Scholars@Duke
Karen Patton Alexander

Karen Patton Alexander

Professor of Medicine
Medicine, Cardiology
Duke Box 3411, Durham, NC 27710
200 Morris St, Durham, NC 27701

Selected Publications

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

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

Effects of albiglutide on myocardial infarction and ischaemic heart disease outcomes in patients with type 2 diabetes and cardiovascular disease in the Harmony Outcomes trial.

Journal Article Eur Heart J Cardiovasc Pharmacother · July 16, 2024 AIMS: Large outcome trials have demonstrated cardiovascular benefits of selected glucagon-like peptide-1 (GLP-1) receptor agonists. We examined coronary disease outcomes in the Harmony Outcomes trial of the GLP-1 receptor agonist albiglutide. METHODS AND R ... Full text Link to item Cite

Predictors of outcomes after PCI with incomplete revascularization: Impact of CTO and LAD vessel.

Journal Article Catheter Cardiovasc Interv · July 15, 2024 BACKGROUND: Incomplete revascularization (ICR) after percutaneous coronary intervention (PCI) is associated with mortality and morbidity. AIM: We sought to investigate whether ICR in the left anterior descending artery (LAD) is worse than ICR of the right ... Full text Link to item Cite

RESPONSE: Dispatches From a Neighboring Land.

Journal Article J Am Coll Cardiol · April 23, 2024 Full text Link to item Cite

Sex Differences in Revascularization, Treatment Goals, and Outcomes of Patients With Chronic Coronary Disease: Insights From the ISCHEMIA Trial.

Journal Article J Am Heart Assoc · March 5, 2024 BACKGROUND: Women with chronic coronary disease are generally older than men and have more comorbidities but less atherosclerosis. We explored sex differences in revascularization, guideline-directed medical therapy, and outcomes among patients with chroni ... Full text Link to item Cite

New statin use, mortality, and first cardiovascular events in older US Veterans by frailty status.

Journal Article J Am Geriatr Soc · February 2024 BACKGROUND: Statins are part of long-term medical regimens for many older adults. Whether frailty modifies the protective relationship between statins, mortality, and major adverse cardiovascular events (MACE) is unknown. METHODS: This was a retrospective ... Full text Link to item Cite

Cardiovascular Disease in the Older Adult: Where Are We 4 Decades Later?

Journal Article JACC Adv · February 2024 The 1986 Bethesda Conference on Cardiovascular Disease (CVD) in the Elderly, co-chaired by Drs. Nanette Wenger, Frank Marcus, and Robert O'Rourke, delineated the anticipated social, political, ethical, economic and technological impact of an aging populati ... Full text Link to item Cite

Impact of Complete Revascularization in the ISCHEMIA Trial.

Journal Article J Am Coll Cardiol · September 19, 2023 BACKGROUND: Anatomic complete revascularization (ACR) and functional complete revascularization (FCR) have been associated with reduced death and myocardial infarction (MI) in some prior studies. The impact of complete revascularization (CR) in patients un ... Full text Link to item Cite

Life's Essential 8: Optimizing Health in Older Adults.

Journal Article JACC Adv · September 2023 The population worldwide is getting older as a result of advances in public health, medicine, and technology. Older individuals are living longer with a higher prevalence of subclinical and clinical cardiovascular disease (CVD). In 2010, the American Heart ... Full text Link to item Cite

Complete Revascularization and Angina-Related Health Status in the ISCHEMIA Trial.

Journal Article J Am Coll Cardiol · July 25, 2023 BACKGROUND: The impact of complete revascularization (CR) on angina-related health status (symptoms, function, quality of life) in chronic coronary disease (CCD) has not been well studied. OBJECTIVES: Among patients with CCD randomized to invasive (INV) vs ... Full text Link to item Cite

A Geriatric Approach to Percutaneous Coronary Interventions in Older Adults, Part II: A JACC: Advances Expert Panel.

Journal Article JACC Adv · July 2023 We review a comprehensive risk assessment approach for percutaneous coronary interventions in older adults and highlight the relevance of geriatric syndromes within that broader perspective to optimize patient-centered outcomes in interventional cardiology ... Full text Link to item Cite

Pragmatic evaluation of events and benefits of lipid lowering in older adults (PREVENTABLE): Trial design and rationale.

Journal Article J Am Geriatr Soc · June 2023 Whether initiation of statins could increase survival free of dementia and disability in adults aged ≥75 years is unknown. PREVENTABLE, a double-blind, placebo-controlled randomized pragmatic clinical trial, will compare high-intensity statin therapy (ator ... Full text Link to item Cite

Assessment and Management of Older Adults Undergoing PCI, Part 1: A JACC: Advances Expert Panel.

Journal Article JACC Adv · June 2023 As the population ages, older adults represent an increasing proportion of patients referred to the cardiac catheterization laboratory. Older adults are the highest-risk group for morbidity and mortality, particularly after complex, high-risk percutaneous ... Full text Link to item Cite

Sarcopenia and Cardiovascular Diseases.

Journal Article Circulation · May 16, 2023 Sarcopenia is the loss of muscle strength, mass, and function, which is often exacerbated by chronic comorbidities including cardiovascular diseases, chronic kidney disease, and cancer. Sarcopenia is associated with faster progression of cardiovascular dis ... Full text Link to item Cite

Health Status and Clinical Outcomes in Older Adults With Chronic Coronary Disease: The ISCHEMIA Trial.

Journal Article J Am Coll Cardiol · May 2, 2023 BACKGROUND: Whether initial invasive management in older vs younger adults with chronic coronary disease and moderate or severe ischemia improves health status or clinical outcomes is unknown. OBJECTIVES: The goal of this study was to examine the impact of ... Full text Link to item Cite

Limited English Proficiency in Older Adults Referred to the Cardiovascular Team.

Journal Article Am J Med · May 2023 Limited English proficiency (LEP) is defined as individuals in whom English is not the primary language and who have limited ability to read, speak, write, or understand the English language. Cardiovascular (CV) team members routinely encounter language ba ... Full text Link to item Cite

Readmission and adverse outcomes after percutaneous coronary intervention in patients with dementia.

Journal Article J Am Geriatr Soc · April 2023 BACKGROUND: As the population ages, clinicians increasingly encounter ischemic heart disease in patients with underlying dementia. Therefore, we quantified differences in inhospital adverse events and 30-day readmission rates among patients with and withou ... Full text Link to item Cite

Cause-Specific Mortality in Patients With Advanced Chronic Kidney Disease in the ISCHEMIA-CKD Trial.

Journal Article JACC Cardiovasc Interv · January 23, 2023 BACKGROUND: In ISCHEMIA-CKD, 777 patients with advanced chronic kidney disease and chronic coronary disease had similar all-cause mortality with either an initial invasive or conservative strategy (27.2% vs 27.8%, respectively). OBJECTIVES: This prespecifi ... Full text Link to item Cite

Management of Acute Coronary Syndrome in the Older Adult Population: A Scientific Statement From the American Heart Association.

Journal Article Circulation · January 17, 2023 Diagnostic and therapeutic advances during the past decades have substantially improved health outcomes for patients with acute coronary syndrome. Both age-related physiological changes and accumulated cardiovascular risk factors increase the susceptibilit ... Full text Link to item Cite

Multimorbidity, functional impairment, and mortality in older patients stable after prior acute myocardial infarction: Insights from the TIGRIS registry.

Journal Article Clin Cardiol · December 2022 BACKGROUND: Data on the association of multimorbidity and functional impairment with cardiovascular (CV) and non-CV outcomes among older myocardial infarction (MI) patients are limited. HYPOTHESIS: Multimorbidity and functional impairment among older MI pa ... Full text Link to item Cite

Cardiovascular and Renal Implications of Myocardial Infarction in the ISCHEMIA-CKD Trial.

Journal Article Circ Cardiovasc Interv · August 2022 BACKGROUND: ISCHEMIA-CKD (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches-Chronic Kidney Disease) reported an initial invasive treatment strategy did not reduce the risk of death or nonfatal myocardial infarctio ... Full text Link to item Cite

Geriatric Cardiology: Coming of Age.

Journal Article JACC Adv · August 2022 Older adults with cardiovascular disease (CVD) contend with deficits across multiple domains of health due to age-related physiological changes and the impact of CVD. Multimorbidity, polypharmacy, cognitive changes, and diminished functional capacity, alon ... Full text Link to item Cite

Preexisting frailty and outcomes in older patients with acute myocardial infarction.

Journal Article Am Heart J · July 2022 BACKGROUND: Little is known about the prevalence and prognostic impact of preexisting frailty on acute care and in-hospital outcomes in older adults in the setting of acute myocardial infarction (AMI). METHODS: Preexisting frailty was assessed at baseline ... Full text Link to item Cite

Causes of cardiovascular and noncardiovascular death in the ISCHEMIA trial.

Conference Am Heart J · June 2022 BACKGROUND: The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches trial demonstrated no overall difference in the composite primary endpoint and the secondary endpoints of cardiovascular (CV) death/myocardial infa ... Full text Link to item Cite

Anxiety and Depression Following Aortic Valve Replacement.

Journal Article J Am Heart Assoc · May 3, 2022 Background The aim of this study was to identify patients vulnerable for anxiety and/or depression following aortic valve replacement (AVR) and to evaluate factors that may mitigate this risk. Methods and Results This is a retrospective cohort study conduc ... Full text Link to item Cite

Presenting Symptoms in Patients Undergoing Coronary Artery Disease Evaluation: Association With Noninvasive Test Results and Clinical Outcomes in the PROMISE Trial.

Journal Article Circ Cardiovasc Qual Outcomes · May 2022 BACKGROUND: Patients evaluated for coronary artery disease have a range of symptoms and underlying risk. The relationships between patient-described symptoms, clinician conclusions, and subsequent clinical management and outcomes remain incompletely descri ... Full text Link to item Cite

Comprehensive Quality-of-Life Outcomes With Invasive Versus Conservative Management of Chronic Coronary Disease in ISCHEMIA.

Journal Article Circulation · April 26, 2022 BACKGROUND: ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) compared an initial invasive treatment strategy (INV) with an initial conservative strategy in 5179 participants with chronic coronary disea ... Full text Link to item Cite

Clinical events classification (CEC) in clinical trials: Report on the current landscape and future directions - proceedings from the CEC Summit 2018.

Journal Article Am Heart J · April 2022 IMPORTANCE: Clinical events adjudication is pivotal for generating consistent and comparable evidence in clinical trials. The methodology of event adjudication is evolving, but research is needed to develop best practices and spur innovation. OBSERVATIONS: ... Full text Link to item Cite

Clinical Frailty Scale classes are independently associated with 6-month mortality for patients after acute myocardial infarction.

Journal Article Eur Heart J Acute Cardiovasc Care · February 8, 2022 AIMS: Data on the prognostic value of frailty to guide clinical decision-making for patients with myocardial infarction (MI) are scarce. To analyse the association between frailty classification, treatment patterns, in-hospital outcomes, and 6-month mortal ... Full text Link to item Cite

Effects of initial invasive vs. initial conservative treatment strategies on recurrent and total cardiovascular events in the ISCHEMIA trial.

Journal Article Eur Heart J · January 13, 2022 AIMS: The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial prespecified an analysis to determine whether accounting for recurrent cardiovascular events in addition to first events modified unders ... Full text Link to item Cite

Treatment of older patients with atrial fibrillation by morbidity burden.

Journal Article Eur Heart J Qual Care Clin Outcomes · January 5, 2022 AIMS: Older patients with atrial fibrillation (AF) are at risk of adverse outcomes, which is accentuated by comorbidities. We sought to examine the association between morbidity burden and the treatment of older AF patients. METHODS AND RESULTS: Using Dani ... Full text Link to item Cite

The PRagmatic EValuation of evENTs And Benefits of Lipid-lowering in oldEr adults (PREVENTABLE) trial: Study design and procedures for cognitive assessment and adjudication

Journal Article Alzheimer's and Dementia · December 1, 2021 Background: No existing therapies for Alzheimer’s disease and related dementias fundamentally alter the trajectory of the disease. While observational data suggests statins may reduce cognitive and functional decline in older adults, randomized evidence is ... Full text Cite

Chest Pain Redux: Updated and Patient Centered.

Journal Article Circulation · November 30, 2021 Full text Link to item Cite

Comparison of Days Alive Out of Hospital With Initial Invasive vs Conservative Management: A Prespecified Analysis of the ISCHEMIA Trial.

Journal Article JAMA Cardiol · September 1, 2021 IMPORTANCE: Traditional time-to-event analyses rate events occurring early as more important than later events, even if later events are more severe, eg, death. Days alive out of hospital (DAOH) adds a patient-focused perspective beyond trial end points. O ... 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

Primary Prevention Trial Designs Using Coronary Imaging: A National Heart, Lung, and Blood Institute Workshop.

Journal Article JACC Cardiovasc Imaging · July 2021 Coronary artery calcium (CAC) is considered a useful test for enhancing risk assessment in the primary prevention setting. Clinical trials are under consideration. The National Heart, Lung, and Blood Institute convened a multidisciplinary working group on ... Full text Link to item Cite

Late-life watercolors, a friendship, and a fall.

Journal Article J Am Geriatr Soc · July 2021 Full text Link to item Cite

Myocardial Infarction in the ISCHEMIA Trial: Impact of Different Definitions on Incidence, Prognosis, and Treatment Comparisons.

Journal Article Circulation · February 23, 2021 BACKGROUND: In the ISCHEMIA trial (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches), an initial invasive strategy did not significantly reduce rates of cardiovascular events or all-cause mortality in comparison ... Full text Link to item Cite

Cardiac Myosin Activation with Omecamtiv Mecarbil in Systolic Heart Failure.

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

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

Gerotechnology for Older Adults With Cardiovascular Diseases: JACC State-of-the-Art Review.

Journal Article J Am Coll Cardiol · December 1, 2020 The growing population of older adults (age ≥65 years) is expected to lead to higher rates of cardiovascular disease. The expansion of digital health (encompassing telehealth, telemedicine, mobile health, and remote patient monitoring), Internet access, an ... Full text Link to item Cite

Initial Invasive Versus Conservative Management of Stable Ischemic Heart Disease in Patients With a History of Heart Failure or Left Ventricular Dysfunction: Insights From the ISCHEMIA Trial.

Journal Article Circulation · November 3, 2020 BACKGROUND: Whether an initial invasive strategy in patients with stable ischemic heart disease and at least moderate ischemia improves outcomes in the setting of a history of heart failure (HF) or left ventricular dysfunction (LVD) when ejection fraction ... Full text Link to item Cite

Management of Coronary Disease in Patients with Advanced Kidney Disease.

Journal Article N Engl J Med · April 23, 2020 BACKGROUND: Clinical trials that have assessed the effect of revascularization in patients with stable coronary disease have routinely excluded those with advanced chronic kidney disease. METHODS: We randomly assigned 777 patients with advanced kidney dise ... Full text Link to item Cite

Health-Status Outcomes with Invasive or Conservative Care in Coronary Disease.

Journal Article N Engl J Med · April 9, 2020 BACKGROUND: In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial ... Full text Link to item Cite

Initial Invasive or Conservative Strategy for Stable Coronary Disease.

Journal Article N Engl J Med · April 9, 2020 BACKGROUND: Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. M ... Full text Link to item Cite

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

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

Age-Related Differences in the Noninvasive Evaluation for Possible Coronary Artery Disease: Insights From the Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) Trial.

Journal Article JAMA Cardiol · February 1, 2020 IMPORTANCE: Although cardiovascular (CV) disease represents the leading cause of morbidity and mortality that increases with age, the best noninvasive test to identify older patients at risk for CV events remains unknown. OBJECTIVE: To determine whether th ... Full text Link to item Cite

Older Adults in the Cardiac Intensive Care Unit: Factoring Geriatric Syndromes in the Management, Prognosis, and Process of Care: A Scientific Statement From the American Heart Association.

Journal Article Circulation · January 14, 2020 Longevity is increasing, and more adults are living to the stage of life when age-related biological factors determine a higher likelihood of cardiovascular disease in a distinctive context of concurrent geriatric conditions. Older adults with cardiovascul ... Full text Link to item Cite

Age, knowledge, preferences, and risk tolerance for invasive cardiac care.

Journal Article Am Heart J · January 2020 BACKGROUND/OBJECTIVES: The extent to which individual knowledge, preferences, and priorities explain lower use of invasive cardiac care among older vs. younger adults presenting with acute coronary syndrome (ACS) is unknown. We directly surveyed a group of ... Full text Link to item Cite

Perspectives on Implementing a Multidomain Approach to Caring for Older Adults With Heart Failure.

Journal Article J Am Geriatr Soc · December 2019 BACKGROUND/OBJECTIVES: The American College of Cardiology (ACC) Geriatric Cardiology Section Leadership Council recently outlined 4 key domains (which are composed of 14 subdomains) that are important to assess in older adults with heart failure (HF). We s ... Full text Link to item Cite

Baseline Predictors of Low-Density Lipoprotein Cholesterol and Systolic Blood Pressure Goal Attainment After 1 Year in the ISCHEMIA Trial.

Journal Article Circ Cardiovasc Qual Outcomes · November 2019 BACKGROUND: Risk factor control is the cornerstone of managing stable ischemic heart disease but is often not achieved. Predictors of risk factor control in a randomized clinical trial have not been described. METHODS AND RESULTS: The ISCHEMIA trial (Inter ... Full text Link to item Cite

Sex-Based Differences in Presentation, Treatment, and Complications Among Older Adults Hospitalized for Acute Myocardial Infarction: The SILVER-AMI Study.

Journal Article Circ Cardiovasc Qual Outcomes · October 2019 BACKGROUND: Studies of sex-based differences in older adults with acute myocardial infarction (AMI) have yielded mixed results. We, therefore, sought to evaluate sex-based differences in presentation characteristics, treatments, functional impairments, and ... Full text Link to item Cite

Association of Cognitive Impairment With Treatment and Outcomes in Older Myocardial Infarction Patients: A Report From the NCDR Chest Pain-MI Registry.

Journal Article J Am Heart Assoc · September 3, 2019 Background Little is known regarding use of cardiac therapies and clinical outcomes among older myocardial infarction (MI) patients with cognitive impairment. Methods and Results Patients ≥65 years old with MI in the NCDR (National Cardiovascular Data Regi ... Full text Link to item Cite

Effects of alirocumab on cardiovascular and metabolic outcomes after acute coronary syndrome in patients with or without diabetes: a prespecified analysis of the ODYSSEY OUTCOMES randomised controlled trial.

Journal Article Lancet Diabetes Endocrinol · August 2019 BACKGROUND: After acute coronary syndrome, diabetes conveys an excess risk of ischaemic cardiovascular events. A reduction in mean LDL cholesterol to 1·4-1·8 mmol/L with ezetimibe or statins reduces cardiovascular events in patients with an acute coronary ... Full text Link to item Cite

Deprescribing in Older Adults With Cardiovascular Disease.

Journal Article J Am Coll Cardiol · May 28, 2019 Deprescribing, an integral component of a continuum of good prescribing practices, is the process of medication withdrawal or dose reduction to correct or prevent medication-related complications, improve outcomes, and reduce costs. Deprescribing is partic ... Full text Link to item Cite

Relationship Between Optimism and Outcomes in Patients With Chronic Angina Pectoris.

Journal Article Am J Cardiol · May 1, 2019 Greater optimism regarding recovery from chronic illness is associated with improved quality of life and clinical outcomes. We performed a post-hoc analysis on the association between optimism and outcomes in Ranolazine in Patients with Incomplete Revascul ... Full text Link to item Cite

Thirty-Day Readmission Risk Model for Older Adults Hospitalized With Acute Myocardial Infarction.

Journal Article Circ Cardiovasc Qual Outcomes · May 2019 BACKGROUND: Early readmissions among older adults hospitalized for acute myocardial infarction (AMI) are costly and difficult to predict. Aging-related functional impairments may inform risk prediction but are unavailable in most studies. Our objective was ... Full text Link to item Cite

Sex And Prognostic Significance of Self-Reported Frailty in Non-ST-Segment Elevation Acute Coronary Syndromes: Insights From the TRILOGY ACS Trial.

Journal Article Can J Cardiol · April 2019 BACKGROUND: The effect of sex on self-reported frailty in acute coronary syndromes (ACS) is unclear. We examined the prevalence of self-reported frailty and its association with all-cause death among men and women. METHODS: Elderly (≥ 65 years) male (n = 2 ... Full text Link to item Cite

Correction

Journal Article JACC: Cardiovascular Interventions · April 2019 Full text Cite

Baseline Characteristics and Risk Profiles of Participants in the ISCHEMIA Randomized Clinical Trial.

Journal Article JAMA Cardiol · March 1, 2019 IMPORTANCE: It is unknown whether coronary revascularization, when added to optimal medical therapy, improves prognosis in patients with stable ischemic heart disease (SIHD) at increased risk of cardiovascular events owing to moderate or severe ischemia. O ... 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

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

Gait Speed and 1-Year Mortality Following Cardiac Surgery: A Landmark Analysis From the Society of Thoracic Surgeons Adult Cardiac Surgery Database.

Journal Article J Am Heart Assoc · December 4, 2018 Background In older adults undergoing cardiac surgery, prediction of downstream risk is critical. Our objective was to determine the association of 5-m gait speed with 1-year mortality and repeat hospitalization following cardiac surgery. Methods and Resul ... 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

The Association of Frailty With In-Hospital Bleeding Among Older Adults With Acute Myocardial Infarction: Insights From the ACTION Registry.

Journal Article JACC Cardiovasc Interv · November 26, 2018 OBJECTIVES: The aim of this study was to determine whether frailty is associated with increased bleeding risk in the setting of acute myocardial infarction (AMI). BACKGROUND: Frailty is a common syndrome in older adults. METHODS: Frailty was examined among ... Full text Link to item Cite

International Study of Comparative Health Effectiveness with Medical and Invasive Approaches-Chronic Kidney Disease (ISCHEMIA-CKD): Rationale and design.

Journal Article Am Heart J · November 2018 BACKGROUND: Patients with chronic kidney disease (CKD) and stable ischemic heart disease are at markedly increased risk of cardiovascular events. Prior trials comparing a strategy of optimal medical therapy (OMT) with or without revascularization have larg ... Full text Link to item Cite

Frailty as an instrument for evaluation of elderly patients with non-ST-segment elevation myocardial infarction: A follow-up after more than 5 years.

Journal Article Eur J Prev Cardiol · November 2018 BACKGROUND: There is a growing body of evidence on the relevance of using frailty measures also in a cardiovascular context. The estimated time to death is crucial in clinical decision-making in cardiology. However, data on the importance of frailty in lon ... Full text Link to item Cite

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

Journal Article Lancet · October 27, 2018 BACKGROUND: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine t ... Full text Link to item Cite

Individual and Joint Effects of Pulse Pressure and Blood Pressure Treatment Intensity on Serious Adverse Events in the SPRINT Trial.

Journal Article Am J Med · October 2018 PURPOSE: The objective of this study was to determine individual and joint effects of pulse pressure and blood pressure treatment intensity on serious adverse events in the Systolic Blood Pressure Intervention Trial. METHODS: Pulse pressure was calculated ... Full text Link to item Cite

Frailty and Outcomes After Myocardial Infarction: Insights From the CONCORDANCE Registry.

Journal Article J Am Heart Assoc · September 18, 2018 Background Little is known about the prognostic implications of frailty, a state of susceptibility to stressors and poor recovery to homeostasis in older people, after myocardial infarction ( MI ). Methods and Results We studied 3944 MI patients aged ≥65 y ... Full text Link to item Cite

International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial: Rationale and design.

Journal Article Am Heart J · July 2018 BACKGROUND: Prior trials comparing a strategy of optimal medical therapy with or without revascularization have not shown that revascularization reduces cardiovascular events in patients with stable ischemic heart disease (SIHD). However, those trials only ... Full text Link to item Cite

Coronary Artery Disease in Patients ≥80 Years of Age.

Journal Article J Am Coll Cardiol · May 8, 2018 Coronary artery disease (CAD) is a major cause of morbidity and mortality in patients ≥80 years of age. Nonetheless, older patients have typically been under-represented in cardiovascular clinical trials. Understanding the pathophysiology, epidemiology, an ... Full text Link to item Cite

Domain Management Approach to Heart Failure in the Geriatric Patient: Present and Future.

Journal Article J Am Coll Cardiol · May 1, 2018 Heart failure (HF) is a quintessential geriatric cardiovascular condition, with more than 50% of hospitalizations occurring in adults age 75 years or older. In older patients, HF is closely linked to processes inherent to aging, which include cellular and ... Full text Link to item Cite

ISCHEMIA: Establishing the Primary End Point.

Journal Article Circ Cardiovasc Qual Outcomes · May 2018 Full text Link to item Cite

Relation of Age and Health-Related Quality of Life to Invasive Versus Ischemia-Guided Management of Patients with Non-ST Elevation Myocardial Infarction.

Journal Article Am J Cardiol · April 1, 2018 In older patients with non-ST-elevation myocardial infarction, an initial invasive strategy reduces cardiovascular events compared with an ischemia-guided approach; however its association with health status outcomes is unknown. Among patients with non-ST- ... Full text Link to item Cite

Slow Gait Speed and Cardiac Rehabilitation Participation in Older Adults After Acute Myocardial Infarction.

Journal Article J Am Heart Assoc · February 24, 2018 BACKGROUND: Lack of participation in cardiac rehabilitation (CR) and slow gait speed have both been associated with poor long-term outcomes in older adults after acute myocardial infarction (AMI). Whether the effect of CR participation on outcomes after AM ... Full text Link to item Cite

Clinical features and outcomes of patients with type 2 myocardial infarction: Insights from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) trial.

Journal Article Am Heart J · February 2018 BACKGROUND: Type 2 myocardial infarction (MI) is characterized by an imbalance between myocardial blood supply and demand, leading to myocardial ischemia without coronary plaque rupture, but its diagnosis is challenging. METHODS: In the TRACER trial, patie ... Full text Link to item Cite

Assessing Frailty in Patients Undergoing Destination Therapy Left Ventricular Assist Device: Observations from Interagency Registry for Mechanically Assisted Circulatory Support.

Journal Article ASAIO J · 2018 Frailty and heart failure share common pathways with symptoms that often coexist. Assessment of frailty may inform patient selection for left ventricular assist device (LVAD) therapy. Using Interagency Registry for Mechanically Assisted Circulatory Support ... Full text Link to item Cite

Contextualizing Myocardial Infarction: Comorbidities and Priorities in Older Adults.

Journal Article Am J Med · October 2017 Cardiovascular care for older adults has become increasingly complex owing to a rise in the concurrent comorbidity burden that accompanies senescence. Internists, hospitalists, and cardiologists often encounter geriatric patients with multiple chronic cond ... Full text Link to item Cite

Walking as a Window to Risk and Resiliency.

Journal Article Circulation · August 15, 2017 Full text Link to item Cite

Use of troponin assay 99th percentile as the decision level for myocardial infarction diagnosis.

Journal Article Am Heart J · August 2017 BACKGROUND: The Universal Definition of Myocardial Infarction recommends the 99th percentile concentration of cardiac troponin in a normal reference population as part of the decision threshold to diagnose type 1 spontaneous myocardial infarction. Adoption ... Full text Link to item Cite

Revascularization Strategies and Outcomes in Elderly Patients With Multivessel Coronary Disease.

Journal Article Ann Thorac Surg · July 2017 BACKGROUND: Balancing risks and benefits of revascularization in elderly patients with multivessel coronary artery disease (CAD) is challenging. The appropriate revascularization strategy for elderly patients with multivessel CAD is unclear. METHODS: We us ... Full text Link to item Cite

The obesity paradox, extreme obesity, and long-term outcomes in older adults with ST-segment elevation myocardial infarction: results from the NCDR.

Journal Article Eur Heart J Qual Care Clin Outcomes · July 1, 2017 AIMS: To investigate the obesity paradox and association of extreme obesity with long-term outcomes among older ST-segment elevation myocardial infarction (STEMI) patients. METHODS AND RESULTS: Nineteen thousand four hundred and ninety-nine patients ≥65 ye ... Full text Link to item Cite

Low-Hanging Fruit for a Healthy Old Age.

Journal Article J Am Coll Cardiol · June 27, 2017 Full text Link to item Cite

Ranolazine After Incomplete Percutaneous Coronary Revascularization in Patients With Versus Without Diabetes Mellitus: RIVER-PCI Trial.

Journal Article J Am Coll Cardiol · May 9, 2017 BACKGROUND: Chronic angina is more common in patients with diabetes mellitus (DM) with poor glucose control. Ranolazine both treats chronic angina and improves glucose control. OBJECTIVES: This study sought to examine ranolazine's antianginal effect in rel ... 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

Knowledge Gaps in Cardiovascular Care of Older Adults: A Scientific Statement from the American Heart Association, American College of Cardiology, and American Geriatrics Society: Executive Summary.

Journal Article J Am Geriatr Soc · November 2016 The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease (CVD) is the leading cause of death and major disability in adults aged 75 and older. Despite the effect of CVD on quality of life, morbidity, and m ... Full text Link to item Cite

Frailty: A Vital Sign for Older Adults With Cardiovascular Disease.

Journal Article Can J Cardiol · September 2016 Mechanisms of aging predispose to cardiovascular disease (CVD), as well as to aggregate health challenges. For older adults, CVD is likely to exist in combination with comorbid conditions, disability, polypharmacy, falling risks, and body composition chang ... Full text Link to item Cite

Predictors of Physician Under-Recognition of Angina in Outpatients With Stable Coronary Artery Disease.

Journal Article Circ Cardiovasc Qual Outcomes · September 2016 BACKGROUND: Under-recognition of angina by physicians may result in undertreatment with revascularization or medications that could improve patients' quality of life. We sought to describe characteristics associated with under-recognition of patients' angi ... Full text Link to item Cite

Effect of age on efficacy and safety of vorapaxar in patients with non-ST-segment elevation acute coronary syndrome: Insights from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) trial.

Journal Article Am Heart J · August 2016 BACKGROUND: Antithrombotic therapy plays an important role in the treatment of non-ST-segment elevation acute coronary syndromes (NSTE ACS) but is associated with bleeding risk. Advanced age may modify the relationship between efficacy and safety. METHODS: ... Full text Link to item Cite

Frailty is associated with worse outcomes in non-ST-segment elevation acute coronary syndromes: Insights from the TaRgeted platelet Inhibition to cLarify the Optimal strateGy to medicallY manage Acute Coronary Syndromes (TRILOGY ACS) trial.

Journal Article Eur Heart J Acute Cardiovasc Care · June 2016 AIMS: Little is known regarding consequences of frailty in patients with acute coronary syndrome (ACS). We assessed the associations of frailty and outcomes in ACS patients who were participating in a clinical trial. METHODS AND RESULTS: The TaRgeted plate ... Full text Link to item Cite

Gait Speed and Operative Mortality in Older Adults Following Cardiac Surgery.

Journal Article JAMA Cardiol · June 1, 2016 IMPORTANCE: Prediction of operative risk is a critical step in decision making for cardiac surgery. Existing risk models may be improved by integrating a measure of frailty, such as 5-m gait speed, to better capture the heterogeneity of the older adult pop ... Full text Link to item Cite

Knowledge Gaps in Cardiovascular Care of the Older Adult Population: A Scientific Statement From the American Heart Association, American College of Cardiology, and American Geriatrics Society.

Journal Article J Am Coll Cardiol · May 24, 2016 The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease is the leading cause of death and major disability in adults ≥75 years of age; however, despite the large impact of cardiovascular disease on qualit ... Full text Link to item Cite

Knowledge Gaps in Cardiovascular Care of the Older Adult Population: A Scientific Statement From the American Heart Association, American College of Cardiology, and American Geriatrics Society.

Journal Article Circulation · May 24, 2016 The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease is the leading cause of death and major disability in adults ≥75 years of age; however, despite the large impact of cardiovascular disease on qualit ... Full text Link to item Cite

Multiple Chronic Conditions in Older Adults with Acute Coronary Syndromes.

Journal Article Clin Geriatr Med · May 2016 Older adults presenting with acute coronary syndromes (ACSs) often have multiple chronic conditions (MCCs). In addition to traditional cardiovascular (CV) risk factors (ie, hypertension, hyperlipidemia, and diabetes), common CV comorbidities include heart ... Full text Link to item Cite

Assessing Quality of Life and Medical Care in Chronic Angina: An Internet Survey.

Journal Article Interact J Med Res · April 28, 2016 BACKGROUND: Angina is a clinical syndrome whose recognition relies heavily on self-report, so its identification can be challenging. Most data come from cohorts identified by physicians and nurses at the point of care; however, current widespread access to ... 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

Gait Speed Predicts 30-Day Mortality After Transcatheter Aortic Valve Replacement: Results From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.

Journal Article Circulation · April 5, 2016 BACKGROUND: Surgical risk scores do not include frailty assessments (eg, gait speed), which are of particular importance for patients with severe aortic stenosis considering transcatheter aortic valve replacement. METHODS AND RESULTS: We assessed the assoc ... 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

Exploring the Nexus Between Chronic Kidney Disease and Cardiovascular Disease.

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

Slow Gait Speed and Risk of Mortality or Hospital Readmission After Myocardial Infarction in the Translational Research Investigating Underlying Disparities in Recovery from Acute Myocardial Infarction: Patients' Health Status Registry.

Journal Article J Am Geriatr Soc · March 2016 OBJECTIVES: To determine the prognostic value of slow gait in predicting outcomes 1 year after acute myocardial infarction (AMI). DESIGN: Observational cohort with longitudinal follow-up. SETTING: Twenty-four U.S. hospitals participating in the Translation ... Full text Link to item Cite

Acute coronary syndrome in the older adults.

Journal Article J Geriatr Cardiol · February 2016 Full text Link to item Cite

Ranolazine in patients with incomplete revascularisation after percutaneous coronary intervention (RIVER-PCI): a multicentre, randomised, double-blind, placebo-controlled trial.

Journal Article Lancet · January 9, 2016 BACKGROUND: Incomplete revascularisation is common after percutaneous coronary intervention and is associated with increased mortality and adverse cardiovascular events. We aimed to assess whether adjunctive anti-ischaemic pharmacotherapy with ranolazine w ... Full text Link to item Cite

Effects of Ranolazine on Angina and Quality of Life After Percutaneous Coronary Intervention With Incomplete Revascularization: Results From the Ranolazine for Incomplete Vessel Revascularization (RIVER-PCI) Trial.

Journal Article Circulation · January 5, 2016 BACKGROUND: Angina often persists or returns in populations following percutaneous coronary intervention (PCI). We hypothesized that ranolazine would be effective in reducing angina and improving quality of life (QOL) in incomplete revascularization (ICR) ... Full text Link to item Cite

Trends in use of anti-thrombotic agents and outcomes in patients with non-ST-segment elevation myocardial infarction (NSTEMI) managed with an invasive strategy.

Journal Article Indian Heart J · 2016 OBJECTIVE: To analyze trends in utilization of anti-thrombotic agents (ATA) and in-hospital clinical outcomes in non-ST-elevation myocardial infarction (NSTEMI) patients managed with an invasive strategy from 2007 to 2010. METHODS & RESULTS: Using ACTION R ... Full text Link to item Cite

Improved Cardiovascular Disease Outcomes in Older Adults.

Journal Article F1000Res · 2016 Longevity is increasing and the population of older adults is growing. The biology of aging is conducive to cardiovascular disease (CVD), such that prevalence of coronary artery disease, heart failure, valvular heart disease, arrhythmia and other disorders ... Full text Link to item Cite

Effect of angina under-recognition on treatment in outpatients with stable ischaemic heart disease.

Journal Article Eur Heart J Qual Care Clin Outcomes · 2016 AIMS: Almost a third of outpatients with chronic coronary artery disease (CAD) report having angina in the prior month, which is frequently under-recognized by their cardiologists. Whether under-recognition is associated with less treatment escalation to c ... Full text Link to item Cite

The Association of Transfer Rate From Hospitals Without Revascularization Capabilities and Mortality Risk for Older Non-ST-Segment Elevation Myocardial Infarction Patients.

Journal Article Clin Cardiol · December 2015 BACKGROUND: Interhospital transfer invasive management patterns and implications for older non-ST-segment elevation myocardial infarction (NSTEMI) patients initially presenting to non-revascularization-capable hospitals have not been explored. HYPOTHESIS: ... Full text Link to item Cite

The Contemporary Use of Angiography and Revascularization Among Patients With Non-ST-Segment Elevation Myocardial Infarction in the United States Compared With South Korea.

Journal Article Clin Cardiol · December 2015 BACKGROUND: Practice guidelines recommend an early invasive strategy for high-risk non-ST-segment elevation myocardial infarction (NSTEMI) patients, but international differences in the use of invasive strategies are unknown. HYPOTHESIS: Profiling NSTEMI p ... Full text Link to item Cite

Cognitive and Physical Function by Statin Exposure in Elderly Individuals Following Acute Myocardial Infarction.

Journal Article Clin Cardiol · August 2015 Despite beneficial effects on morbidity and mortality after acute myocardial infarction (AMI), concerns remain about the safety of statin therapy, particularly their potential effects on cognitive and physical function, in elderly individuals. Among statin ... Full text Link to item Cite

Frequency and Effects of Excess Dosing of Anticoagulants in Patients ≤55 Years With Acute Myocardial Infarction Who Underwent Percutaneous Coronary Intervention (from the VIRGO Study).

Journal Article Am J Cardiol · July 1, 2015 Excess dosing of anticoagulant agents has been linked to increased risk of bleeding after percutaneous coronary intervention (PCI) for women compared with men, but these studies have largely included older patients. We sought to determine the prevalence an ... Full text Link to item Cite

Statin Treatment by Low-Density Lipoprotein Cholesterol Levels in Patients With Non-ST-Segment Elevation Myocardial Infarction/Unstable Angina Pectoris (from the CRUSADE Registry).

Journal Article Am J Cardiol · June 15, 2015 Elevated low-density lipoprotein cholesterol (LDL-C) is associated with increased risk of myocardial infarction and is a target for disease prevention. The association between initial LDL-C and statin treatment in patients with non-ST-segment elevation myo ... Full text Link to item Cite

Hospital variability in use of anticoagulant strategies during acute myocardial infarction treated with an early invasive strategy.

Journal Article J Am Heart Assoc · June 15, 2015 BACKGROUND: During a myocardial infarction, no single best approach of systemic anticoagulation is recommended, likely due to a lack of comparative effectiveness studies and trade-offs between treatments. METHODS AND RESULTS: We investigated the patterns o ... Full text Link to item Cite

Cumulative incidence of death and rehospitalization among the elderly in the first year after NSTEMI.

Journal Article Am J Med · June 2015 BACKGROUND: Age is associated with outcomes in non-ST-segment elevation myocardial infarction; however, less is known about rehospitalization or death among elderly survivors. We aimed to evaluate mortality and cause-specific rehospitalization rates in thi ... Full text Link to item Cite

Doing the right things and doing them the right way: association between hospital guideline adherence, dosing safety, and outcomes among patients with acute coronary syndrome.

Journal Article Circulation · March 17, 2015 BACKGROUND: Performance metrics currently focus on the measurement of the application of guideline-indicated medications without considering the appropriate dosing of these drugs. METHODS AND RESULTS: We studied 39 291 patients from the Can Rapid Risk Stra ... Full text Link to item Cite

Targeted versus standard feedback: results from a randomized quality improvement trial.

Journal Article Am Heart J · January 2015 BACKGROUND: Quality improvement is central to improving the care of patients with cardiovascular disease; however, the optimum type of data feedback to support such efforts is unknown. METHODS: Over 26 months, 149 eligible Acute Coronary Treatment and Inte ... Full text Link to item Cite

Accuracy of bleeding scores for patients presenting with myocardial infarction: a meta-analysis of 9 studies and 13 759 patients.

Journal Article Postepy Kardiol Interwencyjnej · 2015 INTRODUCTION: Due to its negative impact on prognosis, a clear assessment of bleeding risk for patients presenting with acute coronary syndrome (ACS) remains crucial. Different risk scores have been proposed and compared, although with inconsistent results ... Full text Link to item Cite

The association of myocardial infarction process of care measures and in-hospital mortality: a report from the NCDR®.

Journal Article Am Heart J · November 2014 BACKGROUND: The Center for Medicare and Medicaid Services (CMS) publicly reports "core process of care measures" along with 30-day mortality rates for patients with acute myocardial infarction; the American College of Cardiology/American Heart Association ... Full text Link to item Cite

Clinical outcomes with β-blockers for myocardial infarction: a meta-analysis of randomized trials.

Journal Article Am J Med · October 2014 BACKGROUND: Debate exists about the efficacy of β-blockers in myocardial infarction and their required duration of usage in contemporary practice. METHODS: We conducted a MEDLINE/EMBASE/CENTRAL search for randomized trials evaluating β-blockers in myocardi ... Full text Link to item Cite

The challenges with chronic angina.

Journal Article N Engl J Med · September 18, 2014 Full text Link to item Cite

Contemporary patterns of discharge aspirin dosing after acute myocardial infarction in the United States: results from the National Cardiovascular Data Registry (NCDR).

Journal Article Circ Cardiovasc Qual Outcomes · September 2014 BACKGROUND: Accumulated data suggest that low-dose aspirin after myocardial infarction (MI) may offer similar efficacy to higher dose aspirin with reduced risk of bleeding. Few data are available on contemporary aspirin dosing patterns after MI in the Unit ... Full text Link to item Cite

Blood transfusion during acute myocardial infarction: association with mortality and variability across hospitals.

Journal Article J Am Coll Cardiol · August 26, 2014 BACKGROUND: Blood transfusion is controversial for anemic patients with acute myocardial infarction (AMI), with some previous studies reporting increased risk of transfusion-associated mortality. OBJECTIVES: The goal of this study was to examine variabilit ... Full text Link to item Cite

In-hospital switching between clopidogrel and prasugrel among patients with acute myocardial infarction treated with percutaneous coronary intervention: insights into contemporary practice from the national cardiovascular data registry.

Journal Article Circ Cardiovasc Interv · August 2014 BACKGROUND: Although randomized clinical trials have compared clopidogrel with higher potency ADP receptor inhibitors (ADPris) among patients with myocardial infarction, little is known about the frequency and factors associated with switching between ADPr ... Full text Link to item Cite

Futility, benefit, and transcatheter aortic valve replacement.

Journal Article JACC Cardiovasc Interv · July 2014 Transcatheter aortic valve replacement (TAVR) is a transformative innovation that provides treatment for high or prohibitive surgical risk patients with symptomatic severe aortic stenosis who either were previously not referred for or were denied operative ... Full text Link to item Cite

The quality of antiplatelet and anticoagulant medication administration among ST-segment elevation myocardial infarction patients transferred for primary percutaneous coronary intervention.

Journal Article Am Heart J · June 2014 BACKGROUND: Timely and appropriate use of antiplatelet and anticoagulant therapies has been shown to improve outcomes among ST-segment elevation myocardial infarction (STEMI) patients but has not been well described in patients transferred for primary perc ... Full text Link to item Cite

Implications of prior myocardial infarction for patients presenting with an acute myocardial infarction.

Journal Article Am Heart J · June 2014 BACKGROUND: Prior myocardial infarction (MI) is a known risk factor for long-term mortality among acute MI patients; but its prevalence and implications for the short-term outcomes of patients with a new, acute MI remain uncertain. METHODS: We studied a to ... Full text Link to item Cite

Do patients treated at academic hospitals have better longitudinal outcomes after admission for non-ST-elevation myocardial infarction?

Journal Article Am Heart J · May 2014 BACKGROUND: Prior studies have found that academic hospitals provide more consistent use of guideline-recommended therapies in patients with non-ST-segment myocardial infarction (NSTEMI) compared with nonacademic centers, yet it is unclear whether these ca ... Full text Link to item Cite

Frailty assessment in the cardiovascular care of older adults.

Journal Article J Am Coll Cardiol · March 4, 2014 Due to the aging and increasingly complex nature of our patients, frailty has become a high-priority theme in cardiovascular medicine. Despite the recognition of frailty as a pivotal element in the evaluation of older adults with cardiovascular disease (CV ... Full text Link to item Cite

Sources of hospital-level variation in major bleeding among patients with non-st-segment elevation myocardial infarction: a report from the National Cardiovascular Data Registry (NCDR).

Journal Article Circ Cardiovasc Qual Outcomes · March 2014 BACKGROUND: Major bleeding has received increasing attention as a target for quality improvement in care of patients with acute myocardial infarction. However, little is known about variation in bleeding across hospitals and whether variation is attributab ... Full text Link to item Cite

Reperfusion times and in-hospital outcomes among patients with an isolated posterior myocardial infarction: insights from the National Cardiovascular Data Registry (NCDR).

Journal Article Am Heart J · March 2014 BACKGROUND: A posterior myocardial infarction (PMI) is associated with significant morbidity and delays in recognition may prevent the timely revascularization of these patients. The present study sought to evaluate the reperfusion times and in-hospital ou ... Full text Link to item Cite

Influence of heart failure symptoms and ejection fraction on short- and long-term outcomes for older patients with non-ST-segment elevation myocardial infarction.

Journal Article Am Heart J · February 2014 BACKGROUND: Symptomatic heart failure (HF) and reduced ejection fraction (REF) are both associated with mortality, but the long-term outcomes associated with the development of HF in older non-ST-segment elevation myocardial infarction (NSTEMI) patients wi ... Full text Link to item Cite

Trends in outcomes among older patients with non-ST-segment elevation myocardial infarction.

Journal Article Am Heart J · January 2014 OBJECTIVES: The objective of this study is to assess trends in evidence-based therapy use and short- and long-term mortality over time among older patients with non-ST-segment elevation myocardial infarction (NSTEMI). BACKGROUND: With the prevalence of nat ... Full text Link to item Cite

Association of body mass index and long-term outcomes in older patients with non-ST-segment-elevation myocardial infarction: results from the CRUSADE Registry.

Journal Article Circ Cardiovasc Qual Outcomes · January 2014 BACKGROUND: Prior studies have found that obese patients have paradoxically lower in-hospital mortality after non-ST-segment-elevation myocardial infarction than their normal-weight counterparts, yet whether these associations persist long term is unknown. ... Full text Link to item Cite

Balancing the risk of mortality and major bleeding in the treatment of NSTEMI patients - a report from the National Cardiovascular Data Registry.

Journal Article Am Heart J · December 2013 OBJECTIVES: We sought to describe real-world patterns of care in NSTEMI patients across different risk profiles for bleeding and mortality. BACKGROUND: The NCDR ACTION Registry-GWTG in-hospital mortality and major bleeding risk scores were developed to ass ... Full text Link to item Cite

Use of ranolazine in patients with incomplete revascularization after percutaneous coronary intervention: design and rationale of the Ranolazine for Incomplete Vessel Revascularization Post-Percutaneous Coronary Intervention (RIVER-PCI) trial.

Journal Article Am Heart J · December 2013 BACKGROUND: Incomplete revascularization (ICR) after percutaneous coronary intervention (PCI) is common and is associated with increased rates of rehospitalization, revascularization, and mortality. Adjunctive pharmacotherapy with ranolazine, an inhibitor ... Full text Link to item Cite

The association between smoking and long-term outcomes after non-ST-segment elevation myocardial infarction in older patients.

Journal Article Am Heart J · December 2013 BACKGROUND: Prior studies have observed that smokers have paradoxically favorable 1-year mortality rates after acute coronary syndromes, but it is unknown whether this association extends to long-term outcomes and to older patients. METHODS: We identified ... Full text Link to item Cite

Use of aldosterone antagonists at discharge after myocardial infarction: results from the National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network (ACTION) Registry-Get with the Guidelines (GWTG).

Journal Article Am Heart J · October 2013 BACKGROUND: Aldosterone antagonists (AldA) improve survival after myocardial infarction (MI) in patients with left ventricular systolic dysfunction (ejection fraction [EF] <40%) concomitant with either clinical heart failure (HF) or diabetes mellitus (DM). ... Full text Link to item Cite

Portfolio of clinical research in adult cardiovascular disease as reflected in ClinicalTrials.gov.

Journal Article J Am Heart Assoc · September 26, 2013 BACKGROUND: Cardiovascular medicine is widely regarded as a vanguard for evidence-based drug and technology development. Our goal was to describe the cardiovascular clinical research portfolio from ClinicalTrials.gov. METHODS AND RESULTS: We identified 40 ... Full text Open Access Link to item Cite

Aortic stenosis: What long-term care providers need to know

Journal Article Annals of Long-Term Care · September 1, 2013 Aortic stenosis (AS) can be congenital or degenerative, with the latter resulting from calcification of the aortic valve over time. Degenerative calcific AS is the most common form of AS among older adults in the United States. As the population continues ... Cite

Long-term outcomes among older patients with non-ST-segment elevation myocardial infarction complicated by cardiogenic shock.

Journal Article Am Heart J · August 2013 BACKGROUND: Cardiogenic shock complicating acute myocardial infarction (MI) in older patients is associated with a high risk of inhospital mortality; however, the long-term prognosis among these patients who survive the index hospitalization is uncertain. ... Full text Link to item Cite

Nuisance bleeding with prolonged dual antiplatelet therapy after acute myocardial infarction and its impact on health status.

Journal Article J Am Coll Cardiol · May 28, 2013 OBJECTIVES: The purpose of this study was to examine the incidence of nuisance bleeding after AMI and its impact on QOL. BACKGROUND: Prolonged dual antiplatelet therapy (DAPT) is recommended after acute myocardial infarction (AMI) to reduce ischemic events ... Full text Link to item Cite

The reply.

Journal Article Am J Med · May 2013 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

Long-term outcomes after invasive management for older patients with non-ST-segment elevation myocardial infarction.

Journal Article Circ Cardiovasc Qual Outcomes · May 1, 2013 BACKGROUND: Early invasive management is recommended for patients with non-ST-segment elevation myocardial infarction (MI), but the incidence of long-term outcomes after early catheterization among older patients and the relationship of revascularization p ... Full text Link to item Cite

Characteristics and in-hospital outcomes of patients with non-ST-segment elevation myocardial infarction undergoing an invasive strategy according to hemoglobin levels.

Journal Article Am J Cardiol · April 15, 2013 The benefit of an invasive strategy in non-ST-segment elevation myocardial infarction (NSTEMI) was established from randomized trials that included few anemic patients. The aim of this study was to describe the characteristics, therapies, and mortality of ... Full text Link to item Cite

Reply: To PMID 23245838.

Journal Article Am J Cardiol · April 1, 2013 Full text Link to item Cite

Guidelines-based treatment of anaemic STEMI patients: Practice patterns and effects on in-hospital mortality: A retrospective analysis from the NCDR

Journal Article European Heart Journal: Acute Cardiovascular Care · January 1, 2013 Anaemia is associated with an increased risk for morbidity and mortality in ST-elevation myocardial infarction (STEMI) patients. While several physiological mechanisms have been proposed to explain this association, decreased receipt of guidelines-based ca ... Full text Cite

Modifiable factors associated with failure to attain low-density lipoprotein cholesterol goal at 6 months after acute myocardial infarction.

Journal Article Am Heart J · January 2013 BACKGROUND: Although controversial, reducing low-density lipoprotein cholesterol (LDL-C) to target levels remains a common therapeutic goal after acute myocardial infarction (AMI). We sought to illuminate patient and provider characteristics associated wit ... Full text Link to item Cite

Preoperative anxiety as a predictor of mortality and major morbidity in patients aged >70 years undergoing cardiac surgery.

Journal Article Am J Cardiol · January 1, 2013 The present study examined the association between patient-reported anxiety and postcardiac surgery mortality and major morbidity. Frailty Assessment Before Cardiac Surgery was a prospective multicenter cohort study of elderly patients undergoing cardiac s ... Full text Link to item 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

Transitional care after hospitalization for acute stroke or myocardial infarction: a systematic review.

Journal Article Ann Intern Med · September 18, 2012 BACKGROUND: Transitional care is a time-limited service to prevent discontinuous care and adverse outcomes, including rehospitalization. PURPOSE: To describe transitional care interventions and evidence of benefit or harm in patients hospitalized for acute ... Full text Link to item Cite

Atrial fibrillation and acute myocardial infarction: antithrombotic therapy and outcomes.

Journal Article Am J Med · September 2012 BACKGROUND: Atrial fibrillation guidelines recommend long-term use of warfarin according to a patient's predicted risk of stroke. After acute myocardial infarction, however, combining warfarin and antiplatelet medications poses challenges. METHODS: By usin ... Full text Link to item Cite

The association of in-hospital major bleeding with short-, intermediate-, and long-term mortality among older patients with non-ST-segment elevation myocardial infarction.

Journal Article Eur Heart J · August 2012 AIMS: Bleeding complications have been associated with short-term mortality in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Their association with long-term outcomes is less clear. This study examines mortality associated with in- ... Full text Link to item Cite

Polyvascular disease and long-term cardiovascular outcomes in older patients with non-ST-segment-elevation myocardial infarction.

Journal Article Circ Cardiovasc Qual Outcomes · July 1, 2012 BACKGROUND: The impact of polyvascular disease (peripheral arterial disease [PAD] and cerebrovascular disease [CVD]) on long-term cardiovascular outcomes among older patients with acute myocardial infarction has not been well studied. METHODS AND RESULTS: ... Full text Link to item Cite

Physical function and independence 1 year after myocardial infarction: observations from the Translational Research Investigating Underlying disparities in recovery from acute Myocardial infarction: Patients' Health status registry.

Journal Article Am Heart J · May 2012 BACKGROUND: Acute myocardial infarction (AMI) may contribute to health status declines including "independence loss" and "physical function decline." Despite the importance of these outcomes for prognosis and quality of life, their incidence and predictors ... Full text Link to item Cite

Red blood cell indices and development of hospital-acquired anemia during acute myocardial infarction.

Journal Article Am J Cardiol · April 15, 2012 Hospital-acquired anemia (HAA) is common, often develops in the absence of bleeding, and is associated with poor outcomes in patients with acute myocardial infarction (AMI). It is unknown whether red cell distribution width (RDW) and mean corpuscular volum ... Full text Link to item Cite

Safety and effectiveness of antithrombotic strategies in older adult patients with atrial fibrillation and non-ST elevation myocardial infarction.

Journal Article Am Heart J · April 2012 BACKGROUND: We aimed to study the comparative safety and effectiveness of various antithrombotic treatment strategies among older adults with non-ST elevation myocardial infarction (NSTEMI) and atrial fibrillation (AF). METHODS: Using the CRUSADE registry ... Full text Link to item Cite

Admission international normalized ratio levels, early treatment strategies, and major bleeding risk among non-ST-segment-elevation myocardial infarction patients on home warfarin therapy: insights from the National Cardiovascular Data Registry.

Journal Article Circulation · March 20, 2012 BACKGROUND: Non-ST-segment-elevation myocardial infarction patients on home warfarin pose treatment concerns because of their potential increased risk of bleeding. Expert opinion from the American College of Cardiology/American Heart Association guidelines ... Full text Link to item Cite

Addition of frailty and disability to cardiac surgery risk scores identifies elderly patients at high risk of mortality or major morbidity.

Journal Article Circ Cardiovasc Qual Outcomes · March 1, 2012 Background- Cardiac surgery risk scores perform poorly in elderly patients, in part because they do not take into account frailty and disability which are critical determinants of health status with advanced age. There is an unmet need to combine establish ... Full text Link to item Cite

SLOW GAIT AMONG OLDER ADULTS POST-AMI AND RISK FOR HOSPITAL READMISSION

Conference Journal of the American College of Cardiology · March 2012 Full text Cite

Short-term outcomes of acute myocardial infarction in patients with acute kidney injury: a report from the national cardiovascular data registry.

Journal Article Circulation · January 24, 2012 BACKGROUND: Acute kidney injury (AKI) is a risk factor for long-term adverse outcomes, including acute myocardial infarction and death. However, the relationship between severity of AKI and in-hospital outcomes in the setting of acute myocardial infarction ... Full text Link to item Cite

Patterns of anticoagulation following bioprosthetic valve implantation: observations from ANSWER.

Journal Article J Heart Valve Dis · January 2012 BACKGROUND AND AIM OF THE STUDY: The American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend a three-month administration of warfarin following bioprosthetic valve replacement (BVR). However, strong evidence supporting this ... Link to item Cite

Dronedarone in high-risk permanent atrial fibrillation.

Journal Article N Engl J Med · December 15, 2011 BACKGROUND: Dronedarone restores sinus rhythm and reduces hospitalization or death in intermittent atrial fibrillation. It also lowers heart rate and blood pressure and has antiadrenergic and potential ventricular antiarrhythmic effects. We hypothesized th ... Full text Link to item Cite

Impact of body weight and extreme obesity on the presentation, treatment, and in-hospital outcomes of 50,149 patients with ST-Segment elevation myocardial infarction results from the NCDR (National Cardiovascular Data Registry).

Journal Article J Am Coll Cardiol · December 13, 2011 OBJECTIVES: The aim of this study was to assess the impact of extreme (class III) obesity (body mass index [BMI] ≥40 kg/m(2)) on care and outcomes in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Although its prevalence is i ... Full text Link to item Cite

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

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

Predicting long-term mortality in older patients after non-ST-segment elevation myocardial infarction: the CRUSADE long-term mortality model and risk score.

Journal Article Am Heart J · November 2011 OBJECTIVES: We sought to develop a long-term mortality risk prediction model and a simplified risk score for use in older patients with non-ST-segment elevation myocardial infarction (NSTEMI). BACKGROUND: Limited data are available regarding long-term mort ... Full text Link to item Cite

Cognitive impairment and outcomes in older adult survivors of acute myocardial infarction: findings from the translational research investigating underlying disparities in acute myocardial infarction patients' health status registry.

Journal Article Am Heart J · November 2011 BACKGROUND: Cognitive impairment without dementia (CIND) and acute myocardial infarction (AMI) are prevalent in older adults; however, the association of CIND with outcomes after AMI is unknown. METHODS: We used a multicenter registry to study 772 patients ... Full text Link to item Cite

Diagnostic blood loss from phlebotomy and hospital-acquired anemia during acute myocardial infarction.

Journal Article Arch Intern Med · October 10, 2011 BACKGROUND: Hospital-acquired anemia (HAA) during acute myocardial infarction (AMI) is associated with higher mortality and worse health status and often develops in the absence of recognized bleeding. The extent to which diagnostic phlebotomy, a modifiabl ... Full text Link to item Cite

Transition of care for acute stroke and myocardial infarction patients: from hospitalization to rehabilitation, recovery, and secondary prevention.

Journal Article Evid Rep Technol Assess (Full Rep) · October 2011 OBJECTIVES: To review the available published literature to assess whether evidence supports a beneficial role for coordinated transition of care services for the postacute care of patients hospitalized with first or recurrent stroke or myocardial infarcti ... Link to item Cite

Recovery from hospital-acquired anemia after acute myocardial infarction and effect on outcomes.

Journal Article Am J Cardiol · October 1, 2011 New-onset, hospital-acquired anemia (HAA) during acute myocardial infarction (AMI) is independently associated with poor outcomes. The patterns of recovery from HAA after AMI and their association with mortality and health status are unknown. In the prospe ... Full text Link to item Cite

Reply

Journal Article Journal of the American College of Cardiology · August 9, 2011 Full text Cite

Hospital-acquired anemia and in-hospital mortality in patients with acute myocardial infarction.

Journal Article Am Heart J · August 2011 BACKGROUND: Hospital-acquired anemia (HAA) is common during acute myocardial infarction (AMI) and associated with higher long-term mortality. The relationship between HAA and adverse in-hospital outcomes may be particularly relevant to hospitals' efforts t ... Full text Link to item Cite

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

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

In-hospital major bleeding during ST-elevation and non-ST-elevation myocardial infarction care: derivation and validation of a model from the ACTION Registry®-GWTG™.

Journal Article Am J Cardiol · April 15, 2011 Bleeding, a common complication of acute myocardial infarction (AMI) treatment, is associated with worse outcomes. A contemporary model for major bleeding associated with AMI treatment can stratify patients at elevated risk for bleeding and is needed to ri ... Full text Link to item Cite

No association between hemoglobin A1c and in-hospital mortality in patients with diabetes and acute myocardial infarction.

Journal Article Am Heart J · April 2011 BACKGROUND: Patients with diabetes have increased in-hospital mortality following acute myocardial infarction (AMI), with studies suggesting higher risk with both hypoglycemia and hyperglycemia. We assessed whether a J-shaped relation exists between hemogl ... Full text Link to item Cite

Age and outcomes in ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention: findings from the APEX-AMI trial.

Journal Article Arch Intern Med · March 28, 2011 BACKGROUND: To understand the influence of age on treatment and outcomes, we analyzed the largest group of patients 75 years or older with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention (PPCI) in a clinic ... Full text Link to item Cite

Angina frequency after myocardial infarction and quality of life in older versus younger adults: the Prospective Registry Evaluating Myocardial Infarction: Event and Recovery study.

Journal Article Am Heart J · March 2011 BACKGROUND: Residual angina is known to be strongly associated with health-related quality of life (HRQL) in patients with chronic coronary artery disease. As the age of myocardial infarction (MI) survivors increases, better insights into the relationship ... Full text Link to item Cite

Randomized trial of targeted performance feedback to facilitate quality improvement in acute myocardial infarction care.

Journal Article Circ Cardiovasc Qual Outcomes · January 1, 2011 BACKGROUND: Efforts to improve quality of care for patients with acute myocardial infarction (AMI) are a national priority. To date, there have been few studies that have prospectively evaluated hospital quality improvement (QI) interventions. METHODS AND ... Full text Link to item Cite

Risk adjustment for in-hospital mortality of contemporary patients with acute myocardial infarction: the acute coronary treatment and intervention outcomes network (ACTION) registry-get with the guidelines (GWTG) acute myocardial infarction mortality model and risk score.

Journal Article Am Heart J · January 2011 BACKGROUND: accurate risk adjustment is needed to guide quality improvement initiatives and research to improve care of patients with acute myocardial infarction (MI). We developed and validated a model to predict the risk of in-hospital mortality for cont ... Full text Link to item Cite

Changes in glycoprotein IIb/IIIa inhibitor excess dosing with site-specific safety feedback in the Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines (CRUSADE) initiative.

Journal Article Am Heart J · December 2010 BACKGROUND: Glycoprotein (GP) IIb/IIIa inhibitors can improve outcomes in patients with non-ST-segment elevation acute coronary syndromes but raise the risk of bleeding, particularly if dosed in excess. The impact of GP IIb/IIIa dosing feedback on safety a ... Full text Link to item Cite

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

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

Comparison of outcomes in patients aged <75, 75 to 84, and ≥ 85 years with ST-elevation myocardial infarction (from the ACTION Registry-GWTG).

Journal Article Am J Cardiol · November 15, 2010 ST-segment elevation myocardial infarction (STEMI) is common in older adults and has high age-related mortality. We describe contemporary STEMI care using the National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Network Registry- ... Full text Link to item Cite

Gait speed as an incremental predictor of mortality and major morbidity in elderly patients undergoing cardiac surgery.

Journal Article J Am Coll Cardiol · November 9, 2010 OBJECTIVES: The purpose of this study was to test the value of gait speed, a clinical marker for frailty, to improve the prediction of mortality and major morbidity in elderly patients undergoing cardiac surgery. BACKGROUND: It is increasingly difficult to ... Full text Link to item Cite

Use of anticoagulant agents and risk of bleeding among patients admitted with myocardial infarction: a report from the NCDR ACTION Registry--GWTG (National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network Registry--Get With the Guidelines).

Journal Article JACC Cardiovasc Interv · November 2010 OBJECTIVES: The aim of this study was to evaluate anticoagulant use patterns and bleeding risk in a contemporary population of patients with acute coronary syndrome. BACKGROUND: Current practice guidelines support the use of unfractionated heparin, low mol ... Full text Link to item Cite

Clinical and angiographic predictors of short- and long-term ischemic events in acute coronary syndromes: results from the Acute Catheterization and Urgent Intervention Triage strategY (ACUITY) trial.

Journal Article Circ Cardiovasc Interv · August 2010 BACKGROUND: Contemporary adjunctive pharmacology and revascularization strategies have improved the prognosis of patients with acute coronary syndromes (ACSs). We sought to identify the clinical and angiographic predictors of cardiac ischemic events in pat ... Full text Link to item Cite

Incidence, correlates, and outcomes of acute, hospital-acquired anemia in patients with acute myocardial infarction.

Journal Article Circ Cardiovasc Qual Outcomes · July 2010 BACKGROUND: Anemia is common among patients hospitalized with acute myocardial infarction and is associated with poor outcomes. Less is known about the incidence, correlates, and prognostic implications of acute, hospital-acquired anemia (HAA). METHODS AND ... Full text Link to item Cite

Antithrombotic strategy in non-ST-segment elevation myocardial infarction patients undergoing percutaneous coronary intervention: insights from the ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry.

Journal Article JACC Cardiovasc Interv · June 2010 OBJECTIVES: The aim of this study was to examine the use of and outcomes associated with antithrombotic strategies in patients with non-ST-segment elevation myocardial infarction (NSTEMI) who undergo percutaneous coronary intervention (PCI). BACKGROUND: A ... Full text Link to item Cite

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

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

Health care insurance, financial concerns in accessing care, and delays to hospital presentation in acute myocardial infarction.

Journal Article JAMA · April 14, 2010 CONTEXT: Little is known about how health insurance status affects decisions to seek care during emergency medical conditions such as acute myocardial infarction (AMI). OBJECTIVE: To examine the association between lack of health insurance and financial co ... Full text Link to item Cite

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

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

Predictors of outcomes in medically treated patients with acute coronary syndromes after angiographic triage: an Acute Catheterization And Urgent Intervention Triage Strategy (ACUITY) substudy.

Journal Article Circulation · February 23, 2010 BACKGROUND: Outcomes of patients presenting with acute coronary syndromes are improved with an early invasive approach; however, approximately one third of these patients are treated medically after angiographic screening. We sought to assess the predictor ... Full text Link to item Cite

Use of evidence-based therapies in short-term outcomes of ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction in patients with chronic kidney disease: a report from the National Cardiovascular Data Acute Coronary Treatment and Intervention Outcomes Network registry.

Journal Article Circulation · January 26, 2010 BACKGROUND: Chronic kidney disease (CKD) is a risk factor for myocardial infarction (MI) and death. Our goal was to characterize the association between CKD severity and short-term outcomes and the use of in-hospital evidence-based therapies among patients ... Full text Link to item Cite

Contraindicated medication use in dialysis patients undergoing percutaneous coronary intervention.

Journal Article JAMA · December 9, 2009 CONTEXT: The US Food and Drug Administration guides clinicians through drug labeling of medications that are contraindicated or not recommended for use in specific patient groups. Little is known about the use of such medications and their effects on outco ... Full text Link to item Cite

Long-term morbidity and mortality among medically managed patients with angina and multivessel coronary artery disease.

Journal Article Am Heart J · December 2009 BACKGROUND: There are little data regarding outcomes in patients with angina and severe coronary artery disease (CAD) treated with medical management. Using the Duke Databank of Cardiovascular Disease, we describe the prevalence and long-term outcomes of p ... Full text Link to item Cite

Evolving role of revascularization in older adults with acute coronary syndrome

Journal Article Current Cardiovascular Risk Reports · December 1, 2009 Revascularization following acute coronary syndrome reduces morbidity and, in some cases, improves survival. Revascularization is part of a care plan that must include optimal medical therapy for secondary prevention and also counseling to promote healthy ... Full text Cite

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

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

Antiplatelet therapy in older adults with non-ST-segment elevation acute coronary syndrome: considering risks and benefits.

Journal Article Am J Cardiol · September 7, 2009 Antiplatelet agents play an important role in the treatment of non-ST-segment elevation acute coronary syndromes (NSTE ACS), particularly for those at high risk, such as older adults (aged > or =75 years) where treatment may yield the greatest benefits. Pa ... Full text Link to item Cite

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

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

Too much of a good thing--air, that is.

Journal Article Anaesth Intensive Care · July 2009 Link to item Cite

Weight-based dosing of enoxaparin in obese patients with non-ST-segment elevation acute coronary syndromes: results from the CRUSADE initiative.

Journal Article Pharmacotherapy · June 2009 STUDY OBJECTIVE: To evaluate how enoxaparin is dosed in contemporary clinical practice as a function of patients' total body weight (TBW) and body mass index (BMI), and to determine any association between dose and major bleeding. DESIGN: Retrospective coh ... Full text Link to item Cite

Role of frailty in patients with cardiovascular disease.

Journal Article Am J Cardiol · June 1, 2009 Frailty is a geriatric syndrome of increased vulnerability to stressors that has been implicated as a causative and prognostic factor in patients with cardiovascular disease (CVD). The American Heart Association and the Society of Geriatric Cardiology have ... Full text Link to item Cite

Impact of gender and antithrombin strategy on early and late clinical outcomes in patients with non-ST-elevation acute coronary syndromes (from the ACUITY trial).

Journal Article Am J Cardiol · May 1, 2009 Women with non-ST-elevation acute coronary syndrome are at increased risk for ischemic and bleeding complications compared with men. We examined the impact of gender and antithrombotic therapy for non-ST-elevation acute coronary syndrome on outcomes in pat ... Full text Link to item Cite

Baseline risk of major bleeding in non-ST-segment-elevation myocardial infarction: the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines) Bleeding Score.

Journal Article Circulation · April 14, 2009 BACKGROUND: Treatments for non-ST-segment-elevation myocardial infarction (NSTEMI) reduce ischemic events but increase bleeding. Baseline prediction of bleeding risk can complement ischemic risk prediction for optimization of NSTEMI care; however, existing ... Full text Link to item Cite

Advanced age, antithrombotic strategy, and bleeding in non-ST-segment elevation acute coronary syndromes: results from the ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) trial.

Journal Article J Am Coll Cardiol · March 24, 2009 OBJECTIVES: This study sought to evaluate the impact of age on outcomes in patients with moderate- and high-risk non-ST-segment elevation acute coronary syndrome (NSTE-ACS) enrolled in the ACUITY (Acute Catheterization and Urgent Intervention Triage Strate ... Full text Link to item Cite

ST-Elevation Myocardial Infarction Care and Outcomes for the Oldest-Old

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

Risk of GUSTO Moderate or Severe Bleeding identified by the CRUSADE Bleeding Model

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

Management of hyperlipidemia in older adults.

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

The effect of age on functional and mortality outcomes after acute myocardial infarction.

Journal Article J Am Geriatr Soc · February 2009 OBJECTIVES: To determine the prevalence of post-myocardial infarction (MI) functional decline and to describe its association with chronological age in survivors of MI. DESIGN: Prospective observational registry. SETTING: Nineteen U.S. hospitals. PARTICIPA ... Full text Link to item Cite

Bleeding after antithrombotic therapy in patients with acute ischemic heart disease: is it the drugs or how we use them?

Journal Article J Thromb Thrombolysis · December 2008 Definitions of bleeding must be considered when evaluating results of clinical trials. Assessments of bleeding impact based on clinical criteria may be more relevant to patient outcomes than those based on simple laboratory measures like an isolated change ... Full text Link to item Cite

Antiplatelet therapy use after discharge among acute myocardial infarction patients with in-hospital bleeding.

Journal Article Circulation · November 18, 2008 BACKGROUND: Bleeding among patients with acute myocardial infarction (AMI) is associated with worse long-term outcomes. Although the mechanism underlying this association is unclear, a potential explanation is that withholding antiplatelet therapies long b ... Full text Link to item Cite

Profile of chronic and recurrent angina pectoris in a referral population.

Journal Article Am J Cardiol · November 15, 2008 Angina pectoris (AP) often responds to treatment, but in some, it becomes chronic or recurs over time. Identifying patients with continued AP is a necessary to understand its associations and implications. A baseline cohort with coronary disease and AP wer ... Full text Link to item Cite

Impact of anemia on physical function and survival among patients with coronary artery disease.

Journal Article Clin Cardiol · November 2008 BACKGROUND: Anemia is a purported risk factor for adverse outcomes, particularly among patients with cardiac disease. Although anemia at the time of discharge has been associated with poor functional status and survival, its impact over time is not clear. ... Full text Link to item Cite

Dissociation between hospital performance of the smoking cessation counseling quality metric and cessation outcomes after myocardial infarction.

Journal Article Arch Intern Med · October 27, 2008 BACKGROUND: Recognizing the importance of smoking cessation after acute myocardial infarction (AMI), the Centers for Medicare & Medicaid Services and the Joint Commission on Accreditation of Healthcare Organizations currently uses documentation of smoking ... Full text Link to item Cite

Patterns and prognostic implications of low high-density lipoprotein levels in patients with non-ST-segment elevation acute coronary syndromes.

Journal Article Eur Heart J · October 2008 AIMS: The patterns and prognostic significance of low high-density lipoprotein (HDL) cholesterol levels have not been well characterized. We sought to determine the prevalence and prognostic significance of low HDL cholesterol levels in patients with non-S ... Full text Link to item Cite

Frailty and its potential relevance to cardiovascular care.

Journal Article Mayo Clin Proc · October 2008 Frailty is characterized by vulnerability to acute stressors and is a consequence of decline in overall function and physiologic reserves. An estimated 7% of the US population older than 65 years and 30% of octogenarians are frail. The domains to define fr ... Full text Link to item Cite

Excess heparin dosing among fibrinolytic-treated patients with ST-segment elevation myocardial infarction.

Journal Article Am J Med · September 2008 BACKGROUND: Although the use of heparin with fibrinolytics is associated with more rapid ST-segment resolution and increased infarct-related artery patency among patients with ST-segment elevation myocardial infarction (STEMI), its associated increase in b ... Full text Link to item Cite

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

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

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

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

Outcomes in elderly patients with acute coronary syndromes randomized to enoxaparin vs. unfractionated heparin: results from the SYNERGY trial.

Journal Article Eur Heart J · August 2008 AIMS: Elderly patients are at high risk from non-ST-segment elevation acute coronary syndromes (NSTE ACS) as well as from treatment-related complications. Age-associated changes in physiology may alter the risk and benefit expected from therapy. The SYNERG ... Full text Link to item Cite

Transfusion practice and outcomes in non-ST-segment elevation acute coronary syndromes.

Journal Article Am Heart J · June 2008 OBJECTIVES: To describe the association between transfusion and outcomes as a function of nadir hematocrit (HCT) in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS). BACKGROUND: The adverse outcomes associated with transfusion in ... Full text Link to item Cite

The influence of age on health status outcomes after acute myocardial infarction.

Journal Article Am Heart J · May 2008 BACKGROUND: Older age is a risk factor for higher mortality after acute myocardial infarction (AMI), but the association with health status outcomes is largely unexplored. METHODS: In a prospective cohort of 2498 patients in the PREMIER study, we compared ... Full text Link to item Cite

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

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

Bleeding and ischemic events run parallel in NSTEMI patients

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

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

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

Use of evidence-based medicine for acute coronary syndromes in the elderly and very elderly: insights from the Sibrafiban vs aspirin to Yield Maximum Protection from ischemic Heart events postacute cOroNary sYndromes trials.

Journal Article Am Heart J · August 2007 BACKGROUND: Evidence-based medications (EBM) are underused in older patients despite potentially larger absolute benefits. Little is known about factors influencing prescribing in the elderly with acute coronary syndromes. METHODS: Among the 15,904 patient ... Full text Link to item Cite

Comparison of baseline characteristics, treatment patterns, and in-hospital outcomes of Asian versus non-Asian white Americans with non-ST-segment elevation acute coronary syndromes from the CRUSADE quality improvement initiative.

Journal Article Am J Cardiol · August 1, 2007 It has been suggested that Asians may respond differently to antithrombotic therapy, but contemporary management and outcomes of non-ST-segment elevation (NSTE) acute coronary syndromes (ACSs) in Asian patients have not been well characterized. Using data ... Full text Link to item Cite

Enoxaparin dosing and associated risk of in-hospital bleeding and death in patients with non ST-segment elevation acute coronary syndromes.

Journal Article Arch Intern Med · July 23, 2007 BACKGROUND: The efficacy of enoxaparin sodium in non-ST-segment elevation acute coronary syndromes is well established; however, concerns remain regarding bleeding risk. The extent to which bleeding risk is attributable to excess dosing of enoxaparin is un ... Full text Link to item Cite

Response to Dr. Denkinger et al. [12]

Journal Article Journal of the American Geriatrics Society · June 1, 2007 Full text Cite

Acute coronary care in the elderly, part II: ST-segment-elevation myocardial infarction: a scientific statement for healthcare professionals from the American Heart Association Council on Clinical Cardiology: in collaboration with the Society of Geriatric Cardiology.

Journal Article Circulation · May 15, 2007 BACKGROUND: Age is an important determinant of outcomes for patients with acute coronary syndromes. However, community practice reveals a disproportionately lower use of cardiovascular medications and invasive treatment even among elderly patients who woul ... Full text Link to item Cite

Acute coronary care in the elderly, part I: Non-ST-segment-elevation acute coronary syndromes: a scientific statement for healthcare professionals from the American Heart Association Council on Clinical Cardiology: in collaboration with the Society of Geriatric Cardiology.

Journal Article Circulation · May 15, 2007 BACKGROUND: Age is an important determinant of outcomes for patients with acute coronary syndromes (ACS); however, community practice reveals a disproportionately lower use of cardiovascular medications and invasive treatment even among elderly patients wi ... Full text Link to item Cite

Characteristics, management, and outcomes of 5,557 patients age > or =90 years with acute coronary syndromes: results from the CRUSADE Initiative.

Journal Article J Am Coll Cardiol · May 1, 2007 OBJECTIVES: The goal of this work was to explore the treatment and outcomes of patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) age > or =90 years. BACKGROUND: The elderly are often excluded from clinical trials of NSTE-ACS and ar ... Full text Link to item Cite

Associations of gender and etiology with outcomes in heart failure with systolic dysfunction: a pooled analysis of 5 randomized control trials.

Journal Article J Am Coll Cardiol · April 3, 2007 OBJECTIVES: This study sought to explore the gender-related differences in etiology and outcomes in chronic heart failure (HF) patients from 5 randomized trials. BACKGROUND: Each year, 550,000 new cases of HF are identified; however, there remain limited d ... Full text Link to item Cite

Predictors of persistent angina among coronary disease patients

Conference JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · March 6, 2007 Link to item Cite

Less is better, none is best: Angina and health related quality of life

Conference JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · March 6, 2007 Link to item Cite

Statins for the primary prevention of cardiovascular events in older adults: a review of the evidence.

Journal Article Am J Geriatr Pharmacother · March 2007 BACKGROUND: Although statins have been demonstrated to be beneficial for secondary prevention in the elderly, their use for primary prevention has not been well described. OBJECTIVE: In this review, we summarize data regarding the efficacy, safety, and cur ... Full text Link to item Cite

Identifying frailty in hospitalized older adults with significant coronary artery disease.

Journal Article J Am Geriatr Soc · November 2006 OBJECTIVES: To characterize physiological variation in hospitalized older adults with severe coronary artery disease (CAD) and evaluate the prevalence of frailty in this sample, to determine whether single-item performance measures are good indicators of m ... Full text Link to item Cite

Sex differences in major bleeding with glycoprotein IIb/IIIa inhibitors: results from the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines) initiative.

Journal Article Circulation · September 26, 2006 BACKGROUND: Glycoprotein (GP) IIb/IIIa inhibitors are beneficial in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS); their safe use in women, however, remains a concern. The contribution of dosing to the observed sex-related diff ... Full text Link to item Cite

Coronary artery disease in later life

Journal Article Generations · September 1, 2006 Cite

International variation in invasive care of the elderly with acute coronary syndromes.

Journal Article Eur Heart J · July 2006 AIMS: To explore variations in invasive care of the elderly with acute coronary syndromes across international practice. METHODS AND RESULTS: Using combined populations from the SYMPHONY and 2nd SYMPHONY trials, we describe 30-day cardiac catheterization i ... Full text Link to item Cite

In reply [6]

Journal Article JAMA · April 26, 2006 Full text Cite

Enoxaparin dosing and bleeding in real world practice: Results from CRUSADE

Conference JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · February 21, 2006 Link to item Cite

Treatment of non-ST-elevation acute coronary syndrome in the elderly: current practice and future opportunities.

Journal Article Am J Geriatr Cardiol · 2006 The care of elderly patients with non-ST-elevation acute coronary syndrome is challenging, given the wide variability in physiologic condition and preferences among this patient group. Due to a higher burden of comorbidity, the elderly face high risks for ... Full text Link to item Cite

Long-term adherence with cardiovascular drug regimens.

Journal Article Am Heart J · January 2006 BACKGROUND: An increasing number of medications are prescribed for patients with coronary artery disease, but poor adherence may limit realization of their benefits. OBJECTIVE: To characterize adherence to evidence-based cardiovascular medications prescrib ... Full text Link to item Cite

Pulse pressure and vascular risk in the elderly: associations and clinical implications.

Journal Article Am J Geriatr Cardiol · 2006 Pulse pressure provides information beyond systolic and diastolic blood pressures, from which it is calculated. The majority of individuals older than 70 years have a widened pulse pressure resulting from age-related stiffening of the central elastic arter ... Full text Link to item Cite

Excess dosing of antiplatelet and antithrombin agents in the treatment of non-ST-segment elevation acute coronary syndromes.

Journal Article JAMA · December 28, 2005 CONTEXT: Effective medical care assumes delivery of evidence-based medicines to appropriate patients with doses comparable to those studied. OBJECTIVE: To investigate dosing of unfractionated heparin (UFH), low-molecular-weight heparin (LMWH), and glycopro ... Full text Link to item Cite

The implications of blood transfusions for patients with non-ST-segment elevation acute coronary syndromes: results from the CRUSADE National Quality Improvement Initiative.

Journal Article J Am Coll Cardiol · October 18, 2005 OBJECTIVES: In a large contemporary population of patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS), we sought to describe blood transfusion rates (overall and in patients who did not undergo coronary artery bypass grafting [CABG]) ... Full text Link to item Cite

Evolution in cardiovascular care for elderly patients with non-ST-segment elevation acute coronary syndromes: results from the CRUSADE National Quality Improvement Initiative.

Journal Article J Am Coll Cardiol · October 18, 2005 OBJECTIVES: This study evaluated the impact of age on care and outcomes for non-ST-segment elevation acute coronary syndromes (NSTE ACS). BACKGROUND: Recent clinical trials have expanded treatment options for NSTE ACS, now reflected in guidelines. Elderly ... Full text Link to item Cite

Issues with care in the elderly patient presenting with acute ischemia.

Journal Article Curr Cardiol Rep · July 2005 The issues surrounding care of the elderly patient with acute coronary syndromes (ACS) present significant challenges to clinicians and investigators. The elderly often have atypical symptoms of acute ischemia, have greater medical comorbidities, and are m ... Full text Link to item Cite

Research, managed care, and patient privacy: Challenges to successful collaboration

Journal Article Journal of Clinical Outcomes Management · March 1, 2005 • Objective: To illustrate the impact of increased patient privacy concerns on the conduct of research on managed care patients and to suggest mechanisms for successful collaboration between managed care organizations and academic research organizations. • ... Cite

Reperfusion strategies for acute myocardial infarction in the elderly: benefits and risks.

Journal Article J Am Coll Cardiol · February 15, 2005 The optimal reperfusion strategy in elderly patients with ST-segment elevation myocardial infarction (STEMI) remains a topic of debate. This lack of consensus stems from the exclusion or under-representation of the elderly in clinical trials. This review e ... Full text Link to item Cite

Effect of glucose-insulin-potassium infusion on mortality in patients with acute ST-segment elevation myocardial infarction: the CREATE-ECLA randomized controlled trial.

Journal Article JAMA · January 26, 2005 CONTEXT: Glucose-insulin-potassium (GIK) infusion is a widely applicable, low-cost therapy that has been postulated to improve mortality in patients with acute ST-segment elevation myocardial infarction (STEMI). Given the potential global importance of GIK ... Full text Link to item Cite

The case of the disappearing myxoma.

Journal Article J Cardiovasc Magn Reson · 2005 We present a case demonstrating the utility of cardiovascular magnetic resonance (CMR) in the diagnosis of a cardiac mass. A 70-year-old female who presented with chest pressure and left sided jaw pain was found to have a cardiac mass on transthoracic and ... Full text Link to item Cite

Postmenopausal hormone use in women with acute coronary syndromes.

Journal Article J Womens Health (Larchmt) · October 2004 BACKGROUND: Recent trials reveal no benefit and possible harm from chronic hormone replacement therapy (HRT). Less is known about intermediate-term outcomes associated with HRT use in the setting of acute coronary syndromes (ACS). METHODS: To examine the p ... Full text Link to item Cite

Multicenter experience in revascularization of very elderly patients.

Journal Article Am Heart J · September 2004 BACKGROUND: Very elderly patients are increasingly referred for revascularization yet have been underrepresented in both prior percutaneous coronary intervention (PCI) and coronary bypass surgery (CABG) clinical trials. We pooled the largest PCI and CABG c ... Full text Link to item Cite

1153-74 Physician counseling can influence health-related quality of life

Conference Journal of the American College of Cardiology · March 2004 Full text Cite

Influencing medication adherence among women with AIDS.

Journal Article AIDS Care · August 2003 This study examined the effects of a ten-session cognitive-behavioural stress management/expressive supportive therapy (CBSM+) intervention on adherence to antiretroviral medication. Although the intervention was not designed to influence adherence, it was ... Full text Link to item Cite

Home health care for coronary artery disease patients impacts quality of life

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

Elderly patients have better functioning, less angina at one year with coronary artery bypass graft

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

Are patients properly informed prior to revascularization decisions?

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

Evidence-based care for all patients.

Journal Article Am J Med · March 2003 Full text Link to item Cite

Effect of cardiac rehabilitation on functional outcomes after coronary revascularization.

Journal Article Am Heart J · March 2003 BACKGROUND: Current guidelines recommending cardiac rehabilitation (CR) after coronary revascularization are largely based on early studies that evaluated only a subset of the population and failed to assess the impact of CR on a patient's perception of th ... Full text Link to item Cite

PCI in women

Journal Article Cardiology Review · March 1, 2003 Studies have shown that women and men have similar rates of procedural success with percutaneous coronary intervention (PCI), but that women have significantly higher mortality rates. The authors examine why this occurs and compare the risks of PCI with th ... Cite

The finer points of race and hypertension.

Journal Article Am Heart J · February 2003 Full text Link to item Cite

Hormone Replacement Therapy for Primary and Secondary Prevention of Heart Disease.

Journal Article Curr Treat Options Cardiovasc Med · February 2003 Cardiovascular disease is the leading cause of death in women. In pooled analysis, observational studies have shown a 50% reduction in death and myocardial infarction among users of hormone replacement therapy (HRT) for the primary and secondary prevention ... Full text Link to item Cite

Cardiovascular research in the elderly: challenges, opportunities, and impact.

Journal Article Postgrad Med · December 2002 The "graying of America" is resulting in an exponential increase in the number of very elderly patients presenting with cardiovascular disease. Despite the availability of many effective cardiovascular therapeutics, elderly cardiac patients are treated les ... Full text Link to item Cite

The right test for the right price

Conference CIRCULATION · November 5, 2002 Link to item Cite

Effect of cardiac rehabilitation on functional outcomes following coronary revascularization

Journal Article JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · March 6, 2002 Link to item Cite

Aging and patient preferences regarding invasive cardiac care

Journal Article JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · March 6, 2002 Link to item Cite

Paradoxical use of angiography with advancing age: Insights from an international trial population

Journal Article JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · March 6, 2002 Link to item Cite

Cardiac rehabilitation in the elderly.

Journal Article Am Heart J · November 2001 BACKGROUND: Although patients >/=65 years old account for the majority of cardiac admissions and procedures in the United States, studies of cardiac rehabilitation have traditionally focused on younger patients. Only recently has the effectiveness of cardi ... Full text Link to item Cite

Medical and surgical management of coronary artery disease in women.

Journal Article Am J Manag Care · October 2001 Women and men with coronary artery disease (CAD) differ in their presenting symptoms, baseline risk factors, age, and body size. These differences account for most of the previously reported differences in the management of women with CAD. When using large ... Link to item Cite

Representation of elderly persons and women in published randomized trials of acute coronary syndromes.

Journal Article JAMA · August 8, 2001 CONTEXT: Elderly persons and women were underrepresented in randomized controlled trials (RCTs) prior to 1990. Since then, efforts have been made to correct these biases, but their effect is unclear. OBJECTIVE: To determine whether the percentage of elderl ... Full text Link to item Cite

Post-myocardial infarction risk stratification in elderly patients.

Journal Article Am Heart J · July 2001 BACKGROUND: The purpose of this study was to examine the use of post-myocardial infarction (MI) risk stratification in the elderly. Although expert panels have recommended risk stratification after MI, limited data are available on whether patients actuall ... Full text Link to item Cite

Initiation of hormone replacement therapy after acute myocardial infarction is associated with more cardiac events during follow-up.

Journal Article J Am Coll Cardiol · July 2001 OBJECTIVES: This study explored the association between the initiation of hormone replacement therapy (HRT) and early cardiac events (<1 year) in women with a recent myocardial infarction (MI). BACKGROUND: Observational studies have linked postmenopausal h ... Full text Link to item Cite

Representation of the elderly in cardiovascular clinical trials

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

The safety of coronary artery bypass surgery in the aged

Journal Article CIRCULATION · October 31, 2000 Link to item Cite

Outcomes of cardiac surgery in patients > or = 80 years: results from the National Cardiovascular Network.

Journal Article J Am Coll Cardiol · March 1, 2000 OBJECTIVES: The purpose of this study was to evaluate characteristics and outcomes of patients age > or =80 undergoing cardiac surgery. BACKGROUND: Prior single-institution series have found high mortality rates in octogenarians after cardiac surgery. Howe ... Full text Link to item Cite

Comparison of sibrafiban with aspirin for prevention of cardiovascular events after acute coronary syndromes: a randomised trial. The SYMPHONY Investigators. Sibrafiban versus Aspirin to Yield Maximum Protection from Ischemic Heart Events Post-acute Coronary Syndromes.

Journal Article Lancet · January 29, 2000 BACKGROUND: Aspirin lowers risks of death and myocardial infarction in patients with acute coronary syndromes. Intravenous glycoprotein IIb/IIIa receptor antagonists further reduce the rates of ischaemic events in these patients, but the efficacy of long-t ... Link to item Cite

Potential impact of evidence-based medicine in acute coronary syndromes: insights from GUSTO-IIb. Global Use of Strategies to Open Occluded Arteries in Acute Coronary Syndromes trial.

Journal Article J Am Coll Cardiol · December 1998 OBJECTIVES: The purpose of this study to determine whether use of cardiac medications reflects evidence-based recommendations for patients with non-ST elevation acute coronary syndromes. BACKGROUND: Agency for Health Care Policy and Research practice guide ... Full text Link to item Cite

Value of exercise treadmill testing in women.

Journal Article J Am Coll Cardiol · November 15, 1998 OBJECTIVES: We sought to determine the ability of a treadmill score to provide accurate diagnostic and prognostic risk estimates in women. BACKGROUND: Treadmill testing has been reported to have a lower accuracy for diagnosis of chest pain in women. The di ... Full text Link to item Cite

Functional outcome of CABG in the elderly

Journal Article CIRCULATION · October 21, 1997 Link to item Cite

Early catheterization is standard strategy in unstable angina/NQWMI: Results from GUSTO IIb

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