatment of Atr ... Full text Open Access Link to item Cite

A Systematic Literature Review Approach to Estimate the Therapeutic Index of Selected Immunosuppressant Drugs After Renal Transplantation.

Journal Article Ther Drug Monit · February 2017 BACKGROUND: Drugs that exhibit close margins between therapeutic and toxic blood concentrations are considered to have a narrow therapeutic index (NTI). The Food and Drug Administration has proposed that NTI drugs should have more stringent bioequivalence ... Full text Link to item Cite

Use of Therapeutic Drug Monitoring, Electronic Health Record Data, and Pharmacokinetic Modeling to Determine the Therapeutic Index of Phenytoin and Lamotrigine.

Journal Article Ther Drug Monit · December 2016 BACKGROUND: Defining a drug's therapeutic index (TI) is important for patient safety and regulating the development of generic drugs. For many drugs, the TI is unknown. A systematic approach was developed to characterize the TI of a drug using therapeutic ... Full text Link to item Cite

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

Conference Eur Heart J Acute Cardiovasc Care · October 2016 AIMS: We aimed to study the relationship of chronic kidney disease stages with long-term ischemic and bleeding outcomes in medically managed acute coronary syndrome patients and the influence of more potent antiplatelet therapies on platelet reactivity by ... Full text Link to item Cite

Therapeutic Drug Monitoring, Electronic Health Records, and Pharmacokinetic Modeling to Evaluate Sirolimus Drug Exposure-Response Relationships in Renal Transplant Patients.

Journal Article Ther Drug Monit · October 2016 BACKGROUND: Sirolimus, an immunosuppressive agent used in renal transplantation, can prevent allograft rejection. Identification of the therapeutic index (the ratio of minimum toxic concentration to minimum therapeutic concentration) for immunosuppresants ... Full text Link to item Cite

Pooled analysis of adverse event collection from 4 acute coronary syndrome trials.

Journal Article Am Heart J · April 2016 BACKGROUND: Adverse event collection in randomized clinical trials establishes drug safety. Although costly and regulated, it is rarely studied. METHODS: Adverse event data from 4 clinical trials (APPRAISE-2, PLATO, TRACER, TRILOGY ACS) comprising 48,118 p ... Full text Link to item Cite

MANAGEMENT AND OUTCOMES OF PATIENTS WITH ATRIAL FIBRILLATION AND CANCER: THE ORBIT-AF REGISTRY

Conference Journal of the American College of Cardiology · April 2016 Full text Cite

Exploring the Nexus Between Chronic Kidney Disease and Cardiovascular Disease.

Journal Article Eur Heart J Qual Care Clin Outcomes · April 1, 2016 Full text Link to item Cite

Pharmacokinetics and bioequivalence of a liquid formulation of hydroxyurea in children with sickle cell anemia.

Journal Article J Clin Pharmacol · March 2016 Hydroxyurea (HU) is a crucial therapy for children with sickle cell anemia, but its off-label use is a barrier to widespread acceptance. We found HU exposure is not significantly altered by liquid vs capsule formulation, and weight-based dosing schemes pro ... Full text Link to item Cite

Therapeutic Index Estimation of Antiepileptic Drugs: A Systematic Literature Review Approach.

Journal Article Clin Neuropharmacol · 2016 OBJECTIVES: Our study aimed to determine whether data obtained from the medical literature can be used to estimate the therapeutic index of 5 antiepileptic drugs (AEDs): carbamazepine, lamotrigine, phenobarbital, phenytoin, and valproate. METHODS: We perfo ... Full text Link to item Cite

Individual Proton Pump Inhibitors and Outcomes in Patients With Coronary Artery Disease on Dual Antiplatelet Therapy: A Systematic Review.

Journal Article J Am Heart Assoc · October 29, 2015 BACKGROUND: Observational studies evaluating the possible interaction between proton pump inhibitors (PPIs) and clopidogrel have shown mixed results. We conducted a systematic review comparing the safety of individual PPIs in patients with coronary artery ... Full text Open Access Link to item Cite

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

Journal Article Circ Cardiovasc Qual Outcomes · July 2015 BACKGROUND: Adequate representation by sex in trials allows generalizability of results. We examined representation of women in clinical trials during a 17-year period in which inclusion criteria were broadened and federal mandates for representativeness w ... Full text Link to item Cite

Cardiac Safety Research Consortium (CSRC): Cardiovascular Safety and Adverse Event Case Report Forms.

Journal Article Ther Innov Regul Sci · July 2015 Detection of off-target cardiovascular (CV) effects remains a significant challenge to drug development. Documentation of CV events in non-CV trials is often inadequate to interpret imbalances between treatment arms, which may lead to concerns about potent ... Full text Link to item Cite

Conflicting results between randomized trials and observational studies on the impact of proton pump inhibitors on cardiovascular events when coadministered with dual antiplatelet therapy: systematic review.

Journal Article Circ Cardiovasc Qual Outcomes · January 2015 BACKGROUND: Discordant results have been reported on the effects of concomitant use of proton pump inhibitors (PPIs) and dual antiplatelet therapy (DAPT) for cardiovascular outcomes. We conducted a systematic review comparing the effectiveness and safety o ... Full text Link to item Cite

Simultaneous determination of trimethoprim and sulfamethoxazole in dried plasma and urine spots.

Journal Article Bioanalysis · 2015 BACKGROUND: Trimethoprim-sulfamethoxazole (TMP-SMX) is an antimicrobial drug combination commonly prescribed in children and adults. The study objectives were to validate and apply an HPLC-MS/MS method to quantify TMP-SMX in dried plasma spots (DPS) and dr ... Full text Link to item Cite

Emerging treatment options to improve cardiovascular outcomes in patients with acute coronary syndrome: focus on losmapimod.

Journal Article Drug Des Devel Ther · 2015 Each year, despite optimal use of recommended acute and secondary prevention therapies, 4%-5% of patients with acute coronary syndrome (ACS) experience relapse of ACS or other cardiovascular events including stroke, heart failure, or sudden cardiac death a ... Full text Open Access Link to item Cite

Dual antiplatelet therapy with or without oral anticoagulation in the postdischarge management of acute coronary syndrome patients with an indication for long term anticoagulation: a systematic review.

Journal Article J Thromb Thrombolysis · October 2014 Currently, there is a lack of consensus among guidelines for the postdischarge treatment of patients presenting with acute coronary syndrome (ACS) who have a long-term indication for anticoagulation. We conducted a systematic review comparing the safety an ... Full text Link to item Cite

Use of opportunistic clinical data and a population pharmacokinetic model to support dosing of clindamycin for premature infants to adolescents.

Journal Article Clin Pharmacol Ther · October 2014 Clindamycin is commonly prescribed to treat children with skin and skin-structure infections (including those caused by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA)), yet little is known about its pharmacokinetics (PK) across pe ... Full text Link to item Cite

Losmapimod, a novel p38 mitogen-activated protein kinase inhibitor, in non-ST-segment elevation myocardial infarction: a randomised phase 2 trial.

Journal Article Lancet · September 27, 2014 BACKGROUND: p38 MAPK inhibition has potential myocardial protective effects. We assessed losmapimod, a potent oral p38 MAPK inhibitor, in patients with non-ST-segment elevation myocardial infarction (NSTEMI) in a double-blind, randomised, placebo-controlle ... Full text Link to item Cite

Characterization of the population pharmacokinetics of ampicillin in neonates using an opportunistic study design.

Journal Article Antimicrob Agents Chemother · June 2014 Although ampicillin is the most commonly used drug in neonates, developmental pharmacokinetic (PK) data to guide dosing are lacking. Ampicillin is primarily renally eliminated, and developmental changes are expected to influence PK. We conducted an open-la ... Full text Link to item Cite

Representation of Women in Randomized Clinical Trials of Cardiovascular Disease Prevention

Journal Article Current Cardiovascular Risk Reports · January 1, 2014 Cardiovascular disease (CVD) is the leading cause of mortality in women. Differences in pathophysiology, diagnosis, and treatment of women with cardiovascular disease compared with men have become a major focus during the past decades. Guideline of CVD pre ... Full text Cite

Balancing cancer treatment efficacy with the risk of cardiotoxicity and strategies for cardioprotection in adults

Journal Article Progress in Pediatric Cardiology · January 1, 2014 The long-term survival and overall prognosis of patients affected by malignancies has dramatically improved in the last several decades, primarily as a result of improvements in early detection of certain cancers and to advances of pharmacological cancer t ... Full text Cite

The study of LoSmapimod treatment on inflammation and InfarCtSizE (SOLSTICE): design and rationale.

Journal Article Am Heart J · November 2012 The p38 mitogen-activated protein kinase (MAPK) is a nexus point in inflammation, sensing, and stimulating cytokine production and driving cell migration and death. In acute coronary syndromes, p38MAPK inhibition could stabilize ruptured atherosclerotic pl ... Full text Link to item Cite

Prasugrel versus clopidogrel for acute coronary syndromes without revascularization.

Journal Article N Engl J Med · October 4, 2012 BACKGROUND: The effect of intensified platelet inhibition for patients with unstable angina or myocardial infarction without ST-segment elevation who do not undergo revascularization has not been delineated. METHODS: In this double-blind, randomized trial, ... Full text Link to item Cite

Use of early clopidogrel by reperfusion strategy among patients presenting with ST-segment elevation myocardial infarction.

Journal Article Circ Cardiovasc Qual Outcomes · November 1, 2011 BACKGROUND: The 2007 update of the ACC/AHA guidelines for STEMI patients recommended addition of clopidogrel to aspirin regardless of reperfusion strategy, with a bolus dose in patients <75 years of age. METHODS AND RESULTS: We evaluated use and dose of ea ... Full text Link to item Cite

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

Journal Article Am Heart J · November 2011 BACKGROUND: Dose adjustment of renally excreted antithrombotic drugs is recommended for patients with reduced renal function. We examined the influence of dose modification on bleeding and efficacy. METHODS: Based on initial study drug infusion rate, Early ... Full text Link to item Cite

Intravenous erythropoietin in patients with ST-segment elevation myocardial infarction: REVEAL: a randomized controlled trial.

Journal Article JAMA · May 11, 2011 CONTEXT: Acute ST-segment elevation myocardial infarction (STEMI) is a leading cause of morbidity and mortality. In experimental models of MI, erythropoietin reduces infarct size and improves left ventricular (LV) function. OBJECTIVE: To evaluate the safet ... Full text Link to item Cite

Association between patient beliefs and medication adherence following hospitalization for acute coronary syndrome.

Journal Article Am Heart J · May 2011 BACKGROUND: Patient adherence to medications is crucial for reducing risks following acute coronary syndrome (ACS). We assessed the degree to which medication beliefs were associated with patient adherence to β-blockers, angiotensin-converting enzyme inhib ... Full text Link to item Cite

Extended-release ranolazine: critical evaluation of its use in stable angina.

Journal Article Vasc Health Risk Manag · 2011 Coronary heart disease is the major cause of morbidity and mortality throughout the world, and is responsible for approximately one of every six deaths in the US. Angina pectoris is a clinical syndrome characterized by discomfort, typically in the chest, n ... Full text Open Access Link to item Cite

Lipid-lowering intensification and low-density lipoprotein cholesterol achievement from hospital admission to 1-year follow-up after an acute coronary syndrome event: results from the Medications ApplIed aNd SusTAINed Over Time (MAINTAIN) registry.

Journal Article Am Heart J · December 2010 BACKGROUND: Current American College of Cardiology/American Heart Association guidelines recommend initiation or intensification of statin therapy to achieve low-density lipoprotein cholesterol (LDL-C) goals after an acute coronary syndrome (ACS), yet litt ... Full text Link to item Cite

Design and rationale of the Reduction of Infarct Expansion and Ventricular Remodeling with Erythropoietin after Large Myocardial Infarction (REVEAL) trial.

Journal Article Am Heart J · November 2010 BACKGROUND: Acute myocardial infarction (MI) remains a leading cause of death despite advances in pharmacologic and percutaneous therapies. Animal models of ischemia/reperfusion have demonstrated that single-dose erythropoietin may reduce infarct size, dec ... Full text Link to item Cite

Implications and reasons for the lack of use of reperfusion therapy in patients with ST-segment elevation myocardial infarction: findings from the CRUSADE initiative.

Journal Article Am Heart J · May 2010 BACKGROUND: Prompt reperfusion for patients with ST-segment elevation myocardial infarction (STEMI) is a class I guideline recommendation and has been shown to reduce mortality. However, many STEMI patients in contemporary practice still do not receive any ... Full text Link to item Cite

Evaluation of a new heparin agent in percutaneous coronary intervention: results of the phase 2 evaluation of M118 IN pErcutaNeous Coronary intErvention (EMINENCE) Trial.

Journal Article Circulation · April 20, 2010 BACKGROUND: Factor Xa and factor IIa (thrombin) play roles in thrombotic complications after percutaneous coronary intervention. M118 is a novel low-molecular-weight heparin that has been rationally designed to capture the desired attributes of unfractiona ... Full text Link to item Cite

Changes in beliefs about medications during long-term care for ischemic heart disease.

Journal Article Am Heart J · April 2010 BACKGROUND: Beliefs such as self-reported low necessity for medications and high concerns about medications are associated with nonadherence. Changes in these beliefs during long-term care have not previously been studied and were evaluated for purposes of ... Full text Link to item Cite

Representation of women in randomized clinical trials of cardiovascular disease prevention.

Journal Article Circ Cardiovasc Qual Outcomes · March 2010 BACKGROUND: The 2007 American Heart Association guidelines for cardiovascular disease prevention in women drew heavily on results from randomized clinical trials; however, representation of women in trials of cardiovascular disease prevention has not been ... Full text Link to item Cite

Design and rationale of the Evaluation of M118 IN pErcutaNeous Coronary intErvention (EMINENCE) trial.

Journal Article Am Heart J · November 2009 BACKGROUND: Currently recommended anticoagulant agents used in the setting of percutaneous coronary intervention (PCI) inhibit, with varying degrees of intensity, 2 critical targets (factor Xa and/or IIa) of the coagulation cascade, yet they carry signific ... Full text Link to item Cite

Age and persistent use of cardiovascular medication after acute coronary syndrome: results from medication applied and sustained over time.

Journal Article J Am Geriatr Soc · November 2009 OBJECTIVES: To describe the persistent use of evidence-based cardiovascular medications (EBCMs) 3 months after discharge from an acute coronary syndrome (ACS) event and patient-reported reasons for nonpersistence across age groups. DESIGN: Medication Appli ... Full text Link to item Cite

Reporting and representation of race/ethnicity in published randomized trials.

Journal Article Am Heart J · November 2009 BACKGROUND: Although adequate representation of specific subgroups (eg, women and the elderly) in randomized controlled trials (RCTs) has been under intense scrutiny, there are few data on representation by race. METHODS: Using all RCTs cited by the 2007 A ... Full text Link to item Cite

Predictors of early discontinuation of evidence-based medicine after acute coronary syndrome.

Journal Article Am J Cardiol · July 15, 2009 Use of evidence-based medicine (EBM) improves outcomes after acute coronary syndromes (ACS), yet patients often discontinue prescribed therapies after discharge. Although such discontinuation is well documented, patients' reasons for medication discontinua ... Full text Link to item Cite

Reporting and Representation of Race in Published Randomized Trials

Journal Article JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · March 10, 2009 Link to item Cite

Medical records and quality of care in acute coronary syndromes: results from CRUSADE.

Journal Article Arch Intern Med · August 11, 2008 BACKGROUND: Patient medical records are important means of communication among health care providers. Limited evaluation has been performed of the quality of the medical records or its association with health care processes or outcomes. METHODS: We perform ... Full text Link to item Cite

Unfractionated heparin dosing and risk of major bleeding in non-ST-segment elevation acute coronary syndromes.

Journal Article Am Heart J · August 2008 BACKGROUND: Unfractionated heparin (UFH) is a mainstay of treatment for patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS), but the practice of weight-adjusted bolus and infusion dosing has not been carefully evaluated. METHODS: Usi ... Full text Link to item Cite

Management of acute coronary syndromes in patients with renal dysfunction.

Journal Article Curr Opin Cardiol · July 2008 PURPOSE OF REVIEW: Chronic kidney disease is becoming common among patients with acute coronary syndromes and is associated with substantial cardiovascular morbidity and mortality. Often, patients with chronic kidney disease are excluded from clinical tria ... Full text Link to item Cite

Phase 1b randomized study of antidote-controlled modulation of factor IXa activity in patients with stable coronary artery disease.

Journal Article Circulation · June 3, 2008 BACKGROUND: Whether selective factor IXa inhibition produces an appropriate anticoagulant effect when combined with platelet-directed therapy in patients with stable coronary artery disease is unknown. REG1 consists of RB006 (drug), an injectable RNA aptam ... Full text Link to item Cite

Cockcroft-Gault versus modification of diet in renal disease: importance of glomerular filtration rate formula for classification of chronic kidney disease in patients with non-ST-segment elevation acute coronary syndromes.

Journal Article J Am Coll Cardiol · March 11, 2008 OBJECTIVES: Our purpose was to compare formulae for estimating glomerular filtration rate (GFR) in non-ST-segment elevation acute coronary syndromes (NSTE ACS) patients. BACKGROUND: Assessment of GFR is important for antithrombotic dose adjustment in NSTE ... Full text Link to item Cite

Representation of women in randomized clinical trials of cardiovascular disease prevention

Conference JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · March 11, 2008 Link to item Cite

Prognostic value of troponins in patients with non-ST-segment elevation acute coronary syndromes and chronic kidney disease.

Journal Article Clin Cardiol · March 2008 BACKGROUND: The prognostic value of cardiac troponins (cTn) in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) and chronic kidney disease (CKD) is debated. HYPOTHESIS: We tested the performance of cTnI and cTnT for risk stratific ... Full text Link to item Cite

Metabolic efficiency with ranolazine for less ischemia in non-ST elevation acute coronary syndromes (MERLIN TIMI-36) study.

Journal Article Expert Rev Cardiovasc Ther · January 2008 Ranolazine is a piperazine derivative believed to reduce anginal symptoms by preventing ischemia-mediated sodium and calcium overload in myocardial cells through inhibition of the late sodium current (late INa). Three small studies demonstrated the antiang ... Full text Link to item Cite

First-in-human experience of an antidote-controlled anticoagulant using RNA aptamer technology: a phase 1a pharmacodynamic evaluation of a drug-antidote pair for the controlled regulation of factor IXa activity.

Journal Article Circulation · December 5, 2006 BACKGROUND: Selectivity, titratability, rapidity of onset, and active reversibility are desirable pharmacological properties of anticoagulant therapy administered for acute indications and collectively represent an attractive platform to maximize patient s ... Full text Link to item Cite

Periodontal health improves systemic inflammatory and haemostatic status in subjects with coronary heart disease.

Journal Article J Clin Periodontol · February 2005 OBJECTIVES: A relationship between poor oral health and coronary heart disease (CHD) and systemic inflammatory and haemostatic factors has been recently documented in an Italian population. The present study was performed to assess whether intensive dental ... Full text Link to item Cite

Poor oral health is associated with coronary heart disease and elevated systemic inflammatory and haemostatic factors.

Journal Article J Clin Periodontol · January 2004 OBJECTIVES: To assess the relationship between poor oral health and coronary heart disease (CHD) and systemic inflammatory and haemostatic factors in an Italian population. MATERIAL AND METHODS: The study population consisted of 63 males aged 40-65 years w ... Full text Link to item Cite

Acute coronary syndromes: New trends in blood anticoagulation

Journal Article Haematologica · December 1, 2003 Cite

Matrix metalloproteinase genetic polymorphisms in premature coronary artery disease

Journal Article JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · March 19, 2003 Link to item Cite

Clinical use of novel antithrombotic agents in the management of acute coronary syndromes.

Journal Article Pathophysiol Haemost Thromb · 2002 Among patients with ST elevation-acute coronary syndrome (ACS) novel thrombolytic agents can be given as a bolus (reteplase, tenecteplase) and their delivery is easier and may shorten the time to treatment, providing the ideal tool in the pre-hospital sett ... Full text Link to item Cite