Scholars@Duke
John Hunter Peel Alexander

John Hunter Peel Alexander

Professor of Medicine
Medicine, Cardiology
john.h.alexander@duke.edu
Duke Box 17969, Durham, NC 27715
300 W. Morgan Street, Durham, NC 27701

Selected Publications

Plasma Biomarkers Associated With Heart Failure Hospitalization Among Patients With Atrial Fibrillation and Subtypes of Heart Failure.

Journal Article J Am Heart Assoc · January 20, 2026 BACKGROUND: Atrial fibrillation is associated with heart failure (HF) through a complex cause-and-effect relationship. We performed multiplex screening of plasma proteins in patients with atrial fibrillation to identify biomarkers and pathways associated w ... Full text Link to item Cite

Transfusion-related adverse events in patients with restrictive or liberal transfusion strategy. An analysis of the MINT trial.

Journal Article Transfusion · January 2026 BACKGROUND: The aim of this analysis was to quantify and compare the frequency of transfusion-related adverse events (TRAE) in adult patients with myocardial infarction transfused with a restrictive versus liberal transfusion strategy from the Myocardial I ... Full text Link to item Cite

Factor XI inhibitors for the prevention and treatment of venous and arterial thromboembolism.

Journal Article Nat Rev Cardiol · November 2025 Therapeutic anticoagulation is essential to prevent and treat venous and arterial thromboembolism. The available agents target coagulation factors involved in thrombus formation but are associated with an increased risk of bleeding. Factor XI plays a minor ... Full text Link to item Cite

Midterm survival, clinical, and hemodynamic outcomes of a novel mechanical mitral valve prosthesis.

Journal Article J Thorac Cardiovasc Surg · October 2025 OBJECTIVE: To evaluate the midterm survival, clinical, and hemodynamic outcomes of the On-X mechanical mitral valve, based on the 5-year results of the Prospective Randomized On-X Anticoagulation Clinical Trial (PROACT). METHOD: PROACT Mitral was a multice ... Full text Link to item Cite

Counterpoint: the design and interpretation of blood transfusion randomized clinical trials.

Journal Article Blood · August 7, 2025 A recent Perspective in Blood suggested that previous evidence from over a decade ago established that a liberal rather than a restrictive blood transfusion strategy results in better outcomes in patients with anemia and either acute myocardial infarction ... Full text Link to item Cite

Ethical Considerations for Informed Consent in Acute Myocardial Infarction Clinical Trials.

Journal Article Circ Cardiovasc Interv · July 2025 Obtaining informed consent for clinical trial participation in acute myocardial infarction presents unique ethical and logistical challenges because of the patient distress, sedation, and the urgency of treatment. Traditional consent procedures often confl ... Full text Link to item Cite

2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

Journal Article J Am Coll Cardiol · June 10, 2025 AIM: The "2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes" incorporates new evidence since the "2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction" and the corresponding "20 ... Full text Link to item Cite

The left atrial appendage exclusion for prophylactic stroke reduction (LEAAPS) trial: Rationale and design.

Journal Article Am Heart J · June 2025 INTRODUCTION: Left atrial appendage exclusion (LAAE) has been shown in randomized trials to reduce ischemic stroke risk in patients undergoing cardiac surgery with known atrial fibrillation (AF). Many patients undergoing cardiac surgery without pre-existin ... Full text Link to item Cite

Restrictive or Liberal Blood Transfusion in Patients with Myocardial Infarction and CKD.

Journal Article J Am Soc Nephrol · June 1, 2025 KEY POINTS: This Myocardial Ischemia and Transfusion (MINT) trial analysis evaluated the optimal transfusion strategy for patients with CKD and anemia experiencing acute myocardial infarction. In patients with CKD, a liberal transfusion strategy overall di ... Full text Link to item Cite

Asundexian or Apixaban in Patients With Atrial Fibrillation According to Prior Oral Anticoagulant Use: A Subgroup Analysis of the OCEANIC-AF Randomized Clinical Trial.

Journal Article JAMA Cardiol · June 1, 2025 IMPORTANCE: In patients with atrial fibrillation (AF), oral anticoagulants (OACs) reduce the risk of stroke. OBJECTIVE: To investigate if patients with less prior OAC exposure respond differently to a new OAC than patients with more OAC exposure. DESIGN, S ... Full text Link to item Cite

Pre-treatment lysis time of plasma-derived fibrin clots and bleeding in patients on oral anticoagulants for atrial fibrillation in the ARISTOTLE trial.

Journal Article Eur Heart J · May 30, 2025 BACKGROUND AND AIMS: Oral anticoagulation reduces stroke risk in patients with atrial fibrillation (AF) but increases bleeding. Longer fibrin clot lysis time has been shown to predict adverse cardiovascular outcomes in acute coronary syndromes. This study ... Full text Link to item Cite

Association Between Myocardial Infarction and Quality of Life in the ISCHEMIA Trial.

Journal Article JACC Cardiovasc Interv · May 26, 2025 BACKGROUND: The association between myocardial infarction (MI) subtypes (procedural MI [PMI] and spontaneous MI [SMI]) and subsequent quality of life (QoL) is incompletely understood. OBJECTIVES: The authors analyzed the association between PMI and SMI and ... Full text Link to item Cite

Sequential Grafting of the Left Internal Thoracic Artery to the Left Anterior Descending Artery and Graft Failure.

Journal Article Ann Thorac Surg · April 2025 BACKGROUND: There is concern that left internal thoracic artery (LITA)-to diagonal (D)-to left anterior descending artery (LAD) grafts may be more susceptible to failure compared with single LITA-LAD grafts. METHODS: Pooled individual patient data from 8 c ... Full text Link to item Cite

Individualized transfusion decisions to minimize adverse cardiovascular outcomes in patients with acute myocardial infarction and anemia.

Journal Article Am Heart J · April 2025 BACKGROUND: Risk-benefit tradeoffs between restrictive versus liberal red blood cell transfusion strategies may vary across individuals. This exploratory analysis aimed to derive and evaluate individualized treatment effects of defined transfusion strategi ... Full text Link to item Cite

Apixaban Dose in Patients With Atrial Fibrillation and Acute Coronary Syndrome and/or Undergoing Percutaneous Coronary Intervention: Insights From AUGUSTUS.

Journal Article JACC Adv · April 2025 BACKGROUND: Studies have demonstrated the safety and efficacy of reducing the dose of apixaban from 5.0 mg to 2.5 mg twice daily in patients with atrial fibrillation (AF) and ≥2 dose-reduction criteria (age ≥80 years, body weight ≤60 kg, serum creatinine ≥ ... Full text Link to item Cite

Blood Transfusion in Patients With Acute Myocardial Infarction, Anemia, and Heart Failure: Lessons From MINT.

Journal Article Circ Heart Fail · April 2025 BACKGROUND: Blood transfusion may precipitate adverse outcomes, including heart failure (HF), among patients with acute myocardial infarction (MI). This study characterizes the effects of a restrictive or liberal transfusion strategy on outcomes in patient ... Full text Link to item Cite

2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Journal Article Circulation · April 1, 2025 Aim: The “2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes” incorporates new evidence since the “2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction” and the corresponding “20 ... Full text Cite

Antithrombotic Therapy to Minimize Total Events After ACS or PCI in Atrial Fibrillation: Insights From AUGUSTUS.

Journal Article J Am Coll Cardiol · March 25, 2025 BACKGROUND: Limited data exist on the optimal antithrombotic strategy to minimize total bleeding and ischemic events for patients with recent acute coronary syndrome (ACS) or percutaneous coronary intervention (PCI) and atrial fibrillation (AF). OBJECTIVES ... Full text Link to item Cite

Biomarker-Based Model for Prediction of Ischemic Stroke in Patients With Atrial Fibrillation.

Journal Article J Am Coll Cardiol · March 25, 2025 BACKGROUND: In patients with atrial fibrillation (AF) the risk of ischemic stroke is central to recommendations for stroke-prevention treatment. OBJECTIVES: The authors evaluated the biomarker-based Age, Biomarkers, Clinical history (ABC)-AF-stroke risk sc ... Full text Link to item Cite

Effect of apixaban versus vitamin K antagonist and aspirin versus placebo on days alive and out of hospital: An analysis from AUGUSTUS.

Journal Article Am Heart J · February 2025 BACKGROUND: Clinical trials of antithrombotic agents typically use separate time-to-event analyses for bleeding and ischemic events, but this framework has limitations. Days alive and out of hospital (DAOH) is an alternative that may provide additional ins ... Full text Link to item Cite

Restrictive versus Liberal Transfusion in Myocardial Infarction - A Patient-Level Meta-Analysis.

Journal Article NEJM Evid · February 2025 BACKGROUND: Clinical guidelines have concluded that there are insufficient data to provide recommendations for the hemoglobin threshold for the use of red cell transfusion in patients with acute myocardial infarction (MI) and anemia. After the recent publi ... Full text Link to item Cite

Asundexian versus Apixaban in Patients with Atrial Fibrillation.

Journal Article N Engl J Med · January 2, 2025 BACKGROUND: Stroke prevention with direct-acting oral anticoagulant agents in patients with atrial fibrillation confers a risk of bleeding and limits their use. Asundexian, an activated factor XI (XIa) inhibitor, is an oral anticoagulant that may prevent s ... Full text Link to item Cite

Apolipoprotein A-I infusions and cardiovascular outcomes in acute myocardial infarction according to baseline LDL-cholesterol levels: the AEGIS-II trial.

Journal Article Eur Heart J · December 16, 2024 BACKGROUND AND AIMS: In the AEGIS-II trial (NCT03473223), CSL112, a human apolipoprotein A1 derived from plasma that increases cholesterol efflux capacity, did not significantly reduce the risk of the primary endpoint through 90 days vs. placebo after acut ... Full text Link to item Cite

Restrictive Versus Liberal Transfusion in Patients With Type 1 or Type 2 Myocardial Infarction: A Prespecified Analysis of the MINT Trial.

Journal Article Circulation · December 3, 2024 BACKGROUND: The MINT trial (Myocardial Ischemia and Transfusion) raised concern for harm from a restrictive versus liberal transfusion strategy in patients with acute myocardial infarction (MI) and anemia. Type 1 and type 2 MI are distinct pathophysiologic ... Full text Link to item Cite

ApoA-I Infusions and Burden of Ischemic Events After Acute Myocardial Infarction: Insights From the AEGIS-II Trial.

Journal Article J Am Coll Cardiol · November 26, 2024 BACKGROUND: Following an acute myocardial infarction (AMI), patients remain at risk for subsequent cardiovascular (CV) events. In the AEGIS-II trial, CSL112, a human apolipoprotein A-I derived from plasma that enhances cholesterol efflux, did not significa ... Full text Link to item Cite

Anemia Acuity Effect on Transfusion Strategies in Acute Myocardial Infarction: A Secondary Analysis of the MINT Trial.

Journal Article JAMA Netw Open · November 4, 2024 IMPORTANCE: In patients with acute myocardial infarction (MI), limited physiologic adaptation to acute anemia might lead to greater benefit from a liberal red blood cell (RBC) transfusion strategy. Data on such a possible benefit are lacking. OBJECTIVES: T ... Full text Link to item Cite

Effect of Four Hemoglobin Transfusion Threshold Strategies in Patients With Acute Myocardial Infarction and Anemia : A Target Trial Emulation Using MINT Trial Data.

Journal Article Ann Intern Med · November 2024 BACKGROUND: The optimal hemoglobin threshold to guide red blood cell (RBC) transfusion for patients with acute myocardial infarction (MI) and anemia is uncertain. OBJECTIVE: To estimate the efficacy of 4 individual hemoglobin thresholds (<10 g/dL [<100 g/L ... Full text Link to item Cite

Apixaban and Limiting Aspirin for Patients With Atrial Fibrillation, Percutaneous Coronary Intervention, and Multimorbidity.

Journal Article JACC Adv · November 2024 BACKGROUND: Patients with atrial fibrillation (AF) after an acute coronary syndrome (ACS) and/or undergoing percutaneous coronary intervention (PCI) with multiple comorbidities are at increased risk for bleeding and ischemic events. OBJECTIVES: This post-h ... Full text Link to item Cite

Relative Benefit of Dual Versus Single Antiplatelet Therapy Among Patients With Atrial Fibrillation on Oral Anticoagulation According to Time After ACS and PCI: Insights From the AUGUSTUS Trial.

Journal Article Circ Cardiovasc Interv · November 2024 BACKGROUND: In the AUGUSTUS trial (An Open-Label, 2 x 2 Factorial, Randomized Controlled, Clinical Trial to Evaluate the Safety of Apixaban vs Vitamin K Antagonist and Aspirin vs Aspirin Placebo in Patients With Atrial Fibrillation and Acute Coronary Syndr ... Full text Link to item Cite

Antithrombotic Strategies According to Age: Insights from the AUGUSTUS Trial.

Journal Article Am J Med · October 2024 OBJECTIVE: We aimed to evaluate the safety and efficacy of antithrombotic strategies by age in patients with atrial fibrillation and acute coronary syndrome and/or percutaneous coronary intervention in AUGUSTUS. METHODS: Patients were stratified into 3 age ... Full text Link to item Cite

Antithrombotic Strategies in Atrial Fibrillation After ACS and/or PCI: A 4-Way Comparison From AUGUSTUS.

Journal Article J Am Coll Cardiol · September 3, 2024 BACKGROUND: The optimal antithrombotic regimen for patients with atrial fibrillation (AF) who had an acute coronary syndrome (ACS) or have undergone percutaneous coronary intervention (PCI) is not known. OBJECTIVES: The authors sought to determine which an ... Full text Link to item Cite

Impact of anemia on outcomes and resource utilization in patients with myocardial infarction: A national database analysis.

Journal Article Int J Cardiol · August 1, 2024 BACKGROUND: Although anemia is common in patients with myocardial infarction (MI), management remains controversial. We quantified the association of anemia with in-hospital outcomes and resource utilization in patients admitted with MI using a large natio ... Full text Link to item Cite

Predictors of bleeding and thrombotic events among patients admitted to the hospital with COVID-19 and elevated D-dimer: insights from the ACTION randomized clinical trial.

Journal Article J Thromb Thrombolysis · August 2024 Therapeutic anticoagulation showed inconsistent results in hospitalized patients with COVID-19 and selection of the best patients to use this strategy still a challenge balancing the risk of thrombotic and hemorrhagic outcomes. The present post-hoc analysi ... Full text Link to item Cite

Coronary Artery Bypass Graft Failure in Women: Incidence and Clinical Implications.

Journal Article J Am Coll Cardiol · July 9, 2024 BACKGROUND: Women have worse outcomes after coronary artery bypass surgery (CABG) than men. OBJECTIVES: This study aimed to determine the incidence of CABG graft failure in women, its association with cardiac events, and whether it contributes to sex-relat ... Full text Link to item Cite

Effect of Reconstituted Human Apolipoprotein A-I on Recurrent Ischemic Events in Survivors of Acute MI.

Journal Article J Am Coll Cardiol · June 4, 2024 BACKGROUND: The AEGIS-II trial hypothesized that CSL112, an intravenous formulation of human apoA-I, would lower the risk of plaque disruption, decreasing the risk of recurrent events such as myocardial infarction (MI) among high-risk patients with MI. OBJ ... Full text Link to item Cite

Association between overweight and obesity with coronary artery bypass graft failure: an individual patient data analysis of clinical trials.

Journal Article Eur J Cardiothorac Surg · June 3, 2024 OBJECTIVES: The association between obesity and graft failure after coronary artery bypass grafting has not been previously investigated. METHODS: We pooled individual patient data from randomized clinical trials with systematic postoperative coronary imag ... Full text Link to item Cite

Outcomes by sex in the International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA) trial.

Journal Article EuroIntervention · May 10, 2024 BACKGROUND: In the International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA) trial, among participants with stable coronary artery disease, the risk of cardiac events was similar between an invasive (INV) strat ... Full text Link to item Cite

Apolipoprotein A1 Infusions and Cardiovascular Outcomes after Acute Myocardial Infarction.

Journal Article N Engl J Med · May 2, 2024 BACKGROUND: Cardiovascular events frequently recur after acute myocardial infarction, and low cholesterol efflux - a process mediated by apolipoprotein A1, which is the main protein in high-density lipoprotein - has been associated with an increased risk o ... Full text Link to item Cite

Intimal hyperplasia, saphenous vein graft disease, and clinical outcomes: Insights from the CTSN VEST randomized trial.

Journal Article J Thorac Cardiovasc Surg · May 2024 BACKGROUND: Diffuse intimal hyperplasia and graft irregularity adversely affect the long-term patency of saphenous vein grafts (SVGs) and clinical outcomes of patients undergoing coronary artery bypass grafting (CABG). The VEST trial evaluated the efficacy ... Full text Link to item Cite

Repeated Measurement of the Novel Atrial Biomarker BMP10 (Bone Morphogenetic Protein 10) Refines Risk Stratification in Anticoagulated Patients With Atrial Fibrillation: Insights From the ARISTOTLE Trial.

Journal Article J Am Heart Assoc · April 2, 2024 BACKGROUND: BMP10 (bone morphogenic protein 10) has emerged as a novel biomarker associated with the risk of ischemic stroke and other outcomes in patients with atrial fibrillation (AF). The study aimed to determine if repeated BMP10 measurements improve p ... Full text Link to item Cite

Bleeding Outcomes in Patients Treated With Asundexian in Phase II Trials.

Journal Article J Am Coll Cardiol · February 13, 2024 BACKGROUND: Phase II trials of asundexian were underpowered to detect important differences in bleeding. OBJECTIVES: The goal of this study was to obtain best estimates of effects of asundexian vs active control/placebo on major and clinically relevant non ... Full text Link to item Cite

Outcomes According to Coronary Revascularization Modality in the ISCHEMIA Trial.

Journal Article J Am Coll Cardiol · February 6, 2024 BACKGROUND: In the ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial, the risk of ischemic events was similar in patients with stable coronary artery disease treated with an invasive (INV) strateg ... Full text Link to item Cite

Prospective Study of Risk Factors for Postoperative Atrial Fibrillation After Cardiac Surgery.

Journal Article J Surg Res · February 2024 INTRODUCTION: To examine risk factors for new-onset postoperative atrial fibrillation (POAF) after cardiac surgery. METHODS: Patients enrolled in the Cardiothoracic Surgical Trials Network multicenter, randomized trial of rate control versus rhythm control ... Full text Link to item Cite

Hypoglycemia and Cardiovascular Outcomes in the CARMELINA and CAROLINA Trials of Linagliptin: A Secondary Analysis of Randomized Clinical Trials.

Journal Article JAMA Cardiol · February 1, 2024 IMPORTANCE: Previous studies have reported an association between hypoglycemia and cardiovascular (CV) events in people with type 2 diabetes (T2D), but it is unclear if this association is causal or identifies a high-risk patient phenotype. OBJECTIVE: To e ... Full text Link to item Cite

Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia.

Journal Article N Engl J Med · December 28, 2023 BACKGROUND: A strategy of administering a transfusion only when the hemoglobin level falls below 7 or 8 g per deciliter has been widely adopted. However, patients with acute myocardial infarction may benefit from a higher hemoglobin level. METHODS: In this ... Full text Link to item Cite

Morbidity and Mortality Associated With Heart Failure in Acute Coronary Syndrome: A Pooled Analysis of 4 Clinical Trials.

Journal Article J Card Fail · December 2023 BACKGROUND: Heart failure (HF) may complicate acute coronary syndrome (ACS) and is associated with a high burden of short- and long-term morbidity and mortality. Only limited data regarding future ischemic events and rehospitalization are available for pat ... Full text Link to item Cite

Heart rate and death and hospitalization for heart failure in patients with persistent or permanent atrial fibrillation: Insights from the ARISTOTLE trial.

Journal Article Am Heart J · November 2023 Rate control is fundamental in the treatment of patients with atrial fibrillation (AF). The independent association of heart rate with outcomes and range of heart rate associated with best outcomes remains uncertain. We assessed the relationship between he ... Full text Link to item Cite

The Effect of Posterior Pericardiotomy on the Incidence of Atrial Fibrillation After Cardiac Surgery-Extended Follow-Up study (PALACS-EF): rationale and design.

Journal Article Eur Heart J Open · November 2023 AIMS: Postoperative atrial fibrillation (POAF) is the most common complication of cardiac surgery and has been associated with increased postoperative morbidity and hospital costs. The Posterior left pericardiotomy for the prevention of AtriaL fibrillation ... Full text Link to item Cite

Graft Failure After Coronary Artery Bypass Grafting and Its Association With Patient Characteristics and Clinical Events: A Pooled Individual Patient Data Analysis of Clinical Trials With Imaging Follow-Up.

Journal Article Circulation · October 24, 2023 BACKGROUND: Graft patency is the postulated mechanism for the benefits of coronary artery bypass grafting (CABG). However, systematic graft imaging assessment after CABG is rare, and there is a lack of contemporary data on the factors associated with graft ... Full text Link to item Cite

Cardiovascular Effects of GnRH Antagonists Compared With Agonists in Prostate Cancer: A Systematic Review.

Journal Article JACC CardioOncol · October 2023 BACKGROUND: Androgen deprivation therapy is the cornerstone of treatment for patients with advanced prostate cancer. Meta-analysis of small, oncology-focused trials suggest gonadotropin-releasing hormone (GnRH) antagonists may be associated with fewer adve ... Full text Link to item Cite

Plasma angiopoietin-2 and its association with heart failure in patients with atrial fibrillation.

Journal Article Europace · July 4, 2023 AIMS: Several biomarkers are associated with clinical outcomes in patients with atrial fibrillation (AF), but a causal relationship has not been established. This study aimed to evaluate angiopoietin-2, a novel candidate biomarker of endothelial inflammati ... Full text Link to item Cite

Individual net clinical outcome with oral anticoagulation in atrial fibrillation using the ABC-AF risk scores.

Journal Article American heart journal · July 2023 BackgroundDecisions on stroke prevention strategies in patients with atrial fibrillation (AF) depend on the perceived risks of stroke and bleeding with different antithrombotic treatment strategies. The study objectives were to evaluate net clinic ... Full text Cite

Postoperative pericardial effusion, pericardiotomy, and atrial fibrillation: An explanatory analysis of the PALACS trial.

Journal Article Am Heart J · June 2023 BACKGROUND: In the Posterior left pericardiotomy for the prevention of atrial fibrillation after cardiac surgery (PALACS) trial, posterior pericardiotomy was associated with a significant reduction in postoperative atrial fibrillation (POAF) after cardiac ... Full text Link to item Cite

Benefits of Bempedoic Acid - Clearer Now.

Journal Article N Engl J Med · April 13, 2023 Full text Link to item Cite

Low-Dose vs Standard Warfarin After Mechanical Mitral Valve Replacement: A Randomized Trial.

Journal Article Ann Thorac Surg · April 2023 BACKGROUND: Current guidelines recommend a target international normalized ratio (INR) range of 2.5 to 3.5 in patients with a mechanical mitral prosthesis. The Prospective Randomized On-X Anticoagulation Clinical Trial (PROACT) Mitral randomized controlled ... Full text Link to item Cite

Final Study Report of Andexanet Alfa for Major Bleeding With Factor Xa Inhibitors.

Journal Article Circulation · March 28, 2023 BACKGROUND: Andexanet alfa is a modified recombinant inactive factor Xa (FXa) designed to reverse FXa inhibitors. ANNEXA-4 (Andexanet Alfa, a Novel Antidote to the Anticoagulation Effects of Factor Xa Inhibitors) was a multicenter, prospective, phase-3b/4, ... Full text Link to item Cite

Rationale and design for the myocardial ischemia and transfusion (MINT) randomized clinical trial.

Journal Article Am Heart J · March 2023 BACKGROUND: Accumulating evidence from clinical trials suggests that a lower (restrictive) hemoglobin threshold (<8 g/dL) for red blood cell (RBC) transfusion, compared with a higher (liberal) threshold (≥10 g/dL) is safe. However, in anemic patients with ... Full text Link to item Cite

Firibastat Versus Ramipril After Acute Mechanical Reperfusion of Anterior Myocardial Infarction: A Phase 2 Study.

Journal Article Am J Cardiovasc Drugs · March 2023 BACKGROUND: Preclinical data suggest that central renin-angiotensin system blockade by the brain aminopeptidase-A inhibitor firibastat can improve left ventricular ejection fraction (LVEF) after myocardial infarction (MI). OBJECTIVES: This study aimed to c ... Full text Link to item Cite

Clinical Evaluation of Factor XIa Inhibitor Drugs: JACC Review Topic of the Week.

Journal Article J Am Coll Cardiol · February 28, 2023 Factor XI/XIa (FXI/FXIa) represents a potential target for improved precision in anticoagulation because it is involved primarily in thrombus formation and plays a much smaller role in clotting and hemostasis. This suggests that the inhibition of FXI/XIa c ... Full text Link to item Cite

Omnia munda mundis ('to the pure, all things are pure').

Journal Article Eur J Cardiothorac Surg · February 3, 2023 Full text Link to item Cite

Bone morphogenetic protein 10: a novel risk marker of ischaemic stroke in patients with atrial fibrillation.

Journal Article Eur Heart J · January 14, 2023 AIMS: Biomarkers specifically related to atrial tissue may increase the understanding of the pathophysiology of atrial fibrillation (AF) and further improve risk prediction in this setting. Bone morphogenetic protein 10 (BMP10) is a protein expressed in th ... Full text Open Access Link to item Cite

Femoral Vascular Closure Devices and Bleeding, Hemostasis, and Ambulation Following Percutaneous Coronary Intervention.

Conference J Am Heart Assoc · January 3, 2023 Background The effectiveness of vascular closure devices (VCDs) to reduce bleeding after transfemoral percutaneous coronary intervention remains unsettled. Methods and Results Participants in the REGULATE-PCI (Effect of the REG1 anticoagulation system vers ... Full text Link to item Cite

Predictors and associated clinical outcomes of low cardiac output syndrome following cardiac surgery: insights from the LEVO-CTS trial.

Journal Article Eur Heart J Acute Cardiovasc Care · November 30, 2022 AIMS: High-risk cardiac surgery is commonly complicated by low cardiac output syndrome (LCOS), which is associated with high mortality. There are limited data derived from multi-centre studies with adjudicated endpoints describing factors associated with L ... Full text Link to item Cite

A Multicenter, Phase 2, Randomized, Placebo-Controlled, Double-Blind, Parallel-Group, Dose-Finding Trial of the Oral Factor XIa Inhibitor Asundexian to Prevent Adverse Cardiovascular Outcomes After Acute Myocardial Infarction.

Journal Article Circulation · October 18, 2022 BACKGROUND: Oral activated factor XI (FXIa) inhibitors may modulate coagulation to prevent thromboembolic events without substantially increasing bleeding. We explored the pharmacodynamics, safety, and efficacy of the oral FXIa inhibitor asundexian for sec ... Full text Link to item Cite

Biomarkers and heart failure events in patients with atrial fibrillation in the ARISTOTLE trial evaluated by a multi-state model.

Journal Article Am Heart J · September 2022 BACKGROUND: Atrial fibrillation (AF) and heart failure (HF) often coexist. We investigated the prognostic impact of biomarkers on the development of HF and death in patients with AF and different left ventricular systolic function considering the influence ... Full text Link to item Cite

Outcomes After Acute Coronary Syndrome in Patients With Diabetes Mellitus and Peripheral Artery Disease (from the TRACER, TRILOGY-ACS, APPRAISE-2, and PLATO Clinical Trials).

Journal Article Am J Cardiol · September 1, 2022 Patients with acute coronary syndrome (ACS) are at risk for recurrent adverse events, and multiple reports suggest that this risk is increased in patients with concomitant diabetes mellitus (DM) and peripheral artery disease (PAD). The aim of this article ... Full text Link to item Cite

Prophylactic levosimendan in patients with low ejection fraction undergoing coronary artery bypass grafting: A pooled analysis of two multicentre randomised controlled trials.

Journal Article Anaesth Crit Care Pain Med · August 2022 OBJECTIVES: To assess the effect of preoperative levosimendan on mortality at day 90 in patients with left ventricular ejection fraction (LVEF) ≤ 40%, and to investigate a possible differential effect between patients undergoing isolated coronary artery by ... Full text Link to item Cite

External Support for Saphenous Vein Grafts in Coronary Artery Bypass Surgery: A Randomized Clinical Trial.

Journal Article JAMA Cardiol · August 1, 2022 IMPORTANCE: Intimal hyperplasia and subsequent saphenous vein graft failure may have significant adverse clinical effects in patients undergoing coronary artery bypass surgery. External support of saphenous vein grafts has the potential to prevent vein gra ... Full text Link to item Cite

Using multimarker screening to identify biomarkers associated with cardiovascular death in patients with atrial fibrillation.

Journal Article Cardiovasc Res · July 20, 2022 AIMS: Atrial fibrillation (AF) is associated with higher mortality. Biomarkers may improve the understanding of key pathophysiologic processes in AF that lead to death. Using a new multiplex analytic technique, we explored the association between 268 bioma ... Full text Link to item Cite

Discontinuing vs continuing ACEIs and ARBs in hospitalized patients with COVID-19 according to disease severity: Insights from the BRACE CORONA trial.

Journal Article Am Heart J · July 2022 BACKGROUND: We explored the effect of discontinuing versus continuing angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) on clinical outcomes in patients with COVID-19 according to baseline disease severity. METHOD ... Full text Link to item Cite

Apixaban or Warfarin and Aspirin or Placebo After Acute Coronary Syndrome or Percutaneous Coronary Intervention in Patients With Atrial Fibrillation and Prior Stroke: A Post Hoc Analysis From the AUGUSTUS Trial.

Journal Article JAMA Cardiol · July 1, 2022 IMPORTANCE: Data are limited regarding the risk of cerebrovascular ischemic events and major bleeding in patients with atrial fibrillation (AF) and recent acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI). OBJECTIVE: Determine t ... Full text Link to item Cite

Radial artery versus saphenous vein versus right internal thoracic artery for coronary artery bypass grafting.

Journal Article Eur J Cardiothorac Surg · June 15, 2022 OBJECTIVES: We used individual patient data from 4 of the largest contemporary coronary bypass surgery trials to evaluate differences in long-term outcomes when radial artery (RA), right internal thoracic artery (RITA) or saphenous vein graft (SVG) are use ... Full text Link to item Cite

Associated factors and clinical outcomes in mechanical circulatory support use in patients undergoing high risk on-pump cardiac surgery: Insights from the LEVO-CTS trial.

Journal Article Am Heart J · June 2022 BACKGROUND: We describe variables and outcomes associated with peri-operative mechanical circulatory support (MCS) utilization among patients enrolled in the Levosimendan in patients with Left Ventricular Systolic Dysfunction Undergoing Cardiac Surgery Req ... Full text Link to item Cite

Heterogeneity of diabetes as a risk factor for major adverse cardiovascular events in anticoagulated patients with atrial fibrillation: an analysis of the ARISTOTLE trial.

Journal Article Eur Heart J Cardiovasc Pharmacother · May 5, 2022 AIMS: Whether diabetes without insulin therapy is an independent cardiovascular (CV) risk factor in atrial fibrillation (AF) has recently been questioned. We investigated the prognostic relevance of diabetes with or without insulin treatment in patients in ... Full text Link to item Cite

Rationale and design of a randomized trial evaluating an external support device for saphenous vein coronary grafts.

Journal Article Am Heart J · April 2022 BACKGROUND: Coronary artery bypass grafting (CABG) is the most common revascularization approach for the treatment of multi-vessel coronary artery disease. While the internal mammary artery is nearly universally used to bypass the left anterior descending ... Full text Link to item Cite

Antithrombotic Therapy in Patients With Atrial Fibrillation After Acute Coronary Syndromes or Percutaneous Intervention.

Journal Article J Am Coll Cardiol · February 8, 2022 BACKGROUND: The use of apixaban instead of vitamin K antagonists (VKA) as well as dropping aspirin results in less bleeding and comparable ischemic events in patients with atrial fibrillation and acute coronary syndrome and/or percutaneous coronary interve ... Full text Link to item Cite

Impact of prior oral anticoagulant use and outcomes on patients from secondary analysis in the AUGUSTUS trial.

Journal Article Open Heart · February 2022 OBJECTIVE: Managing antithrombotic therapy in patients with atrial fibrillation (AF) and an acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI) is challenging and can be affected by prior oral anticoagulant (OAC) treatment. We exa ... Full text Link to item Cite

Direct Oral Anticoagulants Versus Warfarin in Patients With Atrial Fibrillation: Patient-Level Network Meta-Analyses of Randomized Clinical Trials With Interaction Testing by Age and Sex.

Journal Article Circulation · January 25, 2022 BACKGROUND: Direct oral anticoagulants (DOACs) are preferred over warfarin for stroke prevention in atrial fibrillation. Meta-analyses using individual patient data offer substantial advantages over study-level data. METHODS: We used individual patient dat ... Full text Link to item Cite

Genetic determinants of apixaban plasma levels and their relationship to bleeding and thromboembolic events.

Journal Article Front Genet · 2022 Apixaban is a direct oral anticoagulant, a factor Xa inhibitor, used for the prevention of ischemic stroke in patients with atrial fibrillation. Despite using recommended dosing a few patients might still experience bleeding or lack of efficacy that might ... Full text Link to item Cite

Sex differences in outcomes after coronary artery bypass grafting: a pooled analysis of individual patient data.

Journal Article Eur Heart J · December 28, 2021 AIMS: Data suggest that women have worse outcomes than men after coronary artery bypass grafting (CABG), but results have been inconsistent across studies. Due to the large differences in baseline characteristics between sexes, suboptimal risk adjustment d ... Full text Link to item Cite

Transcatheter mitral valve repair for functional mitral regurgitation: Evaluating the evidence.

Journal Article J Thorac Cardiovasc Surg · November 2021 OBJECTIVES: Two trials (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation Trial and Percutaneous Repair with the MitraClip Device for Severe Functional/Secondary Mitral ... Full text Link to item Cite

Multiplex protein screening of biomarkers associated with major bleeding in patients with atrial fibrillation treated with oral anticoagulation.

Journal Article J Thromb Haemost · November 2021 BACKGROUND: Oral anticoagulants (OAC) in patients with atrial fibrillation (AF) prevent thromboembolic events, but are associated with significant risk of bleeding. OBJECTIVES: To explore associations between a wide range of biomarkers and bleeding risk in ... 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

Lipoprotein(a) and Benefit of PCSK9 Inhibition in Patients With Nominally Controlled LDL Cholesterol.

Journal Article J Am Coll Cardiol · August 3, 2021 BACKGROUND: Guidelines recommend nonstatin lipid-lowering agents in patients at very high risk for major adverse cardiovascular events (MACE) if low-density lipoprotein cholesterol (LDL-C) remains ≥70 mg/dL on maximum tolerated statin treatment. It is unce ... Full text Link to item Cite

Randomized clinical trial to evaluate a routine full anticoagulation Strategy in Patients with Coronavirus Infection (SARS-CoV2) admitted to hospital: Rationale and design of the ACTION (AntiCoagulaTlon cOroNavirus)-Coalition IV trial.

Journal Article Am Heart J · August 2021 BACKGROUND: Observational studies have suggested a higher risk of thrombotic events in patients with coronavirus disease 2019 (COVID-19). Moreover, elevated D-dimer levels have been identified as an important prognostic marker in COVID-19 directly associat ... Full text Open Access 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

Therapeutic versus prophylactic anticoagulation for patients admitted to hospital with COVID-19 and elevated D-dimer concentration (ACTION): an open-label, multicentre, randomised, controlled trial.

Journal Article Lancet (London, England) · June 2021 BackgroundCOVID-19 is associated with a prothrombotic state leading to adverse clinical outcomes. Whether therapeutic anticoagulation improves outcomes in patients hospitalised with COVID-19 is unknown. We aimed to compare the efficacy and safety ... Full text Cite

Premature permanent discontinuation of apixaban or warfarin in patients with atrial fibrillation.

Journal Article Heart · May 2021 AIMS: The ARISTOTLE (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) trial randomised patients with atrial fibrillation at risk of stroke to apixaban or warfarin. We sought to describe patients from ARISTOTLE who pr ... Full text Link to item Cite

The association between coronary graft patency and clinical status in patients with coronary artery disease.

Journal Article Eur Heart J · April 7, 2021 The concept of a direct association between coronary graft patency and clinical status is generally accepted. However, the relationship is more complex and variable than usually thought. Key issues are the lack of a common definition of graft occlusion and ... Full text Link to item Cite

Apixaban or Vitamin K Antagonists and Aspirin or Placebo According to Kidney Function in Patients With Atrial Fibrillation After Acute Coronary Syndrome or Percutaneous Coronary Intervention: Insights From the AUGUSTUS Trial.

Journal Article Circulation · March 23, 2021 BACKGROUND: In the AUGUSTUS trial (An Open-Label, 2×2 Factorial, Randomized Controlled, Clinical Trial to Evaluate the Safety of Apixaban Versus Vitamin K Antagonist and Aspirin Versus Aspirin Placebo in Patients With Atrial Fibrillation and Acute Coronary ... Full text Link to item Cite

Individual Patient Data from the Pivotal Randomized Controlled Trials of Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation (COMBINE AF): Design and Rationale: From the COMBINE AF (A Collaboration between Multiple institutions to Better Investigate Non-vitamin K antagonist oral anticoagulant use in Atrial Fibrillation) Investigators.

Journal Article Am Heart J · March 2021 BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) are the preferred class of medications for prevention of stroke and systemic embolism in patients with atrial fibrillation unless contraindications exist. Five large, international, randomize ... Full text Link to item Cite

Evaluation of the prognostic value of GDF-15, ABC-AF-bleeding score and ABC-AF-death score in patients with atrial fibrillation across different geographical areas.

Journal Article Open Heart · March 2021 OBJECTIVES: Growth differentiation factor 15 (GDF-15) is a biomarker independently associated with bleeding and death in anticoagulated patients with atrial fibrillation (AF). GDF-15 is also used as one component in the more precise biomarker-based ABC (ag ... Full text Open Access Link to item Cite

Progression of Tricuspid Regurgitation After Surgery for Ischemic Mitral Regurgitation.

Journal Article J Am Coll Cardiol · February 16, 2021 BACKGROUND: Whether to repair nonsevere tricuspid regurgitation (TR) during surgery for ischemic mitral valve regurgitation (IMR) remains uncertain. OBJECTIVES: The goal of this study was to investigate the incidence, predictors, and clinical significance ... Full text Open Access Link to item Cite

Effect of Discontinuing vs Continuing Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers on Days Alive and Out of the Hospital in Patients Admitted With COVID-19: A Randomized Clinical Trial.

Journal Article JAMA · January 19, 2021 IMPORTANCE: It is unknown whether angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) have a positive, neutral, or negative effect on clinical outcomes in patients with coronavirus disease 2019 (COVID-19). OBJECTIVE: ... Full text Link to item Cite

Rationale and design of ApoA-I Event Reducing in Ischemic Syndromes II (AEGIS-II): A phase 3, multicenter, double-blind, randomized, placebo-controlled, parallel-group study to investigate the efficacy and safety of CSL112 in subjects after acute myocardial infarction.

Journal Article Am Heart J · January 2021 Acute myocardial infarction (MI) patients remain at high risk for recurrent events. Cholesterol efflux, mediated by apolipoprotein A-I, removes excess cholesterol from atherosclerotic plaque and transports it to the liver for excretion. Impaired cholestero ... Full text Link to item Cite

Association between levosimendan, postoperative AKI, and mortality in cardiac surgery: Insights from the LEVO-CTS trial.

Journal Article Am Heart J · January 2021 OBJECTIVES: We aimed to evaluate the association between levosimendan treatment and acute kidney injury (AKI) as well as assess the clinical sequelae of AKI in cardiac surgery patients with depressed left ventricular function (ejection fraction <35%). METH ... Full text Link to item Cite

Effect of linagliptin versus placebo on cardiovascular and kidney outcomes in nephrotic-range proteinuria and type 2 diabetes: the CARMELINA randomized controlled trial.

Journal Article Clin Kidney J · January 2021 BACKGROUND: Nephrotic-range proteinuria (NRP) is associated with rapid kidney function loss and increased cardiovascular (CV) disease risk. We assessed the effects of linagliptin (LINA) on CV and kidney outcomes in people with Type 2 diabetes (T2D) with or ... Full text Open Access Link to item Cite

Screening of Multiple Biomarkers Associated With Ischemic Stroke in Atrial Fibrillation.

Journal Article J Am Heart Assoc · December 15, 2020 Background To explore the pathophysiological features of ischemic stroke in patients with atrial fibrillation (AF), we evaluated the association between 268 plasma proteins and subsequent ischemic stroke in 2 large AF cohorts receiving oral anticoagulation ... Full text Open Access Link to item Cite

Management of Atrial Fibrillation in Older Patients by Morbidity Burden: Insights From Get With The Guidelines-Atrial Fibrillation.

Journal Article J Am Heart Assoc · December 2020 Background Knowledge is scarce regarding how multimorbidity is associated with therapeutic decisions regarding oral anticoagulants (OACs) in patients with atrial fibrillation. Methods and Results We conducted a cross-sectional study of hospitalized patient ... Full text Open Access Link to item Cite

Rivaroxaban in Patients with Atrial Fibrillation and a Bioprosthetic Mitral Valve.

Journal Article N Engl J Med · November 26, 2020 BACKGROUND: The effects of rivaroxaban in patients with atrial fibrillation and a bioprosthetic mitral valve remain uncertain. METHODS: In this randomized trial, we compared rivaroxaban (20 mg once daily) with dose-adjusted warfarin (target international n ... Full text Link to item Cite

Sex-related differences in outcomes after coronary artery bypass surgery-A patient-level pooled analysis of randomized controlled trials: rationale and study protocol.

Journal Article J Card Surg · October 2020 INTRODUCTION: The impact of sex on the outcomes after coronary artery bypass grafting (CABG) is controversial. The majority of CABG studies are retrospectively collected clinical or registry data, women comprise only a minority, and the reported findings r ... Full text Link to item Cite

Outcomes following revascularization with radial artery bypass grafts: Insights from the PREVENT-IV trial.

Journal Article Am Heart J · October 2020 BACKGROUND: The optimal role of radial artery grafts in coronary artery bypass grafting (CABG) remains uncertain. The purpose of this study was to examine angiographic and clinical outcomes following CABG among patients who received a radial artery graft. ... Full text Link to item Cite

Association of Different Estimates of Renal Function With Cardiovascular Mortality and Bleeding in Atrial Fibrillation.

Journal Article J Am Heart Assoc · September 15, 2020 Background We compared different methods of estimated glomerular filtration rate (eGFR) and their association with cardiovascular death and major bleeding in 14 980 patients with atrial fibrillation in the ARISTOTLE (Apixaban for Reduction in Stroke and Ot ... Full text Open Access Link to item Cite

Serial measurement of interleukin-6 and risk of mortality in anticoagulated patients with atrial fibrillation: Insights from ARISTOTLE and RE-LY trials.

Journal Article J Thromb Haemost · September 2020 BACKGROUND: The inflammatory biomarker interleukin-6 (IL-6) is associated with mortality in atrial fibrillation (AF). OBJECTIVE: To investigate if repeated IL-6 measurements improve the prognostication for stroke or systemic embolism, major bleeding, and m ... Full text Link to item Cite

Rationale and design of PROACT Xa: A randomized, multicenter, open-label, clinical trial to evaluate the efficacy and safety of apixaban versus warfarin in patients with a mechanical On-X Aortic Heart Valve.

Journal Article Am Heart J · September 2020 Vitamin K antagonists are the only approved oral anticoagulants for long-term prophylaxis against valve thrombosis and thromboembolism in patients with a mechanical heart valve. Despite the proven efficacy and safety of anticoagulation with the oral direct ... Full text Link to item Cite

Evaluation of the Age, Biomarkers, and Clinical History-Bleeding Risk Score in Patients With Atrial Fibrillation With Combined Aspirin and Anticoagulation Therapy Enrolled in the ARISTOTLE and RE-LY Trials.

Journal Article JAMA Netw Open · September 1, 2020 IMPORTANCE: Most patients with atrial fibrillation (AF) and coronary artery disease have indications for preventing stroke with oral anticoagulation therapy and preventing myocardial infarction and stent thrombosis with platelet inhibition. OBJECTIVE: To e ... Full text Link to item Cite

Randomized Trials Versus Common Sense and Clinical Observation: JACC Review Topic of the Week.

Journal Article J Am Coll Cardiol · August 4, 2020 Concerns about the external validity of traditional randomized clinical trials (RCTs), together with the widespread availability of real-world data and advanced data analytic tools, have led to claims that common sense and clinical observation, rather than ... Full text Open Access Link to item Cite

A systematic review of randomized trials comparing double versus triple antithrombotic therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention.

Journal Article Catheter Cardiovasc Interv · August 2020 BACKGROUND: Prior randomized controlled trials (RCT) evaluating the optimal antithrombotic therapies for patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) have not been powered to evaluate ischemic outcomes. We comp ... Full text Link to item Cite

Effects of apixaban compared with warfarin as gain in event-free time - a novel assessment of the results of the ARISTOTLE trial.

Journal Article Eur J Prev Cardiol · August 2020 BACKGROUND: A novel approach to determine the effect of a treatment is to calculate the delay of event, which estimates the gain of event-free time. The aim of this study was to estimate gains in event-free time for stroke or systemic embolism, death, blee ... Full text Link to item Cite

Cardiac troponin is associated with cardiac outcomes in men and women with atrial fibrillation, insights from the ARISTOTLE trial.

Journal Article J Intern Med · August 2020 BACKGROUND: Cardiac troponin T (cTnT) and I (cTnI) concentrations provide strong prognostic information in anticoagulated patients with atrial fibrillation (AF). Whether the associations between cardiac troponin concentrations and mortality and morbidity d ... Full text Link to item Cite

Association Between Delays in Mechanical Ventilation Initiation and Mortality in Patients With Refractory Cardiogenic Shock.

Journal Article JAMA Cardiol · August 1, 2020 This study investigates the association between timing of mechanical ventilation initiation and mortality in patients with refractory cardiogenic shock. ... Full text Link to item Cite

Effects of Linagliptin on Cardiovascular and Kidney Outcomes in People With Normal and Reduced Kidney Function: Secondary Analysis of the CARMELINA Randomized Trial.

Journal Article Diabetes Care · August 2020 OBJECTIVE: Type 2 diabetes is a leading cause of kidney failure, but few outcome trials proactively enrolled individuals with chronic kidney disease (CKD). We performed secondary analyses of cardiovascular (CV) and kidney outcomes across baseline estimated ... Full text Open Access Link to item Cite

Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)--The BRACE CORONA Trial.

Journal Article Am Heart J · August 2020 Angiotensin-converting enzyme-2 (ACE2) expression may increase due to upregulation in patients using angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARBs). Because renin-angiotensin system blockers increase levels of ACE2 ... Full text Open Access Link to item Cite

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

Journal Article J Am Coll Cardiol · July 14, 2020 BACKGROUND: The long-term prognostic impact of post-discharge bleeding in the unique population of patients with acute coronary syndrome (ACS) treated without percutaneous coronary intervention (PCI) remains unexplored. OBJECTIVES: The aim of this study wa ... Full text Link to item Cite

Reply: Specifics of Dose Modification in ARISTOTLE.

Journal Article J Am Coll Cardiol · July 7, 2020 Full text Link to item Cite

Levosimendan in patients with reduced left ventricular function undergoing isolated coronary or valve surgery.

Journal Article J Thorac Cardiovasc Surg · June 2020 OBJECTIVE: In the Levosimendan in Patients with Left Ventricular Systolic Dysfunction Undergoing Cardiac Surgery Requiring Cardiopulmonary Bypass (LEVO-CTS) trial, no differences in clinical outcomes were observed between levosimendan and placebo in a broa ... Full text Link to item Cite

Risk/Benefit Tradeoff of Antithrombotic Therapy in Patients With Atrial Fibrillation Early and Late After an Acute Coronary Syndrome or Percutaneous Coronary Intervention: Insights From AUGUSTUS.

Journal Article Circulation · May 19, 2020 BACKGROUND: In AUGUSTUS (Open-Label, 2×2 Factorial, Randomized, Controlled Clinical Trial to Evaluate the Safety of Apixaban vs Vitamin K Antagonist and Aspirin vs Aspirin Placebo in Patients With Atrial Fibrillation and Acute Coronary Syndrome and/or Perc ... Full text Link to item Cite

Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Journal Article Am Heart J · May 13, 2020 Background: Angiotensin-converting enzyme-2 (ACE2) may increase due to upregulation in patients using angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB). Because renin-angiotensin system blockers increase levels of ACE2 ... Full text Open Access Link to item Cite

Optimal Antithrombotic Regimens for Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention: An Updated Network Meta-analysis.

Journal Article JAMA Cardiol · May 1, 2020 IMPORTANCE: Antithrombotic treatment in patients with atrial fibrillation (AF) and percutaneous coronary intervention (PCI) presents a balancing act with regard to bleeding and ischemic risks. OBJECTIVES: To evaluate the safety and efficacy of 4 antithromb ... Full text Link to item Cite

Apixaban Versus Warfarin in Patients With Atrial Fibrillation and Advanced Chronic Kidney Disease.

Journal Article Circulation · April 28, 2020 BACKGROUND: Compared with the general population, patients with advanced chronic kidney disease have a >10-fold higher burden of atrial fibrillation. Limited data are available guiding the use of nonvitamin K antagonist oral anticoagulants in this populati ... Full text Link to item Cite

Linagliptin and cardiorenal outcomes in Asians with type 2 diabetes mellitus and established cardiovascular and/or kidney disease: subgroup analysis of the randomized CARMELINA® trial.

Journal Article Diabetol Int · April 2020 OBJECTIVE: Linagliptin, a dipeptidyl peptidase-4 inhibitor, demonstrated cardiovascular and renal safety in type 2 diabetes mellitus (T2DM) patients with established cardiovascular disease (CVD) with albuminuria and/or kidney disease in the multinational C ... Full text Link to item Cite

Clinical and Pharmacological Effects of Apixaban Dose Adjustment in the ARISTOTLE Trial.

Journal Article J Am Coll Cardiol · March 17, 2020 BACKGROUND: In the ARISTOTLE (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) trial, patients with atrial fibrillation and ≥2 dose-adjustment criteria (age ≥80 years, weight ≤60 kg, or creatinine ≥1.5 mg/dl [133 μmo ... Full text Link to item Cite

Gastrointestinal bleeding in patients with atrial fibrillation treated with Apixaban or warfarin: Insights from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial.

Journal Article Am Heart J · March 2020 OBJECTIVES: A history of gastrointestinal bleeding (GIB) in patients with atrial fibrillation (AF) may impact decisions about anticoagulation treatment. We sought to determine whether prior GIB in patients with AF taking anticoagulants was associated with ... Full text Link to item Cite

Regional variation in clinical characteristics and outcomes in patients with atrial fibrillation: Findings from the ARISTOTLE trial.

Journal Article Int J Cardiol · March 1, 2020 BACKGROUND: Variation in patient characteristics and practice patterns may influence outcomes at a regional level. METHODS: We assessed differences in demographics, practice patterns, outcomes, and the effect of apixaban compared with warfarin in ARISTOTLE ... Full text Link to item Cite

Major Adverse Cardiovascular Events After 12 Months Among Patients With Acute Coronary Syndrome Receiving Loading Doses of Atorvastatin Prior to Planned PCI.

Journal Article JAMA · February 25, 2020 This study uses SECURE-PCI trial data to compare the effects of periprocedural loading doses of atorvastatin vs placebo on major adverse cardiac events (MACE) 12 months after randomization in patients with acute coronary syndrome (ACS) and planned invasive ... Full text Link to item Cite

Patients With Atrial Fibrillation Taking Nonsteroidal Anti-Inflammatory Drugs and Oral Anticoagulants in the ARISTOTLE Trial.

Journal Article Circulation · January 7, 2020 BACKGROUND: The use of nonsteroidal anti-inflammatory drugs (NSAIDs) with oral anticoagulants has been associated with an increased risk of bleeding. We investigated the risk of bleeding and major cardiovascular outcomes in patients with atrial fibrillatio ... Full text Link to item Cite

Antithrombotic Therapy in Patients With Atrial Fibrillation and Acute Coronary Syndrome Treated Medically or With Percutaneous Coronary Intervention or Undergoing Elective Percutaneous Coronary Intervention: Insights From the AUGUSTUS Trial.

Journal Article Circulation · December 3, 2019 BACKGROUND: The safety and efficacy of antithrombotic regimens may differ between patients with atrial fibrillation who have acute coronary syndromes (ACS), treated medically or with percutaneous coronary intervention (PCI), and those undergoing elective P ... Full text Link to item Cite

Claims-based cardiovascular outcome identification for clinical research: Results from 7 large randomized cardiovascular clinical trials.

Journal Article Am Heart J · December 2019 BACKGROUND: Medicare insurance claims may provide an efficient means to ascertain follow-up of older participants in clinical research. We sought to determine the accuracy and completeness of claims- versus site-based follow-up with clinical event committe ... Full text Link to item Cite

Characteristics and Outcomes of Atrial Fibrillation in Patients With Thyroid Disease (from the ARISTOTLE Trial).

Journal Article Am J Cardiol · November 1, 2019 Whether patients with atrial fibrillation (AF) and thyroid disease are clinically distinct from those with AF and no thyroid disease is unknown. Furthermore, the effectiveness of anticoagulation for prevention of AF-related thromboembolic events in patient ... Full text Link to item Cite

Clinical consequences of bleeding among individuals with a recent acute coronary syndrome: Insights from the APPRAISE-2 trial.

Journal Article Am Heart J · September 2019 UNLABELLED: Patients with a recent acute coronary syndrome (ACS) receiving oral antiplatelets and anticoagulants are at risk for bleeding and subsequent adverse non-bleeding-related events. METHODS: In this post hoc analysis, we evaluated 7,392 high-risk p ... Full text Link to item Cite

Safety and Efficacy of Antithrombotic Strategies in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention: A Network Meta-analysis of Randomized Controlled Trials.

Journal Article JAMA Cardiol · August 1, 2019 IMPORTANCE: The antithrombotic treatment of patients with atrial fibrillation (AF) and coronary artery disease, in particular with acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI), poses a significant treatment dilemma in clini ... Full text Link to item Cite

International normalized ratio control and subsequent clinical outcomes in patients with atrial fibrillation using warfarin.

Journal Article J Thromb Thrombolysis · July 2019 We explored associations between INR measures and clinical outcomes in patients with AF using warfarin, and whether INR history predicted future INR measurements. We included patients in ARISTOTLE who were randomized to and received warfarin. Among patient ... Full text Link to item Cite

Pacemaker Implantation After Mitral Valve Surgery With Atrial Fibrillation Ablation.

Journal Article J Am Coll Cardiol · May 21, 2019 BACKGROUND: The incidence of permanent pacemaker (PPM) implantation is higher following mitral valve surgery (MVS) with ablation for atrial fibrillation (AF) compared with MVS alone. OBJECTIVES: This study identified risk factors and outcomes associated wi ... Full text Link to item Cite

Efficacy and Safety of Apixaban Versus Warfarin in Patients With Atrial Fibrillation and Extremes in Body Weight.

Journal Article Circulation · May 14, 2019 BACKGROUND: Guidelines caution against the use of non-vitamin K antagonist oral anticoagulants in patients with extremely high (>120 kg) or low (≤60 kg) body weight because of a lack of data in these populations. METHODS: In a post hoc analysis of ARISTOTL ... Full text Link to item Cite

Efficacy and safety of apixaban vs warfarin in patients with atrial fibrillation and prior bioprosthetic valve replacement or valve repair: Insights from the ARISTOTLE trial.

Journal Article Clin Cardiol · May 2019 BACKGROUND: The optimal anticoagulation strategy for patients with atrial fibrillation (AF) and bioprosthetic valve (BPV) replacement or native valve repair remains uncertain. HYPOTHESIS: We evaluated the safety and efficacy of apixaban vs warfarin in pati ... Full text Link to item Cite

Antithrombotic Therapy after Acute Coronary Syndrome or PCI in Atrial Fibrillation.

Journal Article N Engl J Med · April 18, 2019 BACKGROUND: Appropriate antithrombotic regimens for patients with atrial fibrillation who have an acute coronary syndrome or have undergone percutaneous coronary intervention (PCI) are unclear. METHODS: In an international trial with a two-by-two factorial ... Full text Link to item Cite

Interacting medication use and the treatment effects of apixaban versus warfarin: results from the ARISTOTLE Trial.

Journal Article J Thromb Thrombolysis · April 2019 Warfarin is dependent on multiple hepatic enzymes for metabolism while apixaban is a substrate for P-glycoprotein (P-gp) transport and hepatic CYP3A4 metabolism. The aim of this analysis was to assess the impact of interacting medication use on the treatme ... Full text Link to item Cite

Comparison of Outcomes and Frequency of Graft Failure With Use of Free Versus In Situ Internal Mammary Artery Bypass Conduits (from the PREVENT IV Trial).

Journal Article Am J Cardiol · February 15, 2019 Although in situ internal mammary artery (is-IMA) grafting remains the most frequent conduit in coronary artery bypass grafting (CABG), circumstances may necessitate free grafting of the IMA (f-IMA), though differences in outcomes have not been fully chara ... 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

Effect of apixaban compared with warfarin on coagulation markers in atrial fibrillation.

Journal Article Heart · February 2019 OBJECTIVES: Compare the effect of apixaban and warfarin on coagulation and primary haemostasis biomarkers in atrial fibrillation (AF). METHODS: The biomarker substudy from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibri ... Full text Open Access Link to item Cite

Outcomes of apixaban versus warfarin in patients with atrial fibrillation and multi-morbidity: Insights from the ARISTOTLE trial.

Journal Article Am Heart J · February 2019 BACKGROUND: Patients with atrial fibrillation (AF) often have multi-morbidity, defined as ≥3 comorbid conditions. Multi-morbidity is associated with polypharmacy, adverse events, and frailty potentially altering response to anticoagulation. We sought to de ... Full text Link to item Cite

The CSL112-2001 trial: Safety and tolerability of multiple doses of CSL112 (apolipoprotein A-I [human]), an intravenous formulation of plasma-derived apolipoprotein A-I, among subjects with moderate renal impairment after acute myocardial infarction.

Journal Article Am Heart J · February 2019 BACKGROUND: CSL112 (apolipoprotein A-I [human]) is a plasma-derived apolipoprotein A-I developed for early reduction of cardiovascular risk following an acute myocardial infarction (AMI). The safety of CSL112 among AMI subjects with moderate, stage 3 chron ... Full text Link to item Cite

Linagliptin Effects on Heart Failure and Related Outcomes in Individuals With Type 2 Diabetes Mellitus at High Cardiovascular and Renal Risk in CARMELINA.

Journal Article Circulation · January 15, 2019 BACKGROUND: Individuals with type 2 diabetes mellitus are at increased risk for heart failure (HF), particularly those with coexisting atherosclerotic cardiovascular disease and/or kidney disease. Some but not all dipeptidyl peptidase-4 inhibitors have bee ... Full text Link to item Cite

Longitudinal Changes in Regional Cerebral Perfusion and Cognition After Cardiac Operation.

Journal Article Ann Thorac Surg · January 2019 BACKGROUND: Cardiac operation has been associated with increased risk of postoperative cognitive decline, as well as dementia risk in the general population. Few studies, however, have examined the impact of coronary revascularization or valve replacement ... Full text Open Access Link to item Cite

Effect of Linagliptin vs Placebo on Major Cardiovascular Events in Adults With Type 2 Diabetes and High Cardiovascular and Renal Risk: The CARMELINA Randomized Clinical Trial.

Journal Article JAMA · January 1, 2019 IMPORTANCE: Type 2 diabetes is associated with increased cardiovascular (CV) risk. Prior trials have demonstrated CV safety of 3 dipeptidyl peptidase 4 (DPP-4) inhibitors but have included limited numbers of patients with high CV risk and chronic kidney di ... Full text Link to item Cite

Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome.

Journal Article N Engl J Med · November 29, 2018 BACKGROUND: Patients who have had an acute coronary syndrome are at high risk for recurrent ischemic cardiovascular events. We sought to determine whether alirocumab, a human monoclonal antibody to proprotein convertase subtilisin-kexin type 9 (PCSK9), wou ... Full text Link to item Cite

Crowdsourcing consensus: proposal of a novel method for assessing accuracy in echocardiography interpretation.

Journal Article Int J Cardiovasc Imaging · November 2018 Quality in stress echocardiography interpretation is often gauged against coronary angiography (CA) data but anatomic obstructive coronary disease on CA is an imperfect gold standard for a stress induced wall motion abnormality. We examined the utility of ... Full text Link to item Cite

Timing of Loading Dose of Atorvastatin in Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndromes: Insights From the SECURE-PCI Randomized Clinical Trial.

Journal Article JAMA Cardiol · November 1, 2018 IMPORTANCE: Loading doses of atorvastatin did not show reduction on clinical outcomes in the overall population of patients with acute coronary syndrome (ACS) enrolled in the Statins Evaluation in Coronary Procedures and Revascularization (SECURE-PCI) tria ... Full text Link to item Cite

Use of Biomarkers to Predict Specific Causes of Death in Patients With Atrial Fibrillation.

Journal Article Circulation · October 16, 2018 BACKGROUND: Atrial fibrillation is associated with an increased risk of death. High-sensitivity troponin T, growth differentiation factor-15, NT-proBNP (N-terminal pro-B-type natriuretic peptide), and interleukin-6 levels are predictive of cardiovascular e ... Full text Link to item Cite

Long-term outcomes of mitral regurgitation by type and severity.

Journal Article Am Heart J · September 2018 BACKGROUND: We aimed to determine the association of MR severity and type with all-cause death in a large, real-world, clinical setting. METHODS: We reviewed full echocardiography studies at Duke Echocardiography Laboratory (01/01/1995-12/31/2010), classif ... Full text Link to item Cite

Stroke prevention in atrial fibrillation: re-defining 'real-world data' within the broader data universe.

Journal Article Eur Heart J · August 21, 2018 Real-world data (RWD) has been defined as data generated outside of traditional randomized clinical trials (RCTs). Though RWD has received increasing attention from regulatory authorities and professional societies, dividing evidence into that derived from ... Full text Link to item Cite

Asymmetric and Symmetric Dimethylarginine Predict Outcomes in Patients With Atrial Fibrillation: An ARISTOTLE Substudy.

Journal Article J Am Coll Cardiol · August 14, 2018 BACKGROUND: There is little mechanistic information on factors predisposing atrial fibrillation (AF) patients to thromboembolism or bleeding, but generation of nitric oxide (NO) might theoretically contribute to both. OBJECTIVES: The authors tested the hyp ... Full text Link to item Cite

Outcomes in anticoagulated patients with atrial fibrillation and with mitral or aortic valve disease.

Journal Article Heart · August 2018 OBJECTIVE: To assess stroke/systemic embolism, major bleeding and other outcomes, and treatment effect of apixaban versus warfarin, in patients with atrial fibrillation (AF) and different types of valvular heart disease (VHD), using data from the Apixaban ... Full text Link to item Cite

Incidence, timing, and type of first and recurrent ischemic events in patients with and without peripheral artery disease after an acute coronary syndrome.

Journal Article Am Heart J · July 2018 BACKGROUND: Patients with peripheral artery disease (PAD) are known to have an increased risk of ischemic cardiovascular events. However, the influence of concomitant PAD on first and subsequent recurrent ischemic events after an acute coronary syndrome (A ... Full text Link to item Cite

An open-Label, 2 × 2 factorial, randomized controlled trial to evaluate the safety of apixaban vs. vitamin K antagonist and aspirin vs. placebo in patients with atrial fibrillation and acute coronary syndrome and/or percutaneous coronary intervention: Rationale and design of the AUGUSTUS trial.

Journal Article Am Heart J · June 2018 BACKGROUND: The optimal antithrombotic strategy for patients with atrial fibrillation (AF) who develop acute coronary syndrome (ACS) and/or the need for percutaneous coronary intervention (PCI) is uncertain. The risk of bleeding is a major concern when ora ... Full text Link to item Cite

Clinical trials evaluating red blood cell transfusion thresholds: An updated systematic review and with additional focus on patients with cardiovascular disease.

Journal Article Am Heart J · June 2018 BACKGROUND: Several new trials evaluating transfusion strategies in patients with cardiovascular disease have recently been published, increasing the number of enrolled patients by over 30%. The objective was to evaluate transfusion thresholds in patients ... Full text Link to item Cite

Evaluation of potential antiplatelet effects of CSL112 (Apolipoprotein A-I [Human]) in patients with atherosclerosis: results from a phase 2a study.

Journal Article J Thromb Thrombolysis · May 2018 CSL112 (Apolipoprotein A-I [Human]), an infusible, plasma-derived apolipoprotein A-I, is being developed to reduce cardiovascular events following acute myocardial infarction (AMI). A predecessor compound (CSL111) demonstrated a potential antiplatelet effe ... Full text Link to item Cite

Dual antiplatelet therapy for perioperative myocardial infarction following CABG surgery.

Journal Article Am Heart J · May 2018 OBJECTIVES: Perioperative myocardial infarction (MI) after coronary artery bypass graft surgery (CABG) has been associated with adverse outcome. Whether perioperative MI should be treated with dual antiplatelet therapy (DAPT) is unknown. We compared the ef ... Full text Link to item Cite

Effect of Loading Dose of Atorvastatin Prior to Planned Percutaneous Coronary Intervention on Major Adverse Cardiovascular Events in Acute Coronary Syndrome: The SECURE-PCI Randomized Clinical Trial.

Journal Article JAMA · April 3, 2018 IMPORTANCE: The effects of loading doses of statins on clinical outcomes in patients with acute coronary syndrome (ACS) and planned invasive management remain uncertain. OBJECTIVE: To determine if periprocedural loading doses of atorvastatin decrease 30-da ... Full text Link to item Cite

Secondary surgical-site infection after coronary artery bypass grafting: A multi-institutional prospective cohort study.

Journal Article J Thorac Cardiovasc Surg · April 2018 OBJECTIVE: To analyze patient risk factors and processes of care associated with secondary surgical-site infection (SSI) after coronary artery bypass grafting (CABG). METHODS: Data were collected prospectively between February and October 2010 for consenti ... Full text Link to item Cite

Antithrombotic therapy use and clinical outcomes following thrombo-embolic events in patients with atrial fibrillation: insights from ARISTOTLE.

Journal Article Eur Heart J Cardiovasc Pharmacother · April 1, 2018 AIMS: We investigated baseline characteristics, antithrombotic use, and clinical outcomes of patients with atrial fibrillation (AF) and a thrombo-embolic event in the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation ( ... Full text Link to item Cite

Rationale and design of the Statins Evaluation in Coronary procedUres and REvascularization: The SECURE-PCI Trial.

Journal Article Am Heart J · April 2018 BACKGROUND: Previous evidence suggests that acute treatment with statins reduce atherosclerotic complications, including periprocedural myocardial infarction, but currently, there are no large, adequately powered studies to define the effects of early, hig ... Full text Link to item Cite

Rationale, design, and baseline characteristics of the CArdiovascular safety and Renal Microvascular outcomE study with LINAgliptin (CARMELINA®): a randomized, double-blind, placebo-controlled clinical trial in patients with type 2 diabetes and high cardio-renal risk.

Journal Article Cardiovasc Diabetol · March 14, 2018 BACKGROUND: Cardiovascular (CV) outcome trials in type 2 diabetes (T2D) have underrepresented patients with chronic kidney disease (CKD), leading to uncertainty regarding their kidney efficacy and safety. The CARMELINA® trial aims to evaluate the effects o ... Full text Open Access Link to item Cite

Digoxin and Mortality in Patients With Atrial Fibrillation.

Journal Article J Am Coll Cardiol · March 13, 2018 BACKGROUND: Digoxin is widely used in patients with atrial fibrillation (AF). OBJECTIVES: The goal of this paper was to explore whether digoxin use was independently associated with increased mortality in patients with AF and if the association was modifie ... Full text Link to item Cite

Clinical Outcomes and History of Fall in Patients with Atrial Fibrillation Treated with Oral Anticoagulation: Insights From the ARISTOTLE Trial.

Journal Article Am J Med · March 2018 PURPOSE: We assessed outcomes among anticoagulated patients with atrial fibrillation and a history of falling, and whether the benefits of apixaban vs warfarin are consistent in this population. METHODS: Of the 18,201 patients in the Apixaban for Reduction ... Full text Link to item Cite

Apixaban following acute coronary syndromes in patients with prior stroke: Insights from the APPRAISE-2 trial.

Journal Article Am Heart J · March 2018 BACKGROUND AND PURPOSE: Patients with prior stroke are at greater risk for recurrent cardiovascular events post-acute coronary syndromes (ACS) and may have a different risk/benefit profile with antithrombotic therapy than patients without prior stroke. MET ... Full text Link to item Cite

Percutaneous coronary intervention and antiplatelet therapy in patients with atrial fibrillation receiving apixaban or warfarin: Insights from the ARISTOTLE trial.

Journal Article Am Heart J · March 2018 BACKGROUND: We assessed antiplatelet therapy use and outcomes in patients undergoing percutaneous coronary intervention (PCI) during the ARISTOTLE trial. METHODS: Patients were categorized based on the occurrence of PCI during follow-up (median 1.8 years); ... Full text Link to item Cite

Direct Oral Anticoagulants in Addition to Antiplatelet Therapy for Secondary Prevention After Acute Coronary Syndromes: A Systematic Review and Meta-analysis.

Journal Article JAMA Cardiol · March 1, 2018 IMPORTANCE: Patients with acute coronary syndrome (ACS) remain at high risk for experiencing recurrent ischemic events. Direct oral anticoagulants (DOAC) have been proposed for secondary prevention after ACS. OBJECTIVE: To evaluate the safety and efficacy ... Full text Link to item Cite

A biomarker-based risk score to predict death in patients with atrial fibrillation: the ABC (age, biomarkers, clinical history) death risk score.

Journal Article Eur Heart J · February 7, 2018 AIMS: In atrial fibrillation (AF), mortality remains high despite effective anticoagulation. A model predicting the risk of death in these patients is currently not available. We developed and validated a risk score for death in anticoagulated patients wit ... Full text Link to item Cite

Task-related changes in degree centrality and local coherence of the posterior cingulate cortex after major cardiac surgery in older adults.

Journal Article Hum Brain Mapp · February 2018 OBJECTIVES: Older adults often display postoperative cognitive decline (POCD) after surgery, yet it is unclear to what extent functional connectivity (FC) alterations may underlie these deficits. We examined for postoperative voxel-wise FC changes in respo ... Full text Open Access Link to item Cite

Dyslipidemia and Risk of Cardiovascular Events in Patients With Atrial Fibrillation Treated With Oral Anticoagulation Therapy: Insights From the ARISTOTLE (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) Trial.

Journal Article J Am Heart Assoc · February 1, 2018 BACKGROUND: Dyslipidemia is a major risk factor for cardiovascular events. The prognostic importance of lipoproteins in patients with atrial fibrillation is not well understood. We aimed to explore the association between apolipoprotein A1 (ApoA1) and B (A ... Full text Link to item Cite

Obesity paradox on outcome in atrial fibrillation maintained even considering the prognostic influence of biomarkers: insights from the ARISTOTLE trial.

Journal Article Open Heart · 2018 OBJECTIVE: We investigated the association between obesity and biomarkers indicating cardiac or renal dysfunction or inflammation and their interaction with obesity and outcomes. METHODS: A total of 14 753 patients in the Apixaban for Reduction In STroke a ... 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

Randomized comparison of the clinical outcome of single versus multiple arterial grafts: the ROMA trial-rationale and study protocol.

Journal Article Eur J Cardiothorac Surg · December 1, 2017 SUMMARY: The primary hypothesis of the ROMA trial is that in patients undergoing primary isolated non-emergent coronary artery bypass grafting, the use of 2 or more arterial grafts compared with a single arterial graft (SAG) is associated with a reduction ... Full text Link to item Cite

Echocardiographic Risk Factors for Stroke and Outcomes in Patients With Atrial Fibrillation Anticoagulated With Apixaban or Warfarin.

Journal Article Stroke · December 2017 BACKGROUND AND PURPOSE: Few data exist on the long-term outcomes of patients with spontaneous echo contrast (SEC), left atrial/left atrial appendage (LA/LAA) thrombus, and complex aortic plaque (CAP), in patients with atrial fibrillation receiving oral ant ... Full text Link to item Cite

Five-Year Outcomes after On-Pump and Off-Pump Coronary-Artery Bypass Reply

Journal Article NEW ENGLAND JOURNAL OF MEDICINE · November 9, 2017 Link to item Cite

Levosimendan in Cardiac Surgery.

Journal Article N Engl J Med · November 9, 2017 Full text Link to item Cite

Levosimendan in Cardiac Surgery.

Journal Article N Engl J Med · November 9, 2017 Full text Link to item Cite

Levosimendan in Cardiac Surgery.

Journal Article N Engl J Med · November 9, 2017 Full text Link to item Cite

Levosimendan in Cardiac Surgery.

Journal Article N Engl J Med · November 9, 2017 Full text Link to item Cite

Obesity, Diabetes, and Acute Coronary Syndrome: Differences Between Asians and Whites.

Journal Article Am J Med · October 2017 BACKGROUND: Most diabetes and cardiovascular studies have been conducted in white patients, with data being extrapolated to other population groups. METHODS: For this analysis, patient-level data were extracted from 5 randomized clinical trials in patients ... Full text Link to item Cite

Angiotensin Receptor Blockade Improves Cardiac Surgical Outcomes in Patients With Metabolic Syndrome.

Journal Article Ann Thorac Surg · July 2017 BACKGROUND: Perioperative use of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEis) in patients undergoing cardiac operations remains controversial. The current practice of discontinuing renin-angiotensin-system inhib ... Full text Link to item Cite

Repeated Measurements of Cardiac Biomarkers in Atrial Fibrillation and Validation of the ABC Stroke Score Over Time.

Journal Article J Am Heart Assoc · June 23, 2017 BACKGROUND: Cardiac biomarkers are independent risk markers in atrial fibrillation, and the novel biomarker-based ABC stroke score (age, biomarkers, and clinical history of prior stroke) was recently shown to improve the prediction of stroke risk in patien ... Full text Link to item Cite

Enhancing Insights into Pulmonary Vascular Disease through a Precision Medicine Approach. A Joint NHLBI-Cardiovascular Medical Research and Education Fund Workshop Report.

Journal Article Am J Respir Crit Care Med · June 15, 2017 The Division of Lung Diseases of the NHLBI and the Cardiovascular Medical Education and Research Fund held a workshop to discuss how to leverage the anticipated scientific output from the recently launched "Redefining Pulmonary Hypertension through Pulmona ... Full text Link to item Cite

Intracranial hemorrhage in patients with atrial fibrillation receiving anticoagulation therapy.

Journal Article Blood · June 1, 2017 We investigated the frequency and characteristics of intracranial hemorrhage (ICH), the factors associated with the risk of ICH, and outcomes post-ICH overall and by randomized treatment. We identified patients with ICH from the overall trial population en ... Full text Link to item Cite

Pneumonia after cardiac surgery: Experience of the National Institutes of Health/Canadian Institutes of Health Research Cardiothoracic Surgical Trials Network.

Journal Article J Thorac Cardiovasc Surg · June 2017 RATIONALE: Pneumonia remains the most common major infection after cardiac surgery despite numerous preventive measures. OBJECTIVES: To prospectively examine the timing, pathogens, and risk factors, including modifiable management practices, for postoperat ... Full text Link to item Cite

Effect of Apixaban on All-Cause Death in Patients with Atrial Fibrillation: a Meta-Analysis Based on Imputed Placebo Effect.

Journal Article Cardiovasc Drugs Ther · June 2017 PURPOSE: Vitamin K antagonists (VKAs) are the standard of care for stroke prevention in patients with atrial fibrillation (AF); therefore, there is not equipoise when comparing newer oral anticoagulants with placebo in this setting. METHODS: To explore the ... Full text Link to item Cite

Levosimendan in Patients with Left Ventricular Dysfunction Undergoing Cardiac Surgery.

Journal Article N Engl J Med · May 25, 2017 BACKGROUND: Levosimendan is an inotropic agent that has been shown in small studies to prevent or treat the low cardiac output syndrome after cardiac surgery. METHODS: In a multicenter, randomized, placebo-controlled, phase 3 trial, we evaluated the effica ... Full text Link to item Cite

Association between CK-MB Area Under the Curve and Tranexamic Acid Utilization in Patients Undergoing Coronary Artery Bypass Surgery.

Journal Article J Thromb Thrombolysis · May 2017 Myonecrosis after coronary artery bypass graft (CABG) surgery is associated with excess mortality. Tranexamic acid (TA), an anti-fibrinolytic agent, has been shown to reduce peri-operative blood loss without increasing the risk of myocardial infarction (MI ... Full text Open Access Link to item Cite

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

Journal Article Am Heart J · May 2017 OBJECTIVE: Acute coronary syndrome (ACS) trials typically use a composite primary outcome (myocardial infarction [MI], stroke, or cardiovascular death), but differential patient characteristics, timing, and consequences associated with individual component ... Full text Link to item Cite

Economic Analysis of Apixaban Therapy for Patients With Atrial Fibrillation From a US Perspective: Results From the ARISTOTLE Randomized Clinical Trial.

Journal Article JAMA Cardiol · May 1, 2017 IMPORTANCE: The Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial reported that apixaban therapy was superior to warfarin therapy in preventing stroke and all-cause death while causing significantly f ... Full text Link to item Cite

Dabigatran Compared With Rivaroxaban vs Warfarin.

Journal Article JAMA Intern Med · May 1, 2017 Full text Link to item Cite

Reporting Clinical End Points and Safety Events in an Acute Coronary Syndrome Trial: Results With Integrated Collection.

Journal Article J Am Heart Assoc · April 24, 2017 BACKGROUND: End points and adverse events (AEs) are collected separately in clinical trials, yet regulatory requirements for serious AE reporting vary across regions, so classifying end points according to seriousness criteria can be useful in global trial ... Full text Link to item Cite

Non-major bleeding with apixaban versus warfarin in patients with atrial fibrillation.

Journal Article Heart · April 2017 OBJECTIVE: We describe the incidence, location and management of non-major bleeding, and assess the association between non-major bleeding and clinical outcomes in patients with atrial fibrillation (AF) receiving anticoagulation therapy enrolled in Apixaba ... Full text Link to item Cite

Nonsteroidal Anti-Inflammatory Drugs and Clinical Outcomes in Patients Undergoing Coronary Artery Bypass Surgery.

Journal Article Am J Med · April 2017 BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used in perioperative pain management of patients undergoing coronary artery bypass graft surgery. However, the association of periprocedural use of NSAIDs and clinical outcomes after c ... Full text Link to item Cite

The Role of Cardiovascular Implantable Electronic Devices in the Detection and Treatment of Subclinical Atrial Fibrillation: A Review.

Journal Article JAMA Cardiol · March 1, 2017 IMPORTANCE: Subclinical atrial fibrillation (AF) is associated with an increased risk for stroke. OBSERVATIONS: Subclinical AF is asymptomatic, short in duration, and usually detected with long-term, continuous monitoring. Most prior studies have explored ... Full text Link to item Cite

Anemia is associated with bleeding and mortality, but not stroke, in patients with atrial fibrillation: Insights from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial.

Journal Article Am Heart J · March 2017 BACKGROUND: Patients with atrial fibrillation (AF) are prone to cardiovascular events and anticoagulation-related bleeding complications. We hypothesized that patients with anemia are at increased risk for these outcomes. METHODS: We performed a post hoc a ... Full text Link to item Cite

Efficacy and Safety of Apixaban Compared With Warfarin in Patients With Atrial Fibrillation and Peripheral Artery Disease: Insights From the ARISTOTLE Trial.

Journal Article J Am Heart Assoc · January 17, 2017 BACKGROUND: We studied (1) the rates of stroke or systemic embolism and bleeding in patients with atrial fibrillation and peripheral artery disease (PAD) and (2) the efficacy and safety of apixaban versus warfarin in patients with atrial fibrillation with ... Full text Link to item Cite

Anticoagulation therapy and clinical outcomes in patients with recently diagnosed atrial fibrillation: Insights from the ARISTOTLE trial.

Journal Article Int J Cardiol · January 15, 2017 BACKGROUND: Evidence supporting use of antithrombotic therapy in atrial fibrillation (AF) is based mainly on data from patients with permanent, persistent, or paroxysmal AF. Less is known about the risk following a new diagnosis of AF and the efficacy and ... Full text Link to item Cite

Resting-State Functional Connectivity and Cognition After Major Cardiac Surgery in Older Adults without Preoperative Cognitive Impairment: Preliminary Findings.

Journal Article J Am Geriatr Soc · January 2017 OBJECTIVES: To look for changes in intrinsic functional brain connectivity associated with postoperative changes in cognition, a common complication in seniors undergoing major surgery, using resting-state functional magnetic resonance imaging. DESIGN: Obj ... Full text Open Access Link to item Cite

Safety and Tolerability of CSL112, a Reconstituted, Infusible, Plasma-Derived Apolipoprotein A-I, After Acute Myocardial Infarction: The AEGIS-I Trial (ApoA-I Event Reducing in Ischemic Syndromes I).

Journal Article Circulation · December 13, 2016 BACKGROUND: Human or recombinant apolipoprotein A-I (apoA-I) has been shown to increase high-density lipoprotein-mediated cholesterol efflux capacity and to regress atherosclerotic disease in animal and clinical studies. CSL112 is an infusible, plasma-deri ... Full text Open Access Link to item Cite

Levosimendan in patients with left ventricular systolic dysfunction undergoing cardiac surgery on cardiopulmonary bypass: Rationale and study design of the Levosimendan in Patients with Left Ventricular Systolic Dysfunction Undergoing Cardiac Surgery Requiring Cardiopulmonary Bypass (LEVO-CTS) trial.

Journal Article Am Heart J · December 2016 BACKGROUND: Low cardiac output syndrome is associated with increased mortality and occurs in 3% to 14% of patients undergoing cardiac surgery on cardiopulmonary bypass (CPB). Levosimendan, a novel calcium sensitizer and KATP channel activator with inotropi ... Full text Link to item Cite

Relation of Post-Coronary Artery Bypass Graft Creatine Kinase-MB Elevations and New Q Waves With Long-Term Cardiovascular Death in Patients With Diabetes Mellitus and Multivessel Coronary Artery Disease.

Journal Article Am J Cardiol · December 1, 2016 Associations of early creatine phosphokinase-MB (CK-MB) elevation and new Q waves and their association with cardiovascular death (CVD) after coronary artery bypass grafting (CABG) have been reported, but this association has not been studied in a large po ... Full text Link to item Cite

Performance and Validation of a Novel Biomarker-Based Stroke Risk Score for Atrial Fibrillation.

Journal Article Circulation · November 29, 2016 BACKGROUND: Atrial fibrillation is associated with increased but variable risk of stroke. Our aim was to validate the recently developed biomarker-based ABC (age, biomarkers [high-sensitivity troponin and N-terminal fragment B-type natriuretic peptide], an ... Full text Link to item Cite

Impact of Left Ventricular to Mitral Valve Ring Mismatch on Recurrent Ischemic Mitral Regurgitation After Ring Annuloplasty.

Journal Article Circulation · October 25, 2016 BACKGROUND: In ischemic mitral regurgitation (IMR), ring annuloplasty is associated with a significant rate of recurrent MR. Ring size is based on intertrigonal distance without consideration of left ventricular (LV) size. However, LV size is an important ... Full text Link to item Cite

The 'obesity paradox' in atrial fibrillation: observations from the ARISTOTLE (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) trial.

Journal Article Eur Heart J · October 7, 2016 AIMS: The prognostic implication of adiposity on clinical outcomes in atrial fibrillation (AF) patients treated with oral anticoagulation is unclear. METHODS AND RESULTS: A total of 17 913 patients in the Apixaban for Reduction in Stroke and Other Thromboe ... Full text Link to item Cite

Rationale and design of Apo-I Event Reduction in Ischemic Syndromes I (AEGIS-I): A phase 2b, randomized, placebo-controlled, dose-ranging trial to investigate the safety and tolerability of CSL112, a reconstituted, infusible, human apoA-I, after acute myocardial infarction.

Journal Article Am Heart J · October 2016 BACKGROUND: Despite aggressive pharmacotherapy and stenting, there is a residual risk of major adverse cardiovascular events among patients with acute coronary syndrome. High-density lipoprotein (HDL) has been a major target for secondary acute coronary sy ... Full text Link to item Cite

Coronary-Artery Bypass Grafting.

Journal Article N Engl J Med · September 8, 2016 Full text Link to item Cite

Apixaban 5 mg Twice Daily and Clinical Outcomes in Patients With Atrial Fibrillation and Advanced Age, Low Body Weight, or High Creatinine: A Secondary Analysis of a Randomized Clinical Trial.

Journal Article JAMA Cardiol · September 1, 2016 IMPORTANCE: In the Apixaban for Reduction of Stroke and Other Thromboembolic Complications in Atrial Fibrillation (ARISTOTLE) trial, the standard dose of apixaban was 5 mg twice daily; patients with at least 2 dose-reduction criteria-80 years or older, wei ... Full text Link to item Cite

Efficacy and Safety of Apixaban Compared With Warfarin in Patients With Atrial Fibrillation in Relation to Renal Function Over Time: Insights From the ARISTOTLE Randomized Clinical Trial.

Journal Article JAMA Cardiol · July 1, 2016 IMPORTANCE: Renal impairment confers an increased risk of stroke, bleeding, and death in patients with atrial fibrillation. Little is known about the efficacy and safety of apixaban in relation to renal function changes over time. OBJECTIVES: To evaluate c ... Full text Link to item Cite

Polypharmacy and effects of apixaban versus warfarin in patients with atrial fibrillation: post hoc analysis of the ARISTOTLE trial.

Journal Article BMJ · June 15, 2016 OBJECTIVE:  To determine whether the treatment effect of apixaban versus warfarin differs with increasing numbers of concomitant drugs used by patients with atrial fibrillation. DESIGN:  Post hoc analysis performed in 2015 of results from ARISTOTLE (apixab ... Full text Link to item Cite

The novel biomarker-based ABC (age, biomarkers, clinical history)-bleeding risk score for patients with atrial fibrillation: a derivation and validation study.

Journal Article Lancet · June 4, 2016 BACKGROUND: The benefit of oral anticoagulation in atrial fibrillation is based on a balance between reduction in ischaemic stroke and increase in major bleeding. We aimed to develop and validate a new biomarker-based risk score to improve the prognosticat ... Full text Link to item Cite

The ABC (age, biomarkers, clinical history) stroke risk score: a biomarker-based risk score for predicting stroke in atrial fibrillation.

Journal Article Eur Heart J · May 21, 2016 AIMS: Atrial fibrillation (AF) is associated with an increased risk of stroke, which is currently estimated by clinical characteristics. The cardiac biomarkers N-terminal fragment B-type natriuretic peptide (NT-proBNP) and cardiac troponin high-sensitivity ... Full text Open Access Link to item Cite

Coronary-Artery Bypass Grafting.

Journal Article N Engl J Med · May 19, 2016 Full text Link to item Cite

History of bleeding and outcomes with apixaban versus warfarin in patients with atrial fibrillation in the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation trial.

Journal Article Am Heart J · May 2016 AIMS: History of bleeding strongly influences decisions for anticoagulation in atrial fibrillation (AF). We analyzed outcomes in relation to history of bleeding and randomization in ARISTOTLE trial patients. METHODS AND RESULTS: The on-treatment safety pop ... Full text Link to item Cite

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

Journal Article Circulation · April 19, 2016 BACKGROUND: Representation by age ensures appropriate translation of clinical trial results to practice, but, historically, older patients have been underrepresented in clinical trial populations. As the general population has aged, it is unknown whether c ... Full text Link to item Cite

REGULATE-PCI trial--Author's reply.

Journal Article Lancet · April 9, 2016 Full text Link to item Cite

Biomarkers of inflammation and risk of cardiovascular events in anticoagulated patients with atrial fibrillation.

Journal Article Heart · April 2016 OBJECTIVE: Atrial fibrillation (AF) is a risk factor for stroke and mortality and the prothrombotic state has been linked to inflammation. In this study we evaluated the relationship between inflammatory biomarkers at baseline and future risk of cardiovasc ... 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

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

Journal Article JAMA Cardiol · April 1, 2016 IMPORTANCE: In the current therapeutic era, the risk for sudden cardiac death (SCD) after non-ST-segment elevation acute coronary syndrome (NSTE ACS) has not been characterized completely. OBJECTIVE: To determine the cumulative incidence of SCD during long ... Full text Link to item Cite

Clopidogrel use After Myocardial Revascularization: Prevalence, Predictors, and One-Year Survival Rate.

Journal Article Braz J Cardiovasc Surg · April 2016 INTRODUCTION: Antiplatelet therapy after coronary artery bypass graft (CABG) has been used. Little is known about the predictors and efficacy of clopidogrel in this scenario. OBJECTIVE: Identify predictors of clopidogrel following CABG. METHODS: We evaluat ... Full text Open Access Link to item Cite

Inhibition of factor IXa by the pegnivacogin system during cardiopulmonary bypass: a potential substitute for heparin. A study in baboons.

Journal Article Eur J Cardiothorac Surg · February 2016 OBJECTIVES: Heparin and protamine are standard for anticoagulation and reversal for cardiopulmonary bypass (CPB). The REGADO biosciences protocol 1 (REG1) anticoagulant system, consisting of the Factor IXa (FIXa)-inhibitor pegnivacogin and its reversal age ... Full text Link to item Cite

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

Journal Article Lancet · January 23, 2016 BACKGROUND: REG1 is a novel anticoagulation system consisting of pegnivacogin, an RNA aptamer inhibitor of coagulation factor IXa, and anivamersen, a complementary sequence reversal oligonucleotide. We tested the hypothesis that near complete inhibition of ... Full text Link to item Cite

Frequency and Predictors of Internal Mammary Artery Graft Failure and Subsequent Clinical Outcomes: Insights From the Project of Ex-vivo Vein Graft Engineering via Transfection (PREVENT) IV Trial.

Journal Article Circulation · January 12, 2016 BACKGROUND: The internal mammary artery (IMA) is the preferred conduit for bypassing the left anterior descending (LAD) artery in patients undergoing coronary artery bypass grafting. Systematic evaluation of the frequency and predictors of IMA failure and ... Full text Link to item Cite

Clinical outcomes in patients with atrial fibrillation according to sex during anticoagulation with apixaban or warfarin: a secondary analysis of a randomized controlled trial.

Journal Article Eur Heart J · December 7, 2015 AIM: To assess clinical outcomes, efficacy, and safety according to sex during anticoagulation with apixaban compared with warfarin in patients with atrial fibrillation. METHODS AND RESULTS: Apixaban for Reduction in Stroke and Other Thromboembolic Events ... Full text Link to item Cite

Blood Pressure Control and Risk of Stroke or Systemic Embolism in Patients With Atrial Fibrillation: Results From the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) Trial.

Journal Article J Am Heart Assoc · December 1, 2015 BACKGROUND: Patients with atrial fibrillation (AF) and hypertension are at high risk for stroke. Previous studies have shown elevated risk of stroke in patients with AF who have a history of hypertension (regardless of blood pressure [BP] control) and in p ... Full text Link to item Cite

Management and outcomes in patients with moderate or severe functional mitral regurgitation and severe left ventricular dysfunction.

Journal Article Eur Heart J · October 21, 2015 AIMS: The management and outcomes of patients with functional moderate/severe mitral regurgitation and severe left ventricular (LV) systolic dysfunction are not well defined. We sought to determine the characteristics, management strategies, and outcomes o ... Full text Link to item Cite

Characterising and predicting bleeding in high-risk patients with an acute coronary syndrome.

Journal Article Heart · September 2015 OBJECTIVE: In the Apixaban for Prevention of Acute Ischemic Events (APPRAISE-2) trial, the use of apixaban, when compared with placebo, in high-risk patients with a recent acute coronary syndrome (ACS) resulted in a significant increase in bleeding without ... Full text Link to item Cite

Apixaban in Comparison With Warfarin in Patients With Atrial Fibrillation and Valvular Heart Disease: Findings From the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) Trial.

Conference Circulation · August 25, 2015 BACKGROUND: Apixaban is approved for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. However, the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial inc ... 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

Apixaban Plus Mono Versus Dual Antiplatelet Therapy in Acute Coronary Syndromes: Insights From the APPRAISE-2 Trial.

Journal Article J Am Coll Cardiol · August 18, 2015 BACKGROUND: Bleeding limits anticoagulant treatment in patients with acute coronary syndromes (ACS). OBJECTIVES: We investigated whether background concomitant antiplatelet therapy influences the effects of apixaban after ACS. METHODS: This study examined ... Full text Link to item Cite

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

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

Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes.

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

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

Journal Article J Am Heart Assoc · June 18, 2015 BACKGROUND: Little is known about the incidence, predictors, or outcomes of intracranial hemorrhage (ICH) in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS). We aimed to determine the incidence and timing of ICH, characterize the ... Full text Link to item Cite

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

Journal Article Am Heart J · June 2015 Recent developments have highlighted the challenges facing cardiovascular clinical research in global contemporary practice, particularly in North America, including shifting priorities for drug development targets, increasing regulatory requirements, and ... Full text Link to item Cite

Clinical outcomes and management associated with major bleeding in patients with atrial fibrillation treated with apixaban or warfarin: insights from the ARISTOTLE trial.

Journal Article Eur Heart J · May 21, 2015 AIM: In the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial, apixaban compared with warfarin reduced the risk of stroke, major bleed, and death in patients with atrial fibrillation. In this ancillar ... Full text Link to item Cite

Outcomes after nonemergent electrical cardioversion for atrial arrhythmias.

Journal Article Am J Cardiol · May 15, 2015 Electrical cardioversion (ECV) is recommended for rhythm control in patients with atrial arrhythmia; yet, ECV use and outcomes in contemporary practice are unknown. We reviewed all nonemergent ECVs for atrial arrhythmias at a tertiary care center (2010 to ... Full text Link to item Cite

Genome-wide association study of perioperative myocardial infarction after coronary artery bypass surgery.

Journal Article BMJ Open · May 6, 2015 OBJECTIVES: Identification of patient subpopulations susceptible to develop myocardial infarction (MI) or, conversely, those displaying either intrinsic cardioprotective phenotypes or highly responsive to protective interventions remain high-priority knowl ... Full text Open Access Link to item Cite

Anticoagulant therapy and outcomes in patients with prior or acute heart failure and acute coronary syndromes: Insights from the APixaban for PRevention of Acute ISchemic Events 2 trial.

Journal Article Am Heart J · April 2015 BACKGROUND: Clinical outcomes and the effects of oral anticoagulants among patients with acute coronary syndrome (ACS) and either a history of or acute heart failure (HF) are largely unknown. We aimed to assess the relationship between prior HF or acute HF ... Full text Link to item Cite

Clinical outcomes of patients with diabetes and atrial fibrillation treated with apixaban: results from the ARISTOTLE trial.

Journal Article Eur Heart J Cardiovasc Pharmacother · April 2015 AIMS: We compared clinical outcomes in patients with AF with and without diabetes in the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation trial. METHODS AND RESULTS: The main efficacy endpoints were SSE and mortality; ... Full text Link to item Cite

Comparison of cardiac troponins I and T measured with high-sensitivity methods for evaluation of prognosis in atrial fibrillation: an ARISTOTLE substudy.

Journal Article Clin Chem · February 2015 BACKGROUND: Although cardiac troponin is associated with outcomes in atrial fibrillation (AF), the complementary prognostic information provided by cardiac troponin I (cTnI) and cTnT is unknown. This study investigated the distribution, determinants, and p ... Full text Link to item Cite

Predictors of long-term clinical endpoints in patients with refractory angina.

Journal Article J Am Heart Assoc · January 30, 2015 BACKGROUND: Clinical outcomes in patients with refractory angina (RA) are poorly characterized and variably described. Using the Duke Database for Cardiovascular Disease (DDCD), we explored characteristics that drive clinical endpoints in patients with cla ... Full text Link to item Cite

Costs associated with health care-associated infections in cardiac surgery.

Journal Article J Am Coll Cardiol · January 6, 2015 BACKGROUND: Health care-associated infections (HAIs) are the most common noncardiac complications after cardiac surgery and are associated with increased morbidity and mortality. Current information about their economic burden is limited. OBJECTIVES: This ... Full text Link to item Cite

Clinical events after transitioning from apixaban versus warfarin to warfarin at the end of the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial.

Journal Article Am Heart J · January 2015 BACKGROUND: We sought to assess the occurrence of events after blinded study drug discontinuation and transition to open-label vitamin K antagonist (VKA) in ARISTOTLE. METHODS: At the end of ARISTOTLE, blinded study drug was stopped, and open-label VKA was ... Full text Link to item Cite

Long-term clinical and angiographic outcomes in patients with diabetes undergoing coronary artery bypass graft surgery: results from the Project of Ex-vivo Vein Graft Engineering via Transfection IV trial.

Journal Article Am Heart J · January 2015 BACKGROUND: There is limited information about the association between diabetes, its treatment, and long-term angiographic and clinical outcomes in patients undergoing coronary artery bypass graft surgery (CABG). We evaluated the association of diabetes an ... Full text Link to item Cite

Management and clinical outcomes in patients treated with apixaban vs warfarin undergoing procedures.

Journal Article Blood · December 11, 2014 Using data from ARISTOTLE, we describe the periprocedural management of anticoagulation and rates of subsequent clinical outcomes among patients chronically anticoagulated with warfarin or apixaban. We recorded whether (and for how long) anticoagulant ther ... Full text Link to item Cite

Surgical treatment of moderate ischemic mitral regurgitation.

Journal Article N Engl J Med · December 4, 2014 BACKGROUND: Ischemic mitral regurgitation is associated with increased mortality and morbidity. For surgical patients with moderate regurgitation, the benefits of adding mitral-valve repair to coronary-artery bypass grafting (CABG) are uncertain. METHODS: ... Full text Link to item Cite

Growth differentiation factor 15, a marker of oxidative stress and inflammation, for risk assessment in patients with atrial fibrillation: insights from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial.

Journal Article Circulation · November 18, 2014 BACKGROUND: Growth differentiation factor 15 (GDF-15), high-sensitivity troponin, and N-terminal pro-brain natriuretic peptide levels are predictive of death and cardiovascular events in healthy elderly subjects, patients with acute coronary syndrome, and ... Full text Link to item Cite

Reply: To PMID 24360877.

Journal Article Ann Thorac Surg · November 2014 Full text Link to item Cite

Saphenous vein graft failure after coronary artery bypass surgery: insights from PREVENT IV.

Journal Article Circulation · October 21, 2014 BACKGROUND: Coronary artery bypass grafting success is limited by vein graft failure (VGF). Understanding the factors associated with VGF may improve patient outcomes. METHODS AND RESULTS: We examined 1828 participants in the Project of Ex Vivo Vein Graft ... Full text Link to item Cite

The effect of the REG2 Anticoagulation System on thrombin generation kinetics: a pharmacodynamic and pharmacokinetic first-in-human study.

Journal Article J Thromb Thrombolysis · October 2014 The REG2 Anticoagulation System consists of pegnivacogin, a subcutaneously administered aptamer factor IXa inhibitor, and its intravenous active control agent, anivamersen. Its effect on thrombin generation is unknown. A prospectively designed thrombin gen ... Full text Link to item Cite

Clinical outcomes of hybrid coronary revascularization versus coronary artery bypass surgery in patients with diabetes mellitus.

Journal Article Am Heart J · October 2014 BACKGROUND: Hybrid coronary revascularization (HCR) involves minimally invasive left internal mammary artery to left anterior descending coronary artery grafting combined with percutaneous coronary intervention (PCI) of non-left anterior descending vessels ... Full text Link to item Cite

Readmissions after cardiac surgery: experience of the National Institutes of Health/Canadian Institutes of Health research cardiothoracic surgical trials network.

Journal Article Ann Thorac Surg · October 2014 BACKGROUND: Readmissions are a common problem in cardiac surgery. The goal of this study was to examine the frequency, timing, and associated risk factors for readmission after cardiac operations. METHODS: A 10-center cohort study prospectively enrolled 5, ... Full text Link to item Cite

D-dimer and risk of thromboembolic and bleeding events in patients with atrial fibrillation--observations from the ARISTOTLE trial.

Journal Article J Thromb Haemost · September 2014 BACKGROUND: D-dimer is related to adverse outcomes in arterial and venous thromboembolic diseases. OBJECTIVES: To evaluate the predictive value of D-dimer level for stroke, other cardiovascular events, and bleeds, in patients with atrial fibrillation (AF) ... Full text Link to item Cite

Efficacy and safety of apixaban compared with warfarin for stroke prevention in patients with atrial fibrillation from East Asia: a subanalysis of the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) Trial.

Journal Article Am Heart J · September 2014 BACKGROUND: The perceived risk of serious bleeding is an obstacle to the use of oral anticoagulation in East Asia. The efficacy and safety of apixaban in East Asian patients with atrial fibrillation are unknown. METHODS: ARISTOTLE included 18,201 patients ... Full text Link to item Cite

Endoscopic harvesting device type and outcomes in patients undergoing coronary artery bypass surgery.

Journal Article Ann Surg · August 2014 OBJECTIVE: To evaluate angiographic and clinical outcomes associated with open and closed dissection tunnel endoscopic vein harvesting (EVH) devices. BACKGROUND: A previous PREVENT-IV (PRoject of Ex-vivo Vein graft ENgineering via Transfection IV) analysis ... Full text Link to item Cite

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

Journal Article Am Heart J · August 2014 Independent data monitoring committees (IDMCs) were introduced to monitor patient safety and study conduct in randomized clinical trials (RCTs), but certain challenges regarding the utilization of IDMCs have developed. First, the roles and responsibilities ... Full text Link to item Cite

Use of the REG1 anticoagulation system in patients with acute coronary syndromes undergoing percutaneous coronary intervention: results from the phase II RADAR-PCI study.

Journal Article EuroIntervention · August 2014 AIMS: We sought to determine the feasibility of conducting percutaneous coronary intervention (PCI) in high-risk acute coronary syndrome (ACS) patients utilising the REG1 system consisting of pegnivacogin, an aptameric factor IXa inhibitor, and its control ... Full text Link to item Cite

Vein graft preservation solutions, patency, and outcomes after coronary artery bypass graft surgery: follow-up from the PREVENT IV randomized clinical trial.

Journal Article JAMA Surg · August 2014 IMPORTANCE: In vitro and animal model data suggest that intraoperative preservation solutions may influence endothelial function and vein graft failure (VGF) after coronary artery bypass graft (CABG) surgery. Clinical studies to validate these findings are ... Full text Link to item Cite

Surgical revascularization is associated with maximal survival in patients with ischemic mitral regurgitation: a 20-year experience.

Journal Article Circulation · June 17, 2014 BACKGROUND: The optimal treatment for ischemic mitral regurgitation remains actively debated. Our objective was to evaluate the relationship between ischemic mitral regurgitation treatment strategy and survival. METHODS AND RESULTS: We retrospectively revi ... Full text Link to item Cite

Comparison of clinical trial outcome patterns in patients following acute coronary syndromes and in patients with chronic stable atherosclerosis.

Journal Article Clin Cardiol · June 2014 BACKGROUND: The transition of patients with atherosclerotic vascular disease from the acute phase of the disease to the chronic stable atherosclerosis (CSA) phase has not been well characterized. We sought to compare ischemic and bleeding outcomes in hospi ... Full text Link to item Cite

Major bleeding in patients with atrial fibrillation receiving apixaban or warfarin: The ARISTOTLE Trial (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation): Predictors, Characteristics, and Clinical Outcomes.

Journal Article J Am Coll Cardiol · May 27, 2014 OBJECTIVES: This study sought to characterize major bleeding on the basis of the components of the major bleeding definition, to explore major bleeding by location, to define 30-day mortality after a major bleeding event, and to identify factors associated ... Full text Link to item Cite

Clinical outcomes after hybrid coronary revascularization versus coronary artery bypass surgery: a meta-analysis of 1,190 patients.

Journal Article Am Heart J · April 2014 BACKGROUND: Hybrid coronary revascularization (HCR) represents a minimally invasive revascularization strategy in which the durability of the internal mammary artery to left anterior descending artery graft is combined with percutaneous coronary interventi ... Full text Link to item Cite

Warfarin use and long-term outcomes in patients with acute myocardial infarction and atrial fibrillation.

Journal Article J Thromb Thrombolysis · April 2014 Warfarin use in patients with acute myocardial infarction (AMI) and atrial fibrillation (AF) remains challenging. We describe use of warfarin up to 1 year after hospitalization among patients with AMI and AF according to stroke and bleeding risk, and ident ... Full text Link to item Cite

Efficacy and safety of apixaban in patients after cardioversion for atrial fibrillation: insights from the ARISTOTLE Trial (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation).

Journal Article J Am Coll Cardiol · March 25, 2014 OBJECTIVES: The aim of this study was to determine the risk of major clinical and thromboembolic events after cardioversion for atrial fibrillation in subjects treated with apixaban, an oral factor Xa inhibitor, compared with warfarin. BACKGROUND: In patie ... Full text Link to item Cite

Impact of extracardiac vascular disease on vein graft failure and outcomes after coronary artery bypass surgery.

Journal Article Ann Thorac Surg · March 2014 BACKGROUND: While extracardiac vascular disease (ECVD), defined as a history of peripheral vascular disease (PVD) or cerebrovascular disease (CBVD), is common in patients undergoing coronary artery bypass graft (CABG) surgery, there are limited data availa ... Full text Link to item Cite

High-sensitivity troponin I for risk assessment in patients with atrial fibrillation: insights from the Apixaban for Reduction in Stroke and other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial.

Journal Article Circulation · February 11, 2014 BACKGROUND: High-sensitivity troponin-I (hs-TnI) measurement improves risk assessment for cardiovascular events in many clinical settings, but the added value in atrial fibrillation patients has not been described. METHODS AND RESULTS: At randomization, hs ... Full text Link to item Cite

Standardizing definitions for hybrid coronary revascularization.

Journal Article J Thorac Cardiovasc Surg · February 2014 Full text Link to item Cite

Incidence and outcomes associated with early heart failure pharmacotherapy in patients with ongoing cardiogenic shock.

Journal Article Crit Care Med · February 2014 OBJECTIVES: Guidelines recommend β-blockers and renin-angiotensin-aldosterone system blockers to improve long-term survival in hemodynamically stable myocardial infarction patients with a reduced left ventricular ejection fraction. The prevalence and outco ... Full text Link to item Cite

High-sensitivity troponin T and risk stratification in patients with atrial fibrillation during treatment with apixaban or warfarin.

Conference J Am Coll Cardiol · January 7, 2014 OBJECTIVES: The aim of this study was to evaluate the prognostic value of high-sensitivity troponin T (hs-TnT) in addition to clinical risk factors and the CHA2DS2VASc (congestive heart failure, hypertension, 75 years of age and older, diabetes mellitus, p ... Full text Link to item Cite

Apixaban vs. warfarin with concomitant aspirin in patients with atrial fibrillation: insights from the ARISTOTLE trial.

Journal Article Eur Heart J · January 2014 AIMS: We assessed the effect of concomitant aspirin use on the efficacy and safety of apixaban compared with warfarin in patients with atrial fibrillation (AF). METHODS AND RESULTS: In ARISTOTLE, 18 201 patients were randomized to apixaban 5 mg twice daily ... Full text Link to item Cite

Apixaban in patients with atrial fibrillation and prior coronary artery disease: insights from the ARISTOTLE trial.

Journal Article Int J Cardiol · December 10, 2013 BACKGROUND: A substantial portion of patients with atrial fibrillation (AF) also have coronary artery disease (CAD) and are at risk for coronary events. Warfarin is known to reduce these events, but increase the risk of bleeding. We assessed the effects of ... Full text Link to item Cite

Effect of levosimendan on survival and adverse events after cardiac surgery: a meta-analysis.

Journal Article J Cardiothorac Vasc Anesth · December 2013 OBJECTIVE: Left ventricular systolic dysfunction is associated with increased morbidity and mortality in patients undergoing cardiac surgery. The authors performed a meta-analysis investigating the effects of levosimendan in cardiac surgery patients with a ... Full text Link to item Cite

Status quo of hybrid coronary revascularization for multi-vessel coronary artery disease.

Journal Article Ann Thorac Surg · December 2013 Hybrid coronary revascularization (HCR) combines bypass grafting of the left anterior descending (LAD) coronary artery with percutaneous coronary intervention (PCI) of non-LAD vessels. HCR has been performed as an alternative to CABG or multi-vessel PCI in ... Full text Link to item Cite

Relationship between postoperative clopidogrel use and subsequent angiographic and clinical outcomes following coronary artery bypass grafting.

Journal Article J Thromb Thrombolysis · November 2013 Dual antiplatelet therapy with both aspirin and clopidogrel is increasingly used after coronary artery bypass grafting (CABG); however, little is known about the safety or efficacy. We sought to determine the relationship between postoperative clopidogrel ... Full text Link to item Cite

Safety of very early sheath removal in patients treated with REG1 for acute coronary syndromes: insights from the RADAR trial.

Journal Article J Invasive Cardiol · November 2013 BACKGROUND: RADAR compared REG1 (25%, 50%, 75%, 100% reversal) with unfractionated heparin (UFH) in 640 acute coronary syndrome (ACS) patients (479 REG1 patients, 161 UFH patients) undergoing an invasive management strategy. We sought to determine whether ... Link to item Cite

Dabigatran for periprocedural anticoagulation following radiofrequency ablation for atrial fibrillation: a meta-analysis of observational studies.

Journal Article J Interv Card Electrophysiol · September 2013 PURPOSE: Dabigatran is approved for prevention of stroke or systemic embolism in patients with nonvalvular atrial fibrillation (AF). The safety and effectiveness of periprocedural dabigatran in ablation for AF are unknown. METHODS: We performed a meta-anal ... Full text Link to item Cite

Documentation of study medication dispensing in a prospective large randomized clinical trial: experiences from the ARISTOTLE Trial.

Journal Article Am Heart J · September 2013 BACKGROUND: In ARISTOTLE, apixaban resulted in a 21% reduction in stroke, a 31% reduction in major bleeding, and an 11% reduction in death. However, approval of apixaban was delayed to investigate a statement in the clinical study report that "7.3% of subj ... Full text Link to item Cite

Apixaban versus warfarin in patients with atrial fibrillation according to prior warfarin use: results from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation trial.

Journal Article Am Heart J · September 2013 BACKGROUND: Patients with atrial fibrillation who are vitamin K antagonist (VKA)-naive may have a higher risk of thrombosis and/or bleeding than VKA-experienced patients. METHODS AND RESULTS: Using data from ARISTOTLE, we assessed baseline characteristics ... Full text Link to item Cite

A Phase 2, randomized, partially blinded, active-controlled study assessing the efficacy and safety of variable anticoagulation reversal using the REG1 system in patients with acute coronary syndromes: results of the RADAR trial.

Journal Article Eur Heart J · August 2013 AIMS: We sought to determine the degree of anticoagulation reversal required to mitigate bleeding, and assess the feasibility of using pegnivacogin to prevent ischaemic events in acute coronary syndrome (ACS) patients managed with an early invasive approac ... Full text Link to item Cite

Outcomes of apixaban vs. warfarin by type and duration of atrial fibrillation: results from the ARISTOTLE trial.

Journal Article Eur Heart J · August 2013 AIMS: It is uncertain whether the benefit from apixaban varies by type and duration of atrial fibrillation (AF). METHODS AND RESULTS: A total of 18 201 patients with AF [2786 (15.3%) with paroxysmal and 15 412 (84.7%) with persistent or permanent] were ran ... Full text Link to item Cite

The safety and efficacy of apixaban : where do we stand in 2013?

Journal Article Expert Opin Drug Saf · July 2013 INTRODUCTION: Traditional oral anticoagulants, such as warfarin, are effective but require frequent laboratory monitoring for dose adjustment and have several known interactions with food and other drugs. Oral direct factor Xa inhibitors are an emerging cl ... Full text Link to item Cite

Efficacy and safety of apixaban compared with warfarin at different levels of predicted international normalized ratio control for stroke prevention in atrial fibrillation.

Journal Article Circulation · June 4, 2013 BACKGROUND: In the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial, apixaban compared with warfarin reduced stroke and systemic embolism, major bleeding, and mortality. We evaluated treatment effect ... Full text Link to item Cite

New oral anticoagulants in addition to single or dual antiplatelet therapy after an acute coronary syndrome: a systematic review and meta-analysis.

Journal Article Eur Heart J · June 2013 BACKGROUND: Oral anticoagulation in addition to antiplatelet treatment after an acute coronary syndrome might reduce ischaemic events but increase bleeding risk. We performed a meta-analysis to evaluate the efficacy and safety of adding direct thrombin or ... Full text Link to item Cite

Left ventricular systolic dysfunction, heart failure, and the risk of stroke and systemic embolism in patients with atrial fibrillation: insights from the ARISTOTLE trial.

Journal Article Circ Heart Fail · May 2013 BACKGROUND: We examined the risk of stroke or systemic embolism (SSE) conferred by heart failure (HF) and left ventricular systolic dysfunction (LVSD) in the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation Trial (ARI ... Full text Link to item Cite

Saphenous vein graft failure after coronary artery bypass surgery: pathophysiology, management, and future directions.

Journal Article Ann Surg · May 2013 OBJECTIVE: To review our current understanding of the epidemiology and pathogenesis of vein graft failure (VGF), give an overview of current preventive and interventional measures, and explore strategies that may improve vein graft patency. BACKGROUND: VGF ... Full text Link to item Cite

Saphenous vein graft failure and clinical outcomes: toward a surrogate end point in patients following coronary artery bypass surgery?

Journal Article Am Heart J · May 2013 Saphenous vein graft (SVG) failure is a common finding in patients following coronary artery bypass graft (CABG) surgery. In the literature SVG failure rates have been reported from 25 to over 50% within 10 years. Although common, it remains unclear to wha ... Full text Link to item Cite

Incorporation of bleeding as an element of the composite end point in clinical trials of antithrombotic therapies in patients with non-ST-segment elevation acute coronary syndrome: validity, pitfalls, and future approaches.

Journal Article Am Heart J · May 2013 With the large number of antithrombotic therapies available and under investigation for the treatment of non-ST-segment elevation acute coronary syndromes (NSTE ACS), practice guidelines now stress the importance of selecting an antithrombotic strategy acc ... Full text Link to item Cite

Rate versus rhythm control and outcomes in patients with atrial fibrillation and chronic kidney disease: data from the GUSTO-III Trial.

Journal Article Cardiol J · 2013 BACKGROUND: Atrial fibrillation (AF) and chronic kidney disease (CKD) have both been shown to portend worse outcomes after acute myocardial infarction (MI); however, the benefit of a rhythm control strategy in patients with CKD post-MI is unclear. METHODS: ... Full text Link to item Cite

Efficacy and safety of apixaban compared with warfarin according to patient risk of stroke and of bleeding in atrial fibrillation: a secondary analysis of a randomised controlled trial.

Journal Article Lancet · November 17, 2012 BACKGROUND: The Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial showed that apixaban is better than warfarin at prevention of stroke or systemic embolism, causes less bleeding, and results in lower ... Full text Link to item Cite

Efficacy of apixaban when compared with warfarin in relation to renal function in patients with atrial fibrillation: insights from the ARISTOTLE trial.

Journal Article Eur Heart J · November 2012 AIMS: Atrial fibrillation (AF) is common among patients with impaired renal function. Apixaban, a novel oral anticoagulant with partial renal excretion, was compared with warfarin and reduced the rate stroke, death and bleeding in the ARISTOTLE trial. We e ... Full text Link to item Cite

Antithrombotic therapy in heparin-induced thrombocytopenia: guidelines translated for the clinician.

Journal Article J Thromb Thrombolysis · November 2012 Heparin-induced thrombocytopenia (HIT) is a clinicopathologic syndrome initiated by heparin exposure and characterized by thrombocytopenia and paradoxical thrombophilia. HIT is mediated by the formation of antibodies against the platelet factor 4/heparin c ... 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

Pentasaccharide Derivatives

Journal Article · October 3, 2012 The pivotal position of factor Xa in the coagulation cascade has made its inhibition an attractive target for therapy in the setting of venous thromboembolic events and coronary thrombosis. This chapter explores the mechanism of antithrombotic action of fo ... Full text Cite

Antithrombotic therapy for atrial fibrillation and coronary artery disease in older patients.

Journal Article Am Heart J · October 2012 BACKGROUND: Older patients with atrial fibrillation (AF) and coronary artery disease (CAD) face high risk of stroke and bleeding with antithrombotic therapy. Balancing safe and effective use of aspirin, clopidogrel, and warfarin in this population is impor ... Full text Link to item Cite

Edifoligide and long-term outcomes after coronary artery bypass grafting: PRoject of Ex-vivo Vein graft ENgineering via Transfection IV (PREVENT IV) 5-year results.

Journal Article Am Heart J · September 2012 BACKGROUND: Edifoligide, an E2F transcription factor decoy, does not prevent vein graft failure or adverse clinical outcomes at 1 year in patients undergoing coronary artery bypass grafting (CABG). We compared the 5-year clinical outcomes of patients in PR ... Full text Link to item Cite

Association between endoscopic vs open vein-graft harvesting and mortality, wound complications, and cardiovascular events in patients undergoing CABG surgery.

Journal Article JAMA · August 1, 2012 CONTEXT: The safety and durability of endoscopic vein graft harvest in coronary artery bypass graft (CABG) surgery has recently been called into question. OBJECTIVE: To compare the long-term outcomes of endoscopic vs open vein-graft harvesting for Medicare ... Full text Link to item Cite

A phase 1 ascending dose study of a subcutaneously administered factor IXa inhibitor and its active control agent.

Journal Article J Thromb Haemost · July 2012 BACKGROUND: The REG2 anticoagulation system consists of pegnivacogin, a subcutaneously administered aptamer factor IXa inhibitor, and its intravenous control agent, anivamersen. OBJECTIVES: To assess the safety, tolerability and pharmacokinetic and pharmac ... Full text Link to item Cite

Novel oral anticoagulants after acute coronary syndromes.

Journal Article Cardiovasc Drugs Ther · June 2012 PURPOSE: A number of novel oral anticoagulants, including direct thrombin inhibitors and direct factor Xa inhibitors, have been developed. This review discusses these agents and their respective clinical trials in patients with acute coronary syndromes. ME ... Full text Link to item Cite

Apixaban compared with warfarin in patients with atrial fibrillation and previous stroke or transient ischaemic attack: a subgroup analysis of the ARISTOTLE trial.

Journal Article Lancet Neurol · June 2012 BACKGROUND: In the ARISTOTLE trial, the rate of stroke or systemic embolism was reduced by apixaban compared with warfarin in patients with atrial fibrillation (AF). Patients with AF and previous stroke or transient ischaemic attack (TIA) have a high risk ... Full text Link to item Cite

Effects of atrial fibrillation on treatment of mitral regurgitation in the EVEREST II (Endovascular Valve Edge-to-Edge Repair Study) randomized trial.

Journal Article J Am Coll Cardiol · April 3, 2012 OBJECTIVES: The purpose of this study was to characterize patients with mitral regurgitation (MR) and atrial fibrillation (AF) treated percutaneously using the MitraClip device (Abbott Vascular, Abbott Park, Illinois) and compare the results with surgery i ... Full text Link to item Cite

Relationship between vein graft failure and subsequent clinical outcomes after coronary artery bypass surgery.

Journal Article Circulation · February 14, 2012 BACKGROUND: Vein graft failure (VGF) is common after coronary artery bypass graft surgery, but its relationship with long-term clinical outcomes is unknown. In this retrospective analysis, we examined the relationship between VGF, assessed by coronary angi ... Full text Link to item Cite

Promise of factor Xa inhibition in atrial fibrillation.

Journal Article Curr Cardiol Rep · February 2012 Randomized clinical trials have conclusively demonstrated that warfarin prevents stroke in patients with atrial fibrillation. This evidence led the American College of Cardiology, the American Heart Association, and the European Society of Cardiology to de ... Full text Link to item Cite

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

Journal Article Am J Cardiol · February 1, 2012 Gender-related differences in the incidence of bleeding and its relation to subsequent mortality in patients with ST-segment elevation myocardial infarction (STEMI) treated with fibrinolysis are not well understood. We studied patients with STEMI receiving ... Full text Link to item Cite

Rivaroxaban: An original antithrombotic agent

Conference Archives Des Maladies Du Coeur Et Des Vaisseaux Pratique · January 1, 2012 Full text Cite

Glycemic management in diabetes and the associated cardiovascular risk: are we helping or hurting our patients?

Journal Article Circ J · 2012 Diabetes, which is a metabolic disorder with multiple comorbidities, increases the risk of cardiovascular disease. Although it was once assumed that controlling plasma glucose levels would reduce diabetes-related morbidity and mortality, recent trials have ... Full text Link to item Cite

Design, rationale, and initiation of the Surgical Interventions for Moderate Ischemic Mitral Regurgitation Trial: a report from the Cardiothoracic Surgical Trials Network.

Journal Article J Thorac Cardiovasc Surg · January 2012 OBJECTIVE: Patients with coronary artery disease complicated by moderate ischemic mitral regurgitation have demonstrably poorer outcome than do patients with coronary artery disease but without mitral regurgitation. The optimal treatment of this condition ... Full text Link to item Cite

The kinetics of integrilin limited by obesity: a multicenter randomized pharmacokinetic and pharmacodynamic clinical trial.

Journal Article Am Heart J · December 2011 BACKGROUND: KILO tested 2 novel weight-based eptifibatide dosing strategies compared with standard dosing in obese patients undergoing elective percutaneous coronary intervention (PCI). Eptifibatide dosing is weight adjusted for patients up to 121 kg. Pati ... Full text Link to item Cite

Apixaban after acute coronary syndrome.

Journal Article N Engl J Med · November 10, 2011 Full text Link to item Cite

A double-blind, randomized, controlled, multicenter study to assess the safety and cardiovascular effects of skeletal myoblast implantation by catheter delivery in patients with chronic heart failure after myocardial infarction.

Journal Article Am Heart J · October 2011 BACKGROUND: We sought to determine the safety and preliminary efficacy of transcatheter intramyocardial administration of myoblasts in patients with heart failure (HF). METHODS: MARVEL is a randomized placebo-controlled trial of image-guided, catheter-base ... Full text Link to item Cite

Pegnivacogin results in near complete FIX inhibition in acute coronary syndrome patients: RADAR pharmacokinetic and pharmacodynamic substudy.

Journal Article Eur Heart J · October 2011 AIMS: Establishing factor IX inhibition in patients with acute coronary syndrome/non-ST-elevation myocardial infarction (ACS/NSTEMI), a setting characterized by increased factor IX activity, is critical to investigate the REG1 system in this target populat ... Full text Link to item Cite

Apixaban versus warfarin in patients with atrial fibrillation.

Journal Article N Engl J Med · September 15, 2011 BACKGROUND: Vitamin K antagonists are highly effective in preventing stroke in patients with atrial fibrillation but have several limitations. Apixaban is a novel oral direct factor Xa inhibitor that has been shown to reduce the risk of stroke in a similar ... Full text Link to item Cite

Thrombomodulin gene variants are associated with increased mortality after coronary artery bypass surgery in replicated analyses.

Journal Article Circulation · September 13, 2011 BACKGROUND: We tested the hypothesis that genetic variation in thrombotic and inflammatory pathways is independently associated with long-term mortality after coronary artery bypass graft (CABG) surgery. METHODS AND RESULTS: Two separate cohorts of patient ... Full text Link to item Cite

Apixaban with antiplatelet therapy after acute coronary syndrome.

Journal Article N Engl J Med · August 25, 2011 BACKGROUND: Apixaban, an oral, direct factor Xa inhibitor, may reduce the risk of recurrent ischemic events when added to antiplatelet therapy after an acute coronary syndrome. METHODS: We conducted a randomized, double-blind, placebo-controlled clinical t ... Full text Link to item Cite

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

Journal Article J Thromb Thrombolysis · August 2011 To discuss and share knowledge around advances in the care of patients with thrombotic disorders, the Third International Symposium of Thrombosis and Anticoagulation was held in São Paulo, Brazil, from October 14-16, 2010. This scientific program was devel ... Full text Link to item Cite

Chromogenic laboratory assays to measure the factor Xa-inhibiting properties of apixaban--an oral, direct and selective factor Xa inhibitor.

Journal Article J Thromb Thrombolysis · August 2011 An ability to readily determine an anticoagulant effect with an emerging class of direct, active site, oral factor Xa inhibitors is viewed by the medical community as attractive and by some as an absolute requirement for their use in clinical practice. We ... Full text Link to item Cite

Saphenous vein grafts with multiple versus single distal targets in patients undergoing coronary artery bypass surgery: one-year graft failure and five-year outcomes from the Project of Ex-Vivo Vein Graft Engineering via Transfection (PREVENT) IV trial.

Journal Article Circulation · July 19, 2011 BACKGROUND: Limited information exists on the intermediate-term graft patency and 5-year clinical outcomes of patients receiving saphenous vein grafts with multiple (m-SVG) versus single distal targets (s-SVG) during coronary artery bypass graft (CABG) sur ... Full text Link to item Cite

Dose selection for a direct and selective factor IXa inhibitor and its complementary reversal agent: translating pharmacokinetic and pharmacodynamic properties of the REG1 system to clinical trial design.

Journal Article J Thromb Thrombolysis · July 2011 We performed detailed pharmacokinetic and pharmacodynamic modeling of REG1, an anticoagulation system composed of the direct factor IXa (FIXa) inhibitor pegnivacogin (RB006) and its matched active control agent anivamersen (RB007), with a focus on level of ... Full text Link to item Cite

Antithrombotic therapies in patients with prosthetic heart valves: guidelines translated for the clinician.

Journal Article J Thromb Thrombolysis · May 2011 Patients with prosthetic heart valves require chronic oral anticoagulation. In this clinical scenario, physicians must be mindful of the thromboembolic and bleeding risks related to chronic anticoagulant therapy. Currently, only vitamin K antagonists are a ... Full text Link to item Cite

KINETICS OF INTEGRILIN LIMITED BY OBESITY (KILO): A MULTI-CENTER RANDOMIZED CLINICAL TRIAL

Conference Journal of the American College of Cardiology · April 2011 Full text Cite

Association of myocardial enzyme elevation and survival following coronary artery bypass graft surgery.

Journal Article JAMA · February 9, 2011 CONTEXT: Several small studies have suggested that cardiac enzyme elevation in the 24 hours following coronary artery bypass graft (CABG) surgery is associated with worse prognosis, but a definitive study is not available. Also, the long-term prognostic im ... Full text Link to item Cite

A randomized, partially blinded, multicenter, active-controlled, dose-ranging study assessing the safety, efficacy, and pharmacodynamics of the REG1 anticoagulation system in patients with acute coronary syndromes: design and rationale of the RADAR Phase IIb trial.

Journal Article Am Heart J · February 2011 Anticoagulants are the cornerstone of current acute coronary syndrome (ACS) therapy; however, anticoagulation regimens that aggressively reduce ischemic events are almost uniformly associated with more bleeding. REG1, an anticoagulation system, consists of ... Full text Link to item Cite

SY06-5 Apixaban for the Prevention of Thromboembolic Events in Patients with Atrial Fibrillation: Primary Results of the ARISTOTLE Trial

Journal Article Journal of Arrhythmia · January 1, 2011 Background: Patients with atrial fibrillation are at risk for thromboembolism. Warfarin is effective but underused because of its narrow therapeutic window, risk of bleeding, and need for frequent monitoring. More effective, safer and easier to use anticoa ... Full text Cite

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

Journal Article Am J Med · January 2011 BACKGROUND: studies have shown higher bleeding and mortality rates among African Americans who receive fibrinolytic therapy for ST-segment elevation myocardial infarction (STEMI) compared with whites; however, the relationship of bleeding risk to mortality ... Full text Link to item Cite

Prophylaxis for venous thromboembolism: guidelines translated for the clinician.

Journal Article J Thromb Thrombolysis · January 2011 Venous thromboembolism is a major cause of morbidity and mortality worldwide and most often affects hospitalized postoperative surgical and medical patients. Venous thromboembolism prophylaxis undoubtedly improves the care of these patients, as demonstrate ... Full text Link to item Cite

Antiarrhythmic drug therapy for sustained ventricular arrhythmias complicating acute myocardial infarction.

Journal Article Crit Care Med · January 2011 OBJECTIVE: Few data exist to guide antiarrhythmic drug therapy for sustained ventricular tachycardia/ventricular fibrillation after acute myocardial infarction. The objective of this analysis was to describe the survival of patients with sustained ventricu ... Full text Link to item Cite

The clinical evaluation of the Endeavor zotarolimus-eluting coronary stent in Japanese patients with de novo native coronary artery lesions: primary results and 3-year follow-up of the Endeavor Japan study.

Journal Article Cardiovasc Revasc Med · 2011 BACKGROUND: Angiographic and clinical outcomes associated with coronary stents eluting the new molecular entity zotarolimus have been well characterized in a variety of geographies and patient subsets. The Endeavor Japan study is the first prospective clin ... Full text Link to item Cite

Effect of apixaban, an oral and direct factor Xa inhibitor, on coagulation activity biomarkers following acute coronary syndrome.

Journal Article Thromb Haemost · November 2010 Apixaban is an oral, direct factor Xa inhibitor under development for secondary prevention in acute coronary syndrome (ACS). Apixaban's effect on D-dimer and prothrombin fragment 1.2 (F1.2) (coagulation activity biomarkers ) was determined in a randomised, ... Full text Link to item Cite

First clinical application of an actively reversible direct factor IXa inhibitor as an anticoagulation strategy in patients undergoing percutaneous coronary intervention.

Journal Article Circulation · August 10, 2010 BACKGROUND: The ideal anticoagulant should prevent ischemic complications without increasing the risk of bleeding. Controlled anticoagulation is possible with the REG1 system, an RNA aptamer pair comprising the direct factor IXa inhibitor RB006 and its act ... Full text Link to item Cite

Antithrombotic therapy in acute coronary syndromes: guidelines translated for the clinician.

Journal Article J Thromb Thrombolysis · May 2010 The use of anticoagulant and antiplatelet therapy during the management of acute coronary syndromes (ACS) has been associated with improvements in short- and long-term clinical outcomes, regardless of whether patients are managed conservatively or with acu ... Full text Link to item Cite

A systematic assessment of cardiovascular outcomes in the saxagliptin drug development program for type 2 diabetes.

Journal Article Postgrad Med · May 2010 OBJECTIVE: The objective was to assess the relative risk (RR) for cardiovascular (CV) events across all 8 randomized phase 2/3 trials evaluating saxagliptin in patients with type 2 diabetes mellitus. METHODS: Cardiovascular events (death, myocardial infarc ... 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

Antithrombotic therapy for ischemic stroke: guidelines translated for the clinician.

Journal Article J Thromb Thrombolysis · April 2010 Acute ischemic stroke is the result of abrupt interruption of focal cerebral blood flow. The majority of ischemic strokes are caused by embolic or thrombotic arterial occlusions. Acute stroke management is complex, in part because of the varying etiologies ... Full text Link to item Cite

Apixaban for reduction in stroke and other ThromboemboLic events in atrial fibrillation (ARISTOTLE) trial: design and rationale.

Journal Article Am Heart J · March 2010 Atrial fibrillation (AF) is associated with increased risk of stroke that can be attenuated with vitamin K antagonists (VKAs). Vitamin K antagonist use is limited, in part, by the high incidence of complications when patients' international normalized rati ... Full text Link to item Cite

Endoscopic versus Open Vein-Graft Harvesting REPLY

Journal Article NEW ENGLAND JOURNAL OF MEDICINE · November 5, 2009 Link to item Cite

Patterns of management of atrial fibrillation complicating coronary artery bypass grafting: Results from the PRoject of Ex-vivo Vein graft ENgineering via Transfection IV (PREVENT-IV) Trial.

Journal Article Am Heart J · November 2009 BACKGROUND: Current practice related to the management of atrial fibrillation (AF) complicating coronary artery bypass grafting (CABG) is uncertain. METHODS: We examined management of post-CABG AF in the PREVENT-IV trial, and we explored patterns of use of ... Full text Link to item Cite

Treatment of venous thromboembolism: guidelines translated for the clinician.

Journal Article J Thromb Thrombolysis · October 2009 Venous thromboembolism is a major cause of morbidity and mortality affecting over 2 million people in the United States each year. The American College of Chest Physicians (ACCP) published their first consensus statement on antithrombotic therapy in 1986, ... Full text Link to item Cite

Predictors of 30-day mortality in patients with refractory cardiogenic shock following acute myocardial infarction despite a patent infarct artery.

Journal Article Am Heart J · October 2009 BACKGROUND: Little is known about predictors of survival in patients with persistent shock following acute myocardial infarction (MI) despite a patent infarct artery. METHODS: We examined data from TRIUMPH, a multicenter randomized clinical trial of the ni ... Full text Link to item Cite

Endoscopic versus open vein-graft harvesting in coronary-artery bypass surgery.

Journal Article N Engl J Med · July 16, 2009 BACKGROUND: Vein-graft harvesting with the use of endoscopy (endoscopic harvesting) is a technique that is widely used to reduce postoperative wound complications after coronary-artery bypass grafting (CABG), but the long-term effects on the rate of vein-g ... Full text Link to item Cite

Perioperative management of anticoagulation: guidelines translated for the clinician.

Journal Article J Thromb Thrombolysis · July 2009 The perioperative management of patients taking vitamin K antagonists (VKAs) is an evolving area of medicine and poses significant challenges for health care providers. It has been estimated that this issue affects approximately 250,000 patients annually, ... Full text Link to item Cite

Apixaban, an oral, direct, selective factor Xa inhibitor, in combination with antiplatelet therapy after acute coronary syndrome: results of the Apixaban for Prevention of Acute Ischemic and Safety Events (APPRAISE) trial.

Journal Article Circulation · June 9, 2009 BACKGROUND: After an acute coronary syndrome, patients remain at risk of recurrent events. Apixaban, an oral direct factor Xa inhibitor, is a novel anticoagulant that may reduce these events but also poses a risk of bleeding. METHODS AND RESULTS: Apixaban ... Full text Link to item Cite

Influence of body mass index on the efficacy of revascularization in patients with coronary artery disease.

Journal Article J Thorac Cardiovasc Surg · June 2009 OBJECTIVE: We examined the effect of body mass index on the association between revascularization strategy and survival in patients with coronary artery disease. METHODS: Using the Duke Database for Cardiovascular Disease, we selected 22,877 patients who u ... Full text Link to item Cite

The current state of antiplatelet therapy in acute coronary syndromes: the data and the real world.

Journal Article Cleve Clin J Med · April 2009 Managing antiplatelet therapy for patients with acute coronary syndromes (ACS) is complex, and current therapy options and approaches for these patients are suboptimal. Despite the use of available antiplatelet therapies--aspirin, clopidogrel, and the pare ... Full text Link to item Cite

Antithrombotic therapy in atrial fibrillation: guidelines translated for the clinician.

Journal Article J Thromb Thrombolysis · December 2008 Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice, accounting for approximately one-third of hospitalizations for cardiac rhythm disturbances. The highest incidence of AF is in patients 70-80 years old and other high-risk ... Full text Link to item Cite

Influence of preoperative renal dysfunction on one-year bypass graft patency and two-year outcomes in patients undergoing coronary artery bypass surgery.

Journal Article J Thorac Cardiovasc Surg · November 2008 OBJECTIVE: Limited information exists on the impact of preoperative renal dysfunction on internal thoracic artery and saphenous vein graft failure and 2-year clinical outcomes in patients undergoing coronary artery bypass surgery. METHODS: We studied the i ... Full text Link to item Cite

In reply

Journal Article JAMA · September 3, 2008 Full text Cite

Impact of perioperative myocardial infarction on angiographic and clinical outcomes following coronary artery bypass grafting (from PRoject of Ex-vivo Vein graft ENgineering via Transfection [PREVENT] IV).

Journal Article Am J Cardiol · September 1, 2008 Myocardial infarction (MI) after coronary artery bypass grafting (CABG) is associated with significant morbidity and mortality. Frequency, management, mechanisms, and angiographic and clinical outcomes associated with perioperative MI remain poorly underst ... 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

A randomized, repeat-dose, pharmacodynamic and safety study of an antidote-controlled factor IXa inhibitor.

Journal Article J Thromb Haemost · May 2008 BACKGROUND: Active and safe reversibility of anticoagulation is an unmet need in clinical care. Factor IXa, required for rapid thrombin generation on platelet surfaces, is a novel target for modulating coagulation. REG1 comprises RB006 (drug) and RB007 (an ... Full text Link to item Cite

Efficacy and safety of pyridoxal 5'-phosphate (MC-1) in high-risk patients undergoing coronary artery bypass graft surgery: the MEND-CABG II randomized clinical trial.

Journal Article JAMA · April 16, 2008 CONTEXT: Coronary artery bypass graft (CABG) surgery is frequently performed and effective; however, perioperative complications related to ischemia-reperfusion injury, including myocardial infarction (MI), remain common and result in significant morbidity ... Full text Link to item Cite

A randomized, double-blind, placebo-controlled, multicenter study to evaluate the cardioprotective effects of MC-1 in patients undergoing high-risk coronary artery bypass graft surgery: MC-1 to Eliminate Necrosis and Damage in Coronary Artery Bypass Graft Surgery Trial (MEND-CABG) II--study design and rationale.

Journal Article Am Heart J · April 2008 BACKGROUND: Coronary artery bypass graft (CABG) surgery is effective in relieving angina and improving survival and quality of life in patients with obstructive coronary artery disease; however, recurrent angina, myocardial infarction, neurological injury, ... Full text Link to item Cite

Coronary artery bypass graft failure after on-pump and off-pump coronary artery bypass: findings from PREVENT IV.

Journal Article Ann Thorac Surg · February 2008 BACKGROUND: This analysis compares 1-year vein graft patency and major adverse cardiac and cerebral events (MACCE [death, myocardial infarction, or stroke]) in on-pump and off-pump patients enrolled in PREVENT IV (the PRoject of Ex-vivo Vein graft ENgineer ... Full text Link to item Cite

Impact of saphenous vein graft radiographic markers on clinical events and angiographic parameters.

Journal Article Ann Thorac Surg · February 2008 BACKGROUND: Use of saphenous vein graft (SVG) radiographic markers has been associated with shorter cardiac catheterization procedure times and reduced contrast agent volume for postoperative coronary artery bypass graft (CABG) catheterizations. Use of suc ... Full text Link to item Cite

Randomized, double-blind, dose-ranging study of otamixaban, a novel, parenteral, short-acting direct factor Xa inhibitor, in percutaneous coronary intervention: the SEPIA-PCI trial.

Journal Article Circulation · May 22, 2007 BACKGROUND: The optimal anticoagulant regimen for percutaneous coronary intervention (PCI) remains to be determined. Otamixaban, a selective and direct inhibitor of factor Xa, was investigated in patients undergoing nonurgent percutaneous coronary interven ... Full text Link to item Cite

Effect of nitric oxide synthase inhibition on haemodynamics and outcome of patients with persistent cardiogenic shock complicating acute myocardial infarction: a phase II dose-ranging study.

Journal Article Eur Heart J · May 2007 AIMS: Previous studies suggested haemodynamic benefits and, possibly, mortality reduction with the use of nitric oxide synthase (NOS) inhibition in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS). We assessed prelimina ... Full text Link to item Cite

Effect of tilarginine acetate in patients with acute myocardial infarction and cardiogenic shock: the TRIUMPH randomized controlled trial.

Journal Article JAMA · April 18, 2007 CONTEXT: Cardiogenic shock complicating acute myocardial infarction (MI) remains a common and lethal disorder despite aggressive use of early revascularization. Systemic inflammation, including expression of inducible nitric oxide synthase (NOS) and genera ... Full text Link to item Cite

Outcomes associated with the use of secondary prevention medications after coronary artery bypass graft surgery.

Journal Article Ann Thorac Surg · March 2007 BACKGROUND: Secondary prevention medications are beneficial after acute coronary syndromes, but these benefits are less clear after coronary artery bypass graft surgery. We investigated whether greater use of secondary prevention medications after coronary ... Full text Link to item Cite

Creatine kinase-MB elevation after coronary artery bypass grafting surgery in patients with non-ST-segment elevation acute coronary syndromes predict worse outcomes: results from four large clinical trials.

Journal Article Eur Heart J · February 2007 AIMS: To assess the significance of creatine kinase (CK)-MB elevations in outcomes of patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) who have undergone coronary artery bypass grafting (CABG) surgery. METHODS AND RESULTS: This an ... 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

Time course of degradation of cardiac troponin I in patients with acute ST-elevation myocardial infarction: the ASSENT-2 troponin substudy.

Journal Article Circ Res · November 10, 2006 Although measurement of troponin is widely used for diagnosing acute myocardial infarction (AMI), its diagnostic potential may be increased by a more complete characterization of its molecular appearance and degradation in the blood. The aim of this study ... Full text Link to item Cite

In reply [4]

Journal Article JAMA · April 5, 2006 Full text Cite

Elevated creatine kinase-MB with normal creatine kinase predicts worse outcomes in patients with acute coronary syndromes: results from 4 large clinical trials.

Journal Article Am Heart J · January 2006 BACKGROUND: The degree to which elevated creatine kinase (CK)-MB in the presence of normal CK is predictive of outcome is not well understood despite having been studied for decades. This analysis examined whether normal CK with elevated CK-MB in patients ... Full text Link to item Cite

Effect of the novel direct factor Xa inhibitor DX-9065a on thrombin generation and inhibition among patients with stable atherosclerotic coronary artery disease.

Journal Article Thromb Res · 2006 INTRODUCTION: Thrombin, a pluripotential effector enzyme with prothrombotic, proinflammatory, and mitogenic properties, plays a pivotal role in the pathobiology and clinical expression of atherothrombotic coronary artery disease. Existing anticoagulant dru ... Full text Link to item Cite

Efficacy and safety of edifoligide, an E2F transcription factor decoy, for prevention of vein graft failure following coronary artery bypass graft surgery: PREVENT IV: a randomized controlled trial.

Journal Article JAMA · November 16, 2005 CONTEXT: Coronary artery bypass graft (CABG) surgery with autologous vein grafting is commonly performed. Progressive neointimal hyperplasia, however, contributes to considerable vein graft failure. Edifoligide is an oligonucleotide decoy that binds to and ... Full text Link to item Cite

Relation of early saphenous vein graft failure to outcomes following coronary artery bypass surgery.

Journal Article Am J Cardiol · November 1, 2005 Up to 20% of saphenous vein grafts (SVGs) fail within 2 years of coronary artery bypass grafting (CABG). The long-term effects of early SVG failure on major clinical events remain undefined in contemporary patient populations. We sought to examine the rela ... Full text Link to item Cite

The PRoject of Ex-vivo Vein graft ENgineering via Transfection IV (PREVENT IV) trial: study rationale, design, and baseline patient characteristics.

Journal Article Am Heart J · October 2005 BACKGROUND: Coronary artery bypass graft (CABG) surgery with autologous vein graft (VG) conduit is one of the most frequently performed operations in the United States. Unfortunately, many VGs become occluded during long-term follow-up largely because of n ... Full text Link to item Cite

Characterization of myocardial infarction as an end point in two large trials of acute coronary syndromes.

Journal Article Am J Cardiol · June 15, 2005 Myocardial infarction (MI) is a key component of composite end points in trials that evaluate new therapies in non-ST-segment elevation acute coronary syndromes. Types of MI events in these trials have not been well characterized. A similar clinical-events ... Full text Link to item Cite

Association of height with outcomes in patients with acute myocardial infarction receiving reperfusion therapy.

Journal Article Am J Cardiol · June 1, 2005 Data were evaluated for patients with acute ST-elevation myocardial infarction (n = 94,182) enrolled in 6 large clinical trials evaluating the efficacy of various reperfusion strategies. It was found that compared with the tallest quartile, incidences of i ... Full text Link to item Cite

Relationship of incorrect dosing of fibrinolytic therapy and clinical outcomes.

Journal Article JAMA · April 13, 2005 CONTEXT: Incorrect dosing of alteplase has been associated with worse clinical outcomes in patients. However, patients at high risk of adverse events are more prone to dosing errors, thus confounding this relationship. OBJECTIVE: To determine if the associ ... Full text Link to item Cite

Incidence, predictors, and outcomes of high-degree atrioventricular block complicating acute myocardial infarction treated with thrombolytic therapy.

Journal Article Am Heart J · April 2005 BACKGROUND: In the fibrinolytic era, several studies have suggested that the rate of atrioventricular block (AVB) in the setting of acute myocardial infarction (MI) is high and is associated with increased short-term mortality. We sought to delineate predi ... Full text Link to item Cite

First experience with direct, selective factor Xa inhibition in patients with non-ST-elevation acute coronary syndromes: results of the XaNADU-ACS Trial.

Journal Article J Thromb Haemost · March 2005 BACKGROUND: Unfractionated heparin is widely used in patients with non-ST-elevation acute coronary syndromes but has important limitations. Anticoagulants with predictable kinetics and anticoagulant effects, better efficacy, and greater safety are needed. ... Full text Link to item Cite

Incremental prognostic power of single-photon emission computed tomographic myocardial perfusion imaging in patients with known or suspected coronary artery disease.

Journal Article Am J Cardiol · January 15, 2005 Noninvasive stress testing provides prognostic information in patients who have suspected coronary artery disease, but limited data are available on the incremental value of myocardial perfusion testing in high-risk patients. We studied 3,275 patients who ... Full text Link to item Cite

Inhibition of Factor Xa : a potential target for the development of new anticoagulants.

Journal Article Am J Cardiovasc Drugs · 2005 Anticoagulant therapy plays an important role in the prevention and treatment of pathologic arterial and venous thrombosis. There is increasing enthusiasm in the inhibition of Factor Xa as a target to achieve therapeutic anticoagulation because of its cent ... Full text Link to item Cite

Hand-held echocardiographic examination of patients with symptoms of acute coronary syndromes in the emergency department: the 30-day outcome associated with normal left ventricular wall motion.

Journal Article Am Heart J · December 2004 BACKGROUND: Acute chest pain is a common complaint for patients presenting to emergency departments. Electrocardiography (ECG) results and biochemical markers have strong positive predictive value, but an equally available, inexpensive, and non-invasive te ... Full text Link to item Cite

Vascular endothelial tissue factor pathway inhibitor kinetics in culture following exposure to DX-9065a--a selective and direct factor Xa inhibitor.

Journal Article J Thromb Thrombolysis · December 2004 BACKGROUND: Tissue factor (TF), a membrane-bound glycoprotein that initiates blood coagulation by allosteric activation of factor (f) VII, is regulated predominantly by tissue factor pathway inhibitor (TFPI). Because vascular endothelial cells synthesize a ... Full text Link to item Cite

Development of DX-9065a, a novel direct factor Xa antagonist, in cardiovascular disease.

Journal Article Thromb Haemost · December 2004 The development of anticoagulants for treating patients with atherothrombotic disorders of the arterial circulatory system has focused, either directly or indirectly, on thrombin - a pleuripotential effector enzyme with prothrombotic and proinflammatory pr ... Full text Link to item Cite

Diabetes on a cardiovascular ward: adherence to current recommendations.

Journal Article South Med J · November 2004 OBJECTIVES: Improving diabetes and blood pressure control decreases the incidence and progression of microvascular disease. Likewise, screening for microvascular complications is beneficial in the early detection and treatment of these disorders. However, ... Full text Link to item Cite

Efficacy and safety of two unfractionated heparin dosing strategies with tenecteplase in acute myocardial infarction (results from Assessment of the Safety and Efficacy of a New Thrombolytic Regimens 2 and 3).

Journal Article Am J Cardiol · August 1, 2004 We investigated the effect of smaller dose, weight-adjusted heparin with earlier monitoring of activated partial thromboplastin time on the incidence of ischemic and hemorrhagic complications in patients with ST-elevation myocardial infarction treated with ... Full text Link to item Cite

Rationale and strategies for implementing community-based transfer protocols for primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction.

Journal Article J Am Coll Cardiol · June 16, 2004 The focus for the initial approach to the treatment of acute ST-segment elevation myocardial infarction (STEMI) has shifted toward extending the benefits of mechanical reperfusion with primary percutaneous coronary intervention (PCI) to patients who presen ... Full text Link to item Cite

Efficacy of tenecteplase in combination with enoxaparin, abciximab, or unfractionated heparin: one-year follow-up results of the Assessment of the Safety of a New Thrombolytic-3 (ASSENT-3) randomized trial in acute myocardial infarction.

Journal Article Am Heart J · June 2004 BACKGROUND: In the ASsessment of the Safety of a New Thrombolytic 3 (ASSENT-3) study, full-dose tenecteplase plus enoxaparin or half-dose tenecteplase plus abciximab reduced the frequency of ischemic complications of acute myocardial infarction, when compa ... Full text Link to item Cite

Feasibility of point-of-care echocardiography by internal medicine house staff.

Journal Article Am Heart J · March 2004 OBJECTIVE: To determine whether internal medicine house staff with limited training in echocardiography can use point-of-care echocardiography to make simple, clinically important diagnoses. BACKGROUND: Availability of small, portable ultrasound devices co ... Full text Link to item Cite

Creatine kinase-MB elevation after percutaneous coronary intervention predicts adverse outcomes in patients with acute coronary syndromes.

Journal Article Eur Heart J · February 2004 AIM: To study the relationship between outcomes and peak creatine kinase (CK)-MB levels after percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS). METHODS AND RESULTS: Peak CK-MB ratios (pe ... Full text Link to item Cite

Initial experience with factor-Xa inhibition in percutaneous coronary intervention: the XaNADU-PCI Pilot.

Journal Article J Thromb Haemost · February 2004 BACKGROUND: Direct factor (F)Xa inhibition is an attractive method to limit thrombotic complications during percutaneous coronary intervention (PCI). OBJECTIVES: To investigate drug levels achieved, effect on coagulation markers, and preliminary efficacy a ... Full text Link to item Cite

Integrating antithrombin and antiplatelet therapies with early invasive management for non-ST-segment elevation acute coronary syndromes.

Journal Article Am J Med · January 15, 2004 Non-ST-segment elevation acute coronary syndromes are a dramatic manifestation of coronary artery disease. Multiple clinical trials have shown that early cardiac catheterization improves clinical outcomes in patients with non-ST-segment elevation acute cor ... Full text Link to item Cite

Prognostic importance of new small Q waves following non-ST-elevation acute coronary syndromes.

Journal Article Am J Med · December 1, 2003 PURPOSE: To investigate the prognostic importance of new small Q waves following an acute coronary syndrome. METHODS: We assessed 6-month mortality in 10501 patients with non-ST-elevation acute coronary syndromes who had survived 30 days and had both admis ... Full text Link to item Cite

One-year follow-up of the ASSENT-2 trial: a double-blind, randomized comparison of single-bolus tenecteplase and front-loaded alteplase in 16,949 patients with ST-elevation acute myocardial infarction.

Journal Article Am Heart J · July 2003 BACKGROUND: Single-bolus tenecteplase and accelerated alteplase were shown to be equivalent for 30-day mortality rates in the double-blind Assessment of the Safety of a New Thrombolytic (ASSENT-2) study. The aim of this study is to assess mortality rates a ... Full text Link to item Cite

Effect of tenecteplase versus alteplase on platelets during the first 3 hours of treatment for acute myocardial infarction: the Assessment of the Safety and Efficacy of a New Thrombolytic Agent (ASSENT-2) platelet substudy.

Journal Article Am Heart J · April 2003 Featured Publication BACKGROUND: Platelets play a pivotal role in the pathogenesis of acute myocardial infarction, as well as in the occurrence of coronary artery reocclusion and bleeding events. Therefore, the success of fibrinolytic therapy may be dependent on its direct eff ... Full text Link to item Cite

Minor myocardial damage and prognosis: are spontaneous and percutaneous coronary intervention-related events different?

Journal Article Circulation · February 5, 2002 Featured Publication BACKGROUND: The relevance of the adverse prognostic implications of CK-MB elevation after percutaneous coronary intervention (PCI) remains controversial. Therefore, we compared the relationship between the level of postprocedural CK-MB elevation and 6-mont ... Full text Link to item Cite

Safety of the weight-adjusted dosing regimen of tenecteplase in the ASSENT-Trial.

Journal Article Am J Cardiol · December 1, 2001 Featured Publication The results of the ASsessment of Safety and Efficacy of a New Thrombolytic agent (ASSENT-2) trial revealed that tenecteplase (TNK) is equivalent to tissue plasminogen activator (t-PA) for treating myocardial infarction. Because careful consideration of saf ... Full text Link to item Cite

Platelets and thrombolysis: Cooperation or contrariety?

Journal Article Heartdrug · December 1, 2001 Fibrinolytic therapy is the established treatment for the management of patients with ST elevation acute myocardial infarction (AMI). Present thrombolytic regimens have a number of limitations, including the failure to produce early and sustained reperfusi ... Full text Cite

Short-term trials and long-term effects.

Journal Article Science · September 28, 2001 Full text Link to item Cite

Short-term trials and long-term effects - Response

Journal Article SCIENCE · September 28, 2001 Link to item Cite

Efficacy and safety of tenecteplase in combination with enoxaparin, abciximab, or unfractionated heparin: the ASSENT-3 randomised trial in acute myocardial infarction.

Journal Article Lancet · August 25, 2001 BACKGROUND: Current fibrinolytic therapies fail to achieve optimum reperfusion in many patients. Low-molecular-weight heparins and platelet glycoprotein IIb/IIIa inhibitors have shown the potential to improve pharmacological reperfusion therapy. We did a r ... Full text Link to item Cite

Medicine. Placebo-controls in short-term clinical trials of hypertension.

Journal Article Science · June 15, 2001 Featured Publication Full text Link to item Cite

Risk of major bleeding in patients treated with PTCA early following thrombolysis with TNK vs. t-PA

Journal Article JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · February 1, 2001 Link to item Cite

Platelet function and fibrinolytic agents: two sides of a coin?

Journal Article Cardiology · 2001 Featured Publication Fibrinolytic therapy is the established treatment for the management of patients with ST elevation acute myocardial infarction (AMI). Present fibrinolytic regimens have a number of shortcomings, including the failure to produce early and sustained reperfus ... Full text Link to item Cite

Association between minor elevations of creatine kinase-MB level and mortality in patients with acute coronary syndromes without ST-segment elevation. PURSUIT Steering Committee. Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy.

Journal Article JAMA · January 19, 2000 Featured Publication CONTEXT: Controversy surrounds the diagnostic and prognostic importance of slightly elevated cardiac markers in patients with acute coronary syndromes without ST-segment elevation. OBJECTIVES: To investigate the relationship between peak creatine kinase (C ... Full text Link to item Cite

A protocol of early spiral computed tomography for the detection of stones in patients with renal colic has reduced the time to diagnosis and overall management costs.

Journal Article Aust N Z J Surg · January 2000 Featured Publication BACKGROUND: The recent use of spiral computed tomography (CT) without contrast for the diagnosis of acute flank pain has been shown to be highly sensitive and specific for the detection of urolithiasis. This method has not, however, been evaluated for its ... Full text Link to item Cite

Gastropathy induced by nonsteroidal anti-inflammatory drugs: prescribing patterns among geriatric practitioners.

Journal Article J Am Osteopath Assoc · June 1999 Featured Publication The objective of this study was to determine patterns among geriatric practitioners in prescribing agents that protect the gastrointestinal tract when nonsteroidal anti-inflammatory drug (NSAID) treatment is started for elderly patients. A questionnaire de ... Full text Link to item Cite

Prophylactic lidocaine use in acute myocardial infarction: incidence and outcomes from two international trials. The GUSTO-I and GUSTO-IIb Investigators.

Journal Article Am Heart J · May 1999 Featured Publication BACKGROUND: Early meta-analyses suggested that prophylactic lidocaine use reduces ventricular fibrillation but increases mortality rates after acute myocardial infarction. We determined the frequency and effect on clinical outcomes with its use in the thro ... Full text Link to item Cite

Multicenter randomized trial and a systematic overview of lidocaine in acute myocardial infarction.

Journal Article Am Heart J · May 1999 Featured Publication BACKGROUND: More than 20 randomized trials and 4 meta-analyses have been conducted on the use of prophylactic lidocaine in acute myocardial infarction (MI). The results suggest that lidocaine reduces ventricular fibrillation (VF) but increases mortality ra ... Full text Link to item Cite

Prior aspirin use predicts worse outcomes in patients with non-ST-elevation acute coronary syndromes. PURSUIT Investigators. Platelet IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy.

Journal Article Am J Cardiol · April 15, 1999 Featured Publication Aspirin is beneficial in the prevention and treatment of cardiovascular events, but patients who have events while taking aspirin may have worse outcomes than those not on aspirin. We investigated the association between prior aspirin use and clinical outc ... Full text Link to item Cite

Recent antiplatelet drug trials in the acute coronary syndromes. Clinical interpretation of PRISM, PRISM-PLUS, PARAGON A and PURSUIT.

Journal Article Drugs · December 1998 Featured Publication This paper reviews the results of 4 recent clinical trials, Platelet Receptor inhibition for Ischaemic Syndrome Management (PRISM), Platelet Receptor inhibition for Ischaemic Syndrome Management in Patients Limited to very Unstable Signs and symptoms (PRIS ... Full text Link to item Cite

Combining thrombolysis with the platelet glycoprotein IIb/IIIa inhibitor lamifiban: results of the Platelet Aggregation Receptor Antagonist Dose Investigation and Reperfusion Gain in Myocardial Infarction (PARADIGM) trial.

Journal Article J Am Coll Cardiol · December 1998 OBJECTIVES: The trial was designed to assess the safety, pharmacodynamics and effects on reperfusion of the platelet glycoprotein (GP) IIb/IIIa inhibitor lamifiban when given with thrombolysis to patients with ST segment elevation acute myocardial infarcti ... Full text Link to item Cite

Antiplatelet and antithrombin therapies in the acute coronary syndromes.

Journal Article Curr Opin Cardiol · July 1997 Featured Publication The circulating platelet and the soluble coagulation protein thrombin play key roles in the thrombosis responsible for the acute coronary syndromes. The standard antiplatelet and antithrombin agents used today in patients with acute coronary syndromes are ... Link to item Cite

Relationship of outcomes to treatment with lamifiban in patients undergoing PTCA: Analysis of PARAGON A

Journal Article JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · February 1, 1997 Link to item Cite

Adjunctive Antiplatelet Therapy in Acute Myocardial Infarction: The Road to Improved Infarct-Related Artery Patency.

Journal Article J Thromb Thrombolysis · 1997 Featured Publication A direct relationship exists between infarct artery patency and survival in patients with acute myocardial infarction. Currently available thrombolytic regimens produce 90 minute patency rates on the order of 80%. Preliminary trials suggest that adjunctive ... Full text Link to item Cite

An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction.

Journal Article N Engl J Med · September 2, 1993 BACKGROUND: The relative efficacy of streptokinase and tissue plasminogen activator and the roles of intravenous as compared with subcutaneous heparin as adjunctive therapy in acute myocardial infarction are unresolved questions. The current trial was desi ... Full text Link to item Cite