Journal ArticleJ Am Heart Assoc · February 7, 2023
Background Women with atrial fibrillation (AF) demonstrate more AF-related symptoms and worse quality of life (QOL). Whether increased use of ablation in women reduces sex-related QOL differences is unknown. Sex-related outcomes for ablation versus drug th ...
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Journal ArticleEuropace · October 13, 2022
AIMS: Influence of atrial fibrillation (AF) type on outcomes seen with catheter ablation vs. drug therapy is incompletely understood. This study assesses the impact of AF type on treatment outcomes in the Catheter Ablation vs. Antiarrhythmic Drug Therapy f ...
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Journal ArticleCirculation · August 16, 2022
BACKGROUND: In the CABANA trial (Catheter Ablation vs Antiarrhythmic Drug Therapy for Atrial Fibrillation), catheter ablation did not significantly reduce the primary end point of death, disabling stroke, serious bleeding, or cardiac arrest compared with d ...
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Journal ArticleCirculation · March 15, 2022
BACKGROUND: Observational data suggest that catheter ablation may be safe and effective to treat younger and older patients with atrial fibrillation. No large, randomized trial has examined this issue. This report describes outcomes according to age at ent ...
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Journal ArticleJ Thorac Cardiovasc Surg · February 2022
OBJECTIVE: Chronic kidney disease is a known risk factor in cardiovascular disease, but its influence on treatment effect of bypass surgery remains unclear. We assessed the influence of chronic kidney disease on 10-year mortality and cardiovascular outcome ...
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Journal ArticleCardiol J · 2022
BACKGROUND: Many patients in the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) had a significant improvement (> 10%) in the left ventricular ejection fraction (LVEF) during the course of the study, but the factors and outcomes associated with such ...
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Journal ArticleResuscitation · November 2021
BACKGROUND: Patients with sudden cardiac arrest occurring in the acute phase of myocardial infarction (MI-SCA) are believed to be at similar risk of death after revascularization compared with MI patients without SCA (MI-no SCA). Among patients with anteri ...
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Journal ArticleCirculation · April 6, 2021
BACKGROUND: In patients with heart failure and atrial fibrillation (AF), several clinical trials have reported improved outcomes, including freedom from AF recurrence, quality of life, and survival, with catheter ablation. This article describes the treatm ...
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Journal ArticleCardiovasc Revasc Med · November 2020
BACKGROUND: The Trial to Assess Chelation Therapy (TACT) found that chelation therapy significantly reduced clinical events in patients with a history of myocardial infarction (MI). The initial report of TACT included the observation of an interaction betw ...
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Journal ArticleJ Diabetes Complications · August 2020
BACKGROUND: The NIH-funded Trial to Assess Chelation Therapy (TACT) randomized 1708 stable patients age ≥50 who were ≥6 months post myocardial infarction to 40 infusions of an edetate disodium-based regimen or placebo. In 633 patients with diabetes, edetat ...
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Journal ArticleJ Am Coll Cardiol · July 28, 2020
BACKGROUND: The SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial) randomized 2,521 patients with moderate heart failure (HF) to amiodarone, placebo drug, or implantable cardioverter-defibrillator (ICD) therapy. Original trial follow-up ended October 3 ...
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Journal ArticleJ Am Coll Cardiol · June 30, 2020
BACKGROUND: The CABANA (Catheter Ablation Versus Antiarrhythmic Drug Therapy for Atrial Fibrillation) trial randomized 2,204 patients with atrial fibrillation (AF) to catheter ablation or drug therapy. Analysis by intention-to-treat showed a nonsignificant ...
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Journal ArticleCardiovasc Ultrasound · May 28, 2020
AIMS: We sought to determine which echocardiographic markers of left ventricular (LV) remodeling and diastolic dysfunction can contribute as incremental and independent prognostic information in addition to current clinical risk markers of ischemic LV syst ...
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Journal ArticleHeart · February 2020
OBJECTIVES: To test the relationship between increasing severity of obesity, calculated risk and observed outcomes. METHODS: Patients with symptoms suggestive of coronary artery disease (CAD) (n=10 003) were stratified according to body mass index (BMI). W ...
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Journal ArticleJACC Heart Fail · October 2019
OBJECTIVES: The authors investigated the impact of coronary artery bypass grafting (CABG) on first and recurrent hospitalization in this population. BACKGROUND: In the STICH (Surgical Treatment for Ischemic Heart Failure) trial, CABG reduced all-cause deat ...
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Journal ArticleN Engl J Med · August 22, 2019
BACKGROUND: The role of assessment of myocardial viability in identifying patients with ischemic cardiomyopathy who might benefit from surgical revascularization remains controversial. Furthermore, although improvement in left ventricular function is one o ...
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Journal ArticleJ Diabetes Complications · July 2019
OBJECTIVE: Approximately 1 in 7 US adults have diabetes; and over 60% of deaths in patients with diabetes have cardiac disease as a principal or contributing cause. Both coronary and peripheral artery disease (PAD) identify high-risk cohorts among patients ...
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Journal ArticleJAMA · April 2, 2019
IMPORTANCE: Catheter ablation is more effective than drug therapy in restoring sinus rhythm in patients with atrial fibrillation (AF), but its incremental effect on long-term quality of life (QOL) is uncertain. OBJECTIVE: To determine whether catheter abla ...
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Journal ArticleJAMA · April 2, 2019
IMPORTANCE: Catheter ablation is effective in restoring sinus rhythm in atrial fibrillation (AF), but its effects on long-term mortality and stroke risk are uncertain. OBJECTIVE: To determine whether catheter ablation is more effective than conventional me ...
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Journal ArticleJ Am Coll Cardiol · March 5, 2019
BACKGROUND: The optimal noninvasive test (NIT) for patients with diabetes and stable symptoms of coronary artery disease (CAD) is unknown. OBJECTIVES: The purpose of this study was to assess whether a diagnostic strategy based on coronary computed tomograp ...
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Journal ArticleAm Heart J · February 2019
BACKGROUND: Although sex differences exist in the management of acute coronary syndromes, less is known about the management and outcomes of women and men with suspected coronary artery disease being evaluated with noninvasive testing (NIT). METHODS: We in ...
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Journal ArticleCirc Cardiovasc Imaging · February 2019
BACKGROUND: Patients with high-risk coronary artery disease (CAD) may be difficult to identify. METHODS: Using the PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) cohort randomized to coronary computed tomographic angiography ( ...
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Journal ArticleN Engl J Med · January 24, 2019
BACKGROUND: The cardiovascular safety profile of dapagliflozin, a selective inhibitor of sodium-glucose cotransporter 2 that promotes glucosuria in patients with type 2 diabetes, is undefined. METHODS: We randomly assigned patients with type 2 diabetes who ...
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Journal ArticleJ Cardiovasc Comput Tomogr · 2019
BACKGROUND: Obesity is a risk factor for coronary artery disease (CAD), but adiposity may mimic symptoms of CAD and reduce the accuracy of diagnostic testing. METHODS: Patients from the PROMISE trial (n = 8889) were classified according to body mass index ...
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Journal ArticleEur Heart J · October 1, 2018
AIMS: Hypertension (HTN) is a well-known contributor to cardiovascular disease, including heart failure (HF) and coronary artery disease, and is the leading risk factor for premature death world-wide. A J- or U-shaped relationship has been suggested betwee ...
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Journal ArticleJAMA Netw Open · August 3, 2018
IMPORTANCE: Clinical decisions are frequently based on measurement of left ventricular ejection fraction (LVEF). Limited information exists regarding inconsistencies in LVEF measurements when determined by various imaging modalities and the potential impac ...
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Journal ArticleJACC Clin Electrophysiol · August 2018
OBJECTIVES: The authors previously developed the Seattle Proportional Risk Model (SPRM) in systolic heart failure patients without implantable cardioverter-defibrillators (ICDs)to predict the proportion of deaths that were sudden. They subsequently validat ...
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Journal ArticleJ Cardiothorac Vasc Anesth · June 2018
OBJECTIVE: The authors aimed to assess determinants of intubation time and evaluate its impact on 30-day and 1-year postoperative survival in Surgical Treatment for Ischemic Heart Failure (STICH) trial patients. DESIGN, SETTING, PARTICIPANTS, AND INTERVENT ...
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Journal ArticleEur J Heart Fail · June 2018
AIM: There is limited information on the outcomes after primary prevention implantable cardioverter-defibrillator (ICD) implantation in patients with heart failure (HF) and diabetes. This analysis evaluates the effectiveness of a strategy of ICD plus medic ...
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Journal ArticleAm Heart J · May 2018
The Catheter Ablation Versus Anti-arrhythmic Drug Therapy for Atrial Fibrillation (CABANA,NCT00911508)(1) trial is testing the hypothesis that the treatment strategy of percutaneous left atrial catheter ablation for the purpose of eliminating atrial fibril ...
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Journal ArticleJACC Cardiovasc Imaging · March 2018
OBJECTIVES: This study sought to externally validate prediction models for the presence of obstructive coronary artery disease (CAD). BACKGROUND: A better assessment of the probability of CAD may improve the identification of patients who benefit from noni ...
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Journal ArticleCirculation · February 20, 2018
BACKGROUND: Female sex is conventionally considered a risk factor for coronary artery bypass grafting (CABG) and has been included as a poor prognostic factor in multiple cardiac operative risk evaluation scores. We aimed to investigate the association of ...
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Journal ArticleJAMA Cardiol · February 1, 2018
IMPORTANCE: Coronary computed tomographic angiography (coronary CTA) can characterize coronary artery disease, including high-risk plaque. A noninvasive method of identifying high-risk plaque before major adverse cardiovascular events (MACE) could provide ...
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Journal ArticleAm Heart J · January 2018
IMPORTANCE: In a prespecified subgroup analysis of participants not on statin therapy at baseline in the TACT, a high-dose complex oral multivitamins and multimineral regimen was found to have a large unexpected benefit compared with placebo. The regimen t ...
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Journal ArticleCirculation · November 21, 2017
BACKGROUND: Coronary artery calcium (CAC) is an established predictor of future major adverse atherosclerotic cardiovascular events in asymptomatic individuals. However, limited data exist as to how CAC compares with functional testing (FT) in estimating p ...
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Journal ArticleJACC Cardiovasc Imaging · November 2017
OBJECTIVES: The purpose of this study was to determine whether noninvasive fractional flow reserve derived from computed tomography (FFRCT) predicts coronary revascularization and outcomes and whether its addition improves efficiency of referral to invasiv ...
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ConferenceJ Cardiovasc Electrophysiol · November 2017
BACKGROUND: No precise tools exist to predict appropriate shocks in patients with a primary prevention ICD. We sought to identify characteristics predictive of appropriate shocks in patients with a primary prevention implantable cardioverter defibrillator ...
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Journal ArticleJ Am Heart Assoc · October 31, 2017
BACKGROUND: The impact of diabetes mellitus on the clinical presentation and noninvasive test (NIT) results among stable outpatients presenting with symptoms suggestive of coronary artery disease (CAD) has not been well described. METHODS AND RESULTS: The ...
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Journal ArticleBMJ Open · September 29, 2017
OBJECTIVES: To evaluate potential gaps in preventive medical therapy and healthy lifestyle practices among symptomatic patients with suspected coronary artery disease (CAD) seeing primary care physicians and cardiologists and how gaps vary by sociodemograp ...
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ConferenceAm Heart J · September 2017
BACKGROUND: Primary prevention implantable cardioverter defibrillator (ICD) reduce all-cause mortality by reducing sudden cardiac death. There are conflicting data regarding whether patients with more advanced heart failure derive ICD benefit owing to the ...
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Journal ArticleCirculation · June 13, 2017
BACKGROUND: Optimal management of patients with stable chest pain relies on the prognostic information provided by noninvasive cardiovascular testing, but there are limited data from randomized trials comparing anatomic with functional testing. METHODS: In ...
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Journal ArticleJAMA Cardiol · June 1, 2017
IMPORTANCE: Conflicting data have emerged on the efficacy of implantable cardioverter defibrillators (ICDs) for primary prevention of sudden cardiac death (primary prevention ICDs) in patients with nonischemic cardiomyopathy. OBJECTIVE: To investigate the ...
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Journal ArticleJAMA Cardiol · April 1, 2017
IMPORTANCE: Guidelines recommend noninvasive testing for patients with stable chest pain, although many subsequently have normal test results and no adverse clinical events. OBJECTIVE: To describe a risk tool developed to use only pretest clinical data to ...
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Journal ArticleCirculation · March 21, 2017
BACKGROUND: The risk of sudden cardiac death (SCD) in patients with heart failure after coronary artery bypass graft surgery (CABG) has not been examined in a contemporary clinical trial of surgical revascularization. This analysis describes the incidence, ...
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Journal ArticleAm Heart J · February 2017
BACKGROUND: The outcomes in patients by visual assessment and quantitative coronary angiography (QCA) for obstructive coronary artery disease (CAD) are not known. Our objectives were to compare visual and QCA estimates of obstructive CAD and to assess thei ...
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Journal ArticleAm Heart J · February 2017
BACKGROUND: Identifying predictors of coronary artery disease (CAD)-related procedures and events remains a priority. METHODS: We measured an age- and sex-specific gene expression score (ASGES) previously validated to detect obstructive CAD (oCAD) in sympt ...
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Journal ArticleJ Cardiovasc Comput Tomogr · 2017
BACKGROUND: Coronary computed tomography angiography (CTA) and functional testing strategies for stable chest pain yield similar outcomes; one aspect that may guide test choice is safety. METHODS: We compared test safety (test complications, incidental fin ...
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Journal ArticleJAMA Cardiol · December 1, 2016
P values and hypothesis testing methods are frequently misused in clinical research. Much of this misuse appears to be owing to the widespread, mistaken belief that they provide simple, reliable, and objective triage tools for separating the true and impor ...
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Journal ArticleCirculation · November 1, 2016
BACKGROUND: Advancing age is associated with a greater prevalence of coronary artery disease in heart failure with reduced ejection fraction and with a higher risk of complications after coronary artery bypass grafting (CABG). Whether the efficacy of CABG ...
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Journal ArticleJ Am Heart Assoc · October 12, 2016
BACKGROUND: Diagnostic testing in the care of patients newly presenting with symptoms suggestive of coronary artery disease may influence risk factor management, independent of test type or test results. However, little is known about changes in medication ...
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Journal ArticleAnn Intern Med · July 19, 2016
BACKGROUND: PROMISE (PROspective Multicenter Imaging Study for Evaluation of Chest Pain) found that initial use of at least 64-slice multidetector computed tomography angiography (CTA) versus functional diagnostic testing strategies did not improve clinica ...
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Journal ArticleJ Am Coll Cardiol · June 7, 2016
BACKGROUND: Although risk stratification is an important goal of cardiac noninvasive tests (NITs), few contemporary data exist on the prognostic value of different NITs according to patient sex. OBJECTIVES: The goal of this study was to compare the results ...
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Journal ArticleCirculation · May 24, 2016
BACKGROUND: The Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) trial found that initial use of ≥64 detector-row computed tomography angiography versus standard functional testing strategies (exercise ECG, stress nuclear method ...
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Journal ArticleJ Am Coll Cardiol · May 24, 2016
This review summarizes evidence from 2 lines of research previously thought to be unrelated: the unexpectedly positive results of TACT (Trial to Assess Chelation Therapy), and a body of epidemiological data showing that accumulation of biologically active ...
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Journal ArticleN Engl J Med · April 21, 2016
BACKGROUND: The survival benefit of a strategy of coronary-artery bypass grafting (CABG) added to guideline-directed medical therapy, as compared with medical therapy alone, in patients with coronary artery disease, heart failure, and severe left ventricul ...
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Journal ArticleJACC Cardiovasc Imaging · April 2016
OBJECTIVES: The aim of this study was to determine whether presentation, risk assessment, testing choices, and results differ by sex in stable symptomatic outpatients with suspected coronary artery disease (CAD). BACKGROUND: Although established CAD presen ...
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Journal ArticleInt J Cardiol · January 1, 2016
BACKGROUND: The benefits of CRT for symptomatic heart failure (HF) patients with a wide QRS and reduced left ventricular ejection fraction (LVEF≤35%), are well established .Post-hoc subgroup analyses suggest that CRT benefit may extend to patients with LVE ...
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Conference · November 10, 2015
Introduction: Diagnostic testing may represent a “teachable moment” for patients newly presenting with symptoms suggestive of CAD and requiring further evaluation, and may influence risk factor management, independent of test results. However, little is kn ...
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Journal ArticleHeart Rhythm · October 2015
BACKGROUND: In the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), a significant fraction of the patients with congestive heart failure ultimately did not die suddenly of arrhythmic causes. Patients with CHF will benefit from better tools to identi ...
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Journal ArticleJACC Cardiovasc Imaging · October 2015
OBJECTIVES: This study sought to test the hypothesis that end-systolic volume (ESV), as a marker of severity of left ventricular (LV) remodeling, influences the relationship between myocardial viability and survival in patients with coronary artery disease ...
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Journal ArticleCirculation · August 25, 2015
BACKGROUND: Patients with severe left ventricular dysfunction, ischemic heart failure, and coronary artery disease suitable for coronary artery bypass grafting (CABG) are at higher risk for surgical morbidity and mortality. Paradoxically, those patients wi ...
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Journal ArticleCan J Cardiol · August 2015
BACKGROUND: CHA2DS2-VASc and CHADS2 scores were derived and validated for stroke-risk stratification in patients who have a diagnosis of atrial fibrillation (AF). We hypothesized that these scores would predict adverse cardiovascular events even in the abs ...
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Journal ArticleEur J Heart Fail · July 2015
AIMS: Hypothesis 1 of the Surgical Treatment for Ischemic Heart Failure (STICH) trial enrolled 1212 patients with an LVEF of ≤35% and CAD amenable to coronary artery bypass grafting (CABG). Patients were randomized to CABG and optimal medical therapy (MED) ...
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Journal ArticleN Engl J Med · June 18, 2015
BACKGROUND: Statin therapy reduces low-density lipoprotein (LDL) cholesterol levels and the risk of cardiovascular events, but whether the addition of ezetimibe, a nonstatin drug that reduces intestinal cholesterol absorption, can reduce the rate of cardio ...
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Journal ArticleCirculation · May 19, 2015
BACKGROUND: Oxidative stress may contribute to heart failure (HF) progression. Inhibiting xanthine oxidase in hyperuricemic HF patients may improve outcomes. METHODS AND RESULTS: We randomly assigned 253 patients with symptomatic HF, left ventricular eject ...
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Journal ArticleJ Thorac Cardiovasc Surg · May 2015
OBJECTIVE: Whether right ventricular dysfunction affects clinical outcome after coronary artery bypass grafting with or without surgical ventricular reconstruction is still unknown. The aim of the study was to assess the impact of right ventricular dysfunc ...
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Journal ArticleN Engl J Med · April 2, 2015
BACKGROUND: Many patients have symptoms suggestive of coronary artery disease (CAD) and are often evaluated with the use of diagnostic testing, although there are limited data from randomized trials to guide care. METHODS: We randomly assigned 10,003 sympt ...
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Journal ArticleAm Heart J · April 2015
BACKGROUND: Few guidelines exist regarding authorship on manuscripts resulting from large multicenter trials. The HF-ACTION investigators devised a system to address assignment of authorship on trial publications and tested the outcomes in the course of co ...
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Journal ArticleEur J Heart Fail · April 2015
AIMS: We sought to evaluate associations between baseline sphericity index (SI) and clinical outcome, and changes in SI after coronary artery bypass graft (CABG) surgery with or without surgical ventricular reconstruction (SVR) in ischaemic cardiomyopathy ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · March 2015
BACKGROUND: The impact of patient age on the risks of death or rehospitalization after primary prevention implantable cardioverter-defibrillator (ICD) placement is uncertain. METHODS AND RESULTS: Data from 5 major ICD trials were merged: the Multicenter Au ...
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Journal ArticleCardiology · 2015
OBJECTIVES AND BACKGROUND: We evaluated the ability of 23 genetic variants to provide prognostic information in patients enrolled in the Genetic Substudy of the Surgical Treatment for Ischemic Heart Failure (STICH) trials. METHODS: Patients assigned to STI ...
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Journal ArticleJ Thorac Cardiovasc Surg · December 2014
OBJECTIVES: In the Surgical Treatment for Ischemic Heart Failure trial, surgical ventricular reconstruction plus coronary artery bypass surgery was not associated with a reduction in the rate of death or cardiac hospitalization compared with bypass alone. ...
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Journal ArticleJACC Heart Fail · December 2014
OBJECTIVES: The aim of this study was to determine if the benefit of implantable cardioverter-defibrillators (ICDs) is modulated by medical comorbidity. BACKGROUND: Primary prevention ICDs improve survival in patients at risk for sudden cardiac death. Thei ...
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Journal ArticleJ Am Coll Cardiol · October 28, 2014
BACKGROUND: Classification of chronic heart failure (HF) is on the basis of criteria that may not adequately capture disease heterogeneity. Improved phenotyping may help inform research and therapeutic strategies. OBJECTIVES: This study used cluster analys ...
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Journal ArticlePacing Clin Electrophysiol · September 2014
BACKGROUND: Patients with a pacing indication and first-degree atrioventricular (AV)-block pose a clinical challenge. The prognostic impact of first-degree AV-block in patients with sinus node dysfunction and the impact of pacing in this setting are not kn ...
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Journal ArticleJ Am Coll Cardiol · August 12, 2014
BACKGROUND: Patients with ischemic left ventricular dysfunction have higher operative risk with coronary artery bypass graft surgery (CABG). However, those whose early risk is surpassed by subsequent survival benefit have not been identified. OBJECTIVES: T ...
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Journal ArticleAm Heart J · August 2014
Independent data monitoring committees (IDMCs) were introduced to monitor patient safety and study conduct in randomized clinical trials (RCTs), but certain challenges regarding the utilization of IDMCs have developed. First, the roles and responsibilities ...
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Journal ArticleJACC Heart Fail · August 2014
OBJECTIVES: The objective of this study was to assess the prognostic significance of exercise capacity in patients with ischemic left ventricular (LV) dysfunction eligible for coronary artery bypass graft surgery (CABG). BACKGROUND: Poor exercise capacity ...
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Journal ArticleAm J Kidney Dis · July 2014
BACKGROUND: The benefit of a primary prevention implantable cardioverter-defibrillator (ICD) among patients with chronic kidney disease is uncertain. STUDY DESIGN: Meta-analysis of patient-level data from randomized controlled trials. SETTING & POPULATION: ...
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Journal ArticleAm Heart J · July 2014
BACKGROUND: Disodium ethylenediaminetetraacetic acid (EDTA) reduced adverse cardiac outcomes in a factorial trial also testing oral vitamins. This report describes the intent-to-treat comparison of the 4 factorial groups overall and in patients with diabet ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · July 2014
BACKGROUND: The National Institutes of Health.funded Trial to Assess Chelation Therapy (TACT) randomized 1708 stablecoronary disease patients aged .50 years who were .6 months post.myocardial infarction (2003.2010) to 40 infusions ofa multicomponent EDTA c ...
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Journal ArticleJ Am Coll Cardiol · June 24, 2014
OBJECTIVES: This study sought to determine whether circadian patterns in ventricular arrhythmias (VAs) occur in a current primary prevention defibrillator (implantable cardioverter-defibrillator [ICD]) population. BACKGROUND: Cardiovascular events, includi ...
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Journal ArticleJ Am Coll Cardiol · June 17, 2014
OBJECTIVES: The purpose of this study was to determine if 6-min walk test data assists in treatment decisions for patients with heart failure. BACKGROUND: In the SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial), a pre-specified subgroup analysis show ...
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Journal ArticleAm Heart J · June 2014
BACKGROUND: Suspected coronary artery disease (CAD) is one of the most common, potentially life-threatening diagnostic problems clinicians encounter. However, no large outcome-based randomized trials have been performed to guide the selection of diagnostic ...
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ConferenceBlood · May 22, 2014
C-abl oncogene 1, nonreceptor tyrosine kinase (ABL1) kinase inhibitors such as imatinib mesylate (imatinib) are effective in managing chronic myeloid leukemia (CML) but incapable of eliminating leukemia stem cells (LSCs), suggesting that kinase-independent ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · January 2014
BACKGROUND: The Trial to Assess Chelation Therapy (TACT) showed clinical benefit of an EDTA-based infusion regimen in patients aged ≥50 years with prior myocardial infarction. Diabetes mellitus before enrollment was a prespecified subgroup. METHODS AND RES ...
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Journal ArticleJAMA · December 18, 2013
IMPORTANCE: Small studies suggest that low-dose dopamine or low-dose nesiritide may enhance decongestion and preserve renal function in patients with acute heart failure and renal dysfunction; however, neither strategy has been rigorously tested. OBJECTIVE ...
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Journal ArticleAnn Intern Med · December 17, 2013
BACKGROUND: Whether high-dose multivitamins are effective for secondary prevention of atherosclerotic disease is unknown. OBJECTIVE: To assess whether oral multivitamins reduce cardiovascular events and are safe. DESIGN: Double-blind, placebo-controlled, 2 ...
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Journal ArticleAm J Cardiol · December 1, 2013
The mechanisms underlying functional mitral regurgitation (MR) and the relation between mechanism and severity of MR have not been evaluated in a large, multicenter, randomized controlled trial. Transesophageal echocardiography (TEE) was performed in 215 p ...
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Journal ArticleJ Thorac Cardiovasc Surg · November 2013
OBJECTIVE: The present analysis of the Surgical Treatment for Ischemic Heart Failure randomized trial data examined the left ventricular volumes at baseline and 4 months after surgery to determine whether any magnitude of postoperative reduction in end-sys ...
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Journal ArticleJACC Heart Fail · October 2013
OBJECTIVES: This study sought to assess the effect of the addition of coronary artery bypass grafting (CABG) to medical therapy on mode of death in heart failure. BACKGROUND: Although CABG therapy is widely used in ischemic cardiomyopathy patients, there a ...
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Journal ArticleCirculation · August 27, 2013
BACKGROUND: The most frequent complications associated with implantable cardioverter-defibrillators (ICDs) involve the transvenous leads. A subcutaneous implantable cardioverter-defibrillator (S-ICD) has been developed as an alternative system. This study ...
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Journal ArticleHeart Rhythm · July 2013
BACKGROUND: Dual coil implantable cardioverter-defibrillator (ICD) leads with a superior vena cava (SVC) electrode have been considered standard of care despite sparse data suggesting improved ICD defibrillation efficacy. SVC coils increase lead complexity ...
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Journal ArticleHeart Rhythm · June 2013
BACKGROUND: Whether there is an optimal time to place an implantable cardioverter-defibrillator (ICD) more than 40 days after myocardial infarction (MI) in guideline-eligible patients is unknown. OBJECTIVE: To evaluate the effect of time from MI to randomi ...
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Journal ArticleJ Am Coll Cardiol · May 28, 2013
OBJECTIVES: The aim of this study was to examine rapid-rate nonsustained ventricular tachycardia (RR-NSVT) during routine implantable cardioverter-defibrillator (ICD) evaluation in patients with heart failure and its relationship to outcomes. BACKGROUND: T ...
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Journal ArticleJ Am Coll Cardiol · May 7, 2013
OBJECTIVES: The study objectives were to test the hypotheses that ischemia during stress testing has prognostic value and identifies those patients with coronary artery disease (CAD) with left ventricular (LV) dysfunction who derive the greatest benefit fr ...
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Journal ArticleCirc Heart Fail · May 2013
BACKGROUND: To assess the influence of therapy crossovers on treatment comparisons and mortality at 5 years in patients with ischemic heart disease and heart failure randomly assigned to medical therapy alone (MED) or to MED and coronary artery bypass graf ...
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Journal ArticleCirc Heart Fail · May 2013
BACKGROUND: Patients with heart failure and coronary artery disease often undergo coronary artery bypass grafting, but assessment of the risk of an adverse outcome in these patients is difficult. To evaluate the ability of biomarkers to contribute independ ...
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Journal ArticleJAMA · March 27, 2013
IMPORTANCE: Studies in experimental and human heart failure suggest that phosphodiesterase-5 inhibitors may enhance cardiovascular function and thus exercise capacity in heart failure with preserved ejection fraction (HFPEF). OBJECTIVE: To determine the ef ...
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Journal ArticleJAMA · March 27, 2013
IMPORTANCE: Chelation therapy with disodium EDTA has been used for more than 50 years to treat atherosclerosis without proof of efficacy. OBJECTIVE: To determine if an EDTA-based chelation regimen reduces cardiovascular events. DESIGN, SETTING, AND PARTICI ...
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Journal ArticleCirc Heart Fail · March 2013
BACKGROUND: Congestion is a primary driver of symptoms in patients with acute heart failure, and relief of congestion is a critical goal of therapy. Monitoring of response to therapy through the assessment of daily weights and net fluid loss is the current ...
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Journal ArticleJACC Heart Fail · February 2013
OBJECTIVES: The aim of this study was to investigate whether patients with systolic heart failure (HF) and abnormal thyroid function are at increased risk for death. BACKGROUND: Thyroid hormone homeostasis is vital to the optimal functioning of the cardiov ...
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Journal ArticleJAMA · January 2, 2013
IMPORTANCE: Randomized clinical trials have shown that implantable cardioverter-defibrillator (ICD) therapy saves lives. Whether the survival of patients who received an ICD in primary prevention clinical trials differs from that of trial-eligible patients ...
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Journal ArticleEur Heart J · January 2013
AIMS: The Surgical Treatment for Ischemic Heart Failure (STICH) trial demonstrated no overall benefit when surgical ventricular reconstruction (SVR) was added to coronary artery bypass grafting (CABG) in patients with ischaemic cardiomyopathy. The present ...
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Journal ArticleN Engl J Med · December 13, 2012
BACKGROUND: Ultrafiltration is an alternative strategy to diuretic therapy for the treatment of patients with acute decompensated heart failure. Little is known about the efficacy and safety of ultrafiltration in patients with acute decompensated heart fai ...
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Journal ArticleJ Card Fail · November 2012
BACKGROUND: Obesity could attenuate diuretic effectiveness in treatment of acute decompensated heart failure (HF). METHODS AND RESULTS: The DOSE trial randomized 308 subjects with acute HF to low- versus high-intensification intravenous diuretic therapy. W ...
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Journal ArticleCirc Heart Fail · September 1, 2012
Heart failure (HF) with preserved ejection fraction (HFpEF) or “diastolic HF” accounts for approximately half of HF cases. To date, neurohumoral antagonists have failed to show a significant benefit on clinical outcomes in HFpEF. While our understanding of ...
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Journal ArticleCirculation · May 29, 2012
BACKGROUND: Whether mitral valve repair during coronary artery bypass grafting (CABG) improves survival in patients with ischemic mitral regurgitation (MR) remains unknown. METHODS AND RESULTS: Patients with ejection fraction ≤35% and coronary artery disea ...
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Journal ArticleN Engl J Med · April 12, 2012
BACKGROUND: Thrombin potently activates platelets through the protease-activated receptor PAR-1. Vorapaxar is a novel antiplatelet agent that selectively inhibits the cellular actions of thrombin through antagonism of PAR-1. METHODS: We randomly assigned 2 ...
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Journal ArticleJ Card Fail · March 2012
BACKGROUND: Worsening renal function is common among patients hospitalized for acute decompensated heart failure (ADHF). When this occurs, subsequent management decisions often pit the desire for effective decongestion against concerns about further worsen ...
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Journal ArticleJ Am Soc Echocardiogr · March 2012
BACKGROUND: The Surgical Treatment for Ischemic Heart Failure (STICH) randomized trial was designed to identify an optimal management strategy for patients with ischemic cardiomyopathy. Baseline echocardiographic examinations were required for all patients ...
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Journal ArticleAnn Thorac Surg · February 2012
BACKGROUND: We prospectively applied the Surgical Treatment of Ischemic Cardiomyopathy trial entry criteria to an observational database to determine whether coronary artery bypass grafting (CABG) decreases mortality compared with medical therapy (MED) for ...
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Journal ArticleCirc Heart Fail · January 2012
BACKGROUND: We aimed to develop a multivariable statistical model for risk stratification in patients with chronic heart failure with systolic dysfunction, using patient data that are routinely collected and easily obtained at the time of initial presentat ...
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Journal ArticleAm Heart J · January 2012
TACT is an National Institutes of Health-sponsored, randomized, double-blind, placebo-controlled, 2 × 2 factorial clinical trial testing the benefits and risks of 40 infusions of a multicomponent disodium EDTA chelation solution compared with placebo and o ...
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Journal ArticleN Engl J Med · April 28, 2011
BACKGROUND: The role of coronary-artery bypass grafting (CABG) in the treatment of patients with coronary artery disease and heart failure has not been clearly established. METHODS: Between July 2002 and May 2007, a total of 1212 patients with an ejection ...
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Journal ArticleN Engl J Med · April 28, 2011
BACKGROUND: The assessment of myocardial viability has been used to identify patients with coronary artery disease and left ventricular dysfunction in whom coronary-artery bypass grafting (CABG) will provide a survival benefit. However, the efficacy of thi ...
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Journal ArticleN Engl J Med · March 3, 2011
BACKGROUND: Loop diuretics are an essential component of therapy for patients with acute decompensated heart failure, but there are few prospective data to guide their use. METHODS: In a prospective, double-blind, randomized trial, we assigned 308 patients ...
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Journal ArticleHeart Rhythm · March 2011
BACKGROUND: The implantable cardioverter-defibrillator (ICD) is an effective therapy for preventing sudden cardiac death (SCD) in patients with prior myocardial infarction (MI) and reduced left ventricular function; however, the optimal timing of ICD impla ...
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Journal ArticleHeart Rhythm · January 2011
BACKGROUND: Only a minority of patients receiving implantable cardioverter-defibrillators (ICDs) for the primary prevention of sudden death receive appropriate shocks, yet almost as many are subjected to inappropriate shocks and device complications. Ident ...
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Journal ArticleCirc Cardiovasc Interv · October 2010
BACKGROUND: Accurate models to predict mortality are needed for risk stratification in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). METHODS AND RESULTS: We examined 5745 patie ...
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Journal ArticleEuropace · August 2010
AIMS: We sought to assess the relation between time from myocardial infarction (MI) to enrolment and patient outcomes and to examine the association between these outcomes and implantable cardioverter defibrillator (ICD) therapy. METHODS AND RESULTS: We an ...
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Journal ArticleJ Am Coll Cardiol · July 13, 2010
OBJECTIVES: The aim of this study was to determine whether single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) is an effective method of risk stratification for sudden cardiac death (SCD) in patients with coronary artery d ...
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Journal ArticleJ Am Coll Cardiol · April 27, 2010
OBJECTIVES: The goal of this study was to evaluate the relationship between the presence of sinus rhythm and outcomes in patients with a history of congestive heart failure (CHF) and atrial fibrillation (AF). BACKGROUND: The value of sinus rhythm maintenan ...
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Journal ArticleAm Heart J · April 2010
BACKGROUND: Public access automatic external defibrillators (AEDs) can save lives, but most deaths from out-of-hospital sudden cardiac arrest occur at home. The Home Automatic External Defibrillator Trial (HAT) found no survival advantage for adding a home ...
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Journal ArticleAm J Cardiol · December 15, 2009
The currently available sudden cardiac death (SCD) risk prediction tools fail to identify most at-risk patients and cannot delineate a specific patient's SCD risk. We sought to develop a tool to improve the risk stratification of patients with coronary art ...
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Journal ArticleAm Heart J · December 2009
BACKGROUND: Clinical trials of antithrombotic agents for the treatment of ACS routinely assess bleeding as a safety endpoint, but variation in bleeding definitions makes comparison of the relative safety of these agents difficult. METHODS: The ABC Multidis ...
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Journal ArticleCirculation · December 1, 2009
BACKGROUND: The Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) demonstrated that implantable cardioverter-defibrillator (ICD) therapy reduces all-cause mortality in patients with New York Heart Association class II/III heart failure and a left vent ...
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Journal ArticleAnn Intern Med · September 15, 2009
With the emergence of large multicenter trials over the past 20 years, the numbers of investigators involved and publications resulting from each study have grown exponentially. An efficient, fair, and effective way to establish authorship on study-related ...
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Journal ArticleCirculation · September 8, 2009
BACKGROUND: Although implantable cardioverter-defibrillator (ICD) therapy reduces mortality in moderately symptomatic heart failure patients with an ejection fraction
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Journal ArticleJ Cardiovasc Electrophysiol · August 2009
INTRODUCTION: Programmed stimulation is an important prognostic tool in the evaluation of patients with an ejection fraction
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Journal ArticleAm Heart J · July 2009
BACKGROUND: In the Mode Selection Trial (MOST) of 2,010 patients with sinus node dysfunction, dual-chamber-paced patients had less atrial fibrillation (AF) and heart failure and had slightly improved health-related quality of life (QOL) compared with rate ...
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Journal ArticleN Engl J Med · May 21, 2009
BACKGROUND: Glycoprotein IIb/IIIa inhibitors are indicated in patients with acute coronary syndromes who are undergoing an invasive procedure. The optimal timing of the initiation of such therapy is unknown. METHODS: We compared a strategy of early, routin ...
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Journal ArticleN Engl J Med · April 23, 2009
BACKGROUND: Surgical ventricular reconstruction is a specific procedure designed to reduce left ventricular volume in patients with heart failure caused by coronary artery disease. We conducted a trial to address the question of whether surgical ventricula ...
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Journal ArticleJAMA · April 8, 2009
CONTEXT: Guidelines recommend that exercise training be considered for medically stable outpatients with heart failure. Previous studies have not had adequate statistical power to measure the effects of exercise training on clinical outcomes. OBJECTIVE: To ...
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Journal ArticleAm Heart J · December 2008
BACKGROUND: Ejection fraction (EF) is an important method of mortality prediction among cardiac patients, and has been used to identify the highest risk patients for enrollment in the defibrillator primary prevention trials. Evidence suggests that measures ...
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Journal ArticleCirculation · November 11, 2008
BACKGROUND: Sudden cardiac death remains a leading cause of mortality despite advances in medical treatment for the prevention of ischemic heart disease and heart failure. Recent studies showed a benefit of implantable cardioverter defibrillator implantati ...
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Journal ArticleCirc Cardiovasc Imaging · November 2008
BACKGROUND: Single-photon emission computed tomography myocardial perfusion imaging defects are associated with increased all-cause mortality and cardiovascular death. However, it is unknown whether single-photon emission computed tomography myocardial per ...
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Journal ArticleJ Cardiovasc Electrophysiol · October 2008
INTRODUCTION: We conducted this study to examine the effect of the ICD on the outcomes of patients with prior coronary revascularization enrolled in the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) and to assess the association of time from coron ...
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Journal ArticleN Engl J Med · September 4, 2008
BACKGROUND: Patients with heart failure who receive an implantable cardioverter-defibrillator (ICD) for primary prevention (i.e., prevention of a first life-threatening arrhythmic event) may later receive therapeutic shocks from the ICD. Information about ...
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Journal ArticleN Engl J Med · September 4, 2008
BACKGROUND: Implantable cardioverter-defibrillator (ICD) therapy significantly prolongs life in patients at increased risk for sudden death from depressed left ventricular function. However, whether this increased longevity is accompanied by deterioration ...
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Journal ArticleJ Am Coll Cardiol · August 12, 2008
OBJECTIVES: This study investigated whether defibrillation threshold (DFT) testing during implantable cardioverter-defibrillator (ICD) implantation predicts clinical outcomes. BACKGROUND: Defibrillation testing is often performed during insertion of ICDs t ...
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Journal ArticleJ Cardiovasc Electrophysiol · July 2008
INTRODUCTION: The Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) demonstrated that implantable cardioverter defibrillator (ICD) therapy reduced overall mortality in patients with class II or III heart failure and left ventricular ejection fraction ...
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Journal ArticleN Engl J Med · June 19, 2008
BACKGROUND: It is common practice to restore and maintain sinus rhythm in patients with atrial fibrillation and heart failure. This approach is based in part on data indicating that atrial fibrillation is a predictor of death in patients with heart failure ...
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Journal ArticleN Engl J Med · June 12, 2008
BACKGROUND: Epidemiologic studies have shown a relationship between glycated hemoglobin levels and cardiovascular events in patients with type 2 diabetes. We investigated whether intensive therapy to target normal glycated hemoglobin levels would reduce ca ...
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Journal ArticleN Engl J Med · April 24, 2008
BACKGROUND: The most common location of out-of-hospital sudden cardiac arrest is the home, a situation in which emergency medical services are challenged to provide timely care. Consequently, home use of an automated external defibrillator (AED) might offe ...
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Journal ArticleJ Am Coll Cardiol · April 1, 2008
OBJECTIVES: The outcome of congestive heart failure (CHF) patients with syncope is understood incompletely. BACKGROUND: We analyzed data from patients enrolled in the SCD-HeFT (Sudden Cardiac Death Heart Failure Trial) to determine whether syncope predicte ...
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Journal ArticleAm Heart J · March 2008
Most cardiac arrests occur in the home, where emergency medical services (EMS) systems are challenged to provide timely care. Because a large proportion of sudden cardiac arrests (SCAs) are due to ventricular tachycardia or ventricular fibrillation, home u ...
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Journal ArticleAm Heart J · March 2008
BACKGROUND: The SCD-HeFT demonstrated that implantable cardioverter/defibrillator (ICD) therapy significantly improved survival compared to medical therapy alone in stable moderately symptomatic heart failure patients with an ejection fraction < or = 35%. ...
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Journal ArticleJ Thorac Cardiovasc Surg · December 2007
OBJECTIVES: The rationale and design of the Surgical Treatment for Ischemic Heart Failure trial is described. Before the Surgical Treatment for Ischemic Heart Failure trial, less than 1000 patients with ischemic cardiomyopathy had been studied in randomize ...
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Journal ArticleJ Am Coll Cardiol · September 18, 2007
OBJECTIVES: We determined the contribution of multiple variables to predict arrhythmic death and total mortality risk in patients with coronary disease and left ventricular dysfunction. We then constructed an algorithm to predict risk of mortality and sudd ...
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Journal ArticleHeart Rhythm · September 2007
BACKGROUND: Ninety-nine percent of pacemakers implanted in the United States include an option for rate modulation. OBJECTIVE: The purpose of this study was to determine whether dual-chamber rate-modulated pacing, when compared with dual-chamber pacing alo ...
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Journal ArticleAm Heart J · July 2007
BACKGROUND: Technetium Tc 99m gated single photon emission computed tomography (SPECT) has become the cornerstone of noninvasive risk stratification in patients with ischemic heart disease, but its role in patients with heart failure is not as well establi ...
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Journal ArticleAm J Cardiol · July 1, 2007
Patients with coronary artery disease, depressed left ventricular ejection fraction, and nonsustained ventricular tachycardia (VT) have a high mortality rate due to arrhythmic (arrhythmic death/cardiac arrest) and other cardiac causes. The Multicenter UnSu ...
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Journal ArticleAm Heart J · June 2007
Accurate and timely prediction of sudden cardiac death (SCD) is a necessary prerequisite for effective prevention and therapy. Although the largest number of SCD events occurs in patients without overt heart disease, there are currently no tests that are o ...
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Journal ArticleAm Heart J · June 2007
BACKGROUND: Common locations of death in patients with congestive heart failure (CHF) are unknown. In the SCD-HeFT, mortality of patients with CHF was assessed after randomization to an implantable cardioverter/defibrillator (ICD), amiodarone, or placebo. ...
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Journal ArticleAm Heart J · June 2007
Although current evidence supporting a more precise strategy for identifying patients at highest risk for sudden cardiac death (SCD) is sparse, strategies for translating existing and future evidence into clinical practice and policy are needed today. A gr ...
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Journal ArticleCirculation · May 22, 2007
BACKGROUND: In patients with heart failure, rates of clinically apparent stroke range from 1.3% to 3.5% per year. Little is known about the incidence and risk factors in the absence of atrial fibrillation. In the Sudden Cardiac Death in Heart Failure Trial ...
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Journal ArticleAm Heart J · May 2007
BACKGROUND: Amiodarone's role as a cause of toxic optic neuropathy is based on case reports. Annual frequency estimates of 0.36% to 2.0%, which have been made without reference to the dose or duration of treatment, are 12 to 200 times higher than those for ...
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Journal ArticleAm Heart J · April 2007
BACKGROUND: Recent observations suggest statin treatment may be associated with lower mortality in heart failure (HF). The SCD-HeFT was a study of 2521 functional class II and III HF patients with left ventricular ejection fractions < or = 35% and ischemic ...
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Journal ArticleAm Heart J · February 2007
BACKGROUND: Although there are limited clinical data to support the use of exercise training as a means to reduce mortality and morbidity in patients with heart failure, current guidelines state that exercise is beneficial. TRIAL DESIGN: The objective of t ...
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Journal ArticleAm Heart J · November 2006
BACKGROUND: Heart failure complicated by atrial fibrillation (AF) is associated with excessive mortality and morbidity. The aim of the study was to determine the role of amiodarone or implantable cardioverter/defibrillator (ICD) in patients with AF and hea ...
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Journal ArticleAnn Thorac Surg · October 2006
BACKGROUND: Treatment of coronary artery disease (CAD) is evolving with better medications, improvements in percutaneous coronary intervention (PCI), and enhanced techniques for coronary artery bypass grafting (CABG). METHODS: In this study, 18,481 patient ...
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Journal ArticleCirculation · July 11, 2006
BACKGROUND: In the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), implantable cardioverter-defibrillator (ICD) therapy significantly reduced all-cause mortality rates compared with medical therapy alone in patients with stable, moderately symptoma ...
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Journal ArticleCirculation · July 4, 2006
BACKGROUND: Several randomized trials have compared atrial-based (dual-chamber or atrial) pacing with ventricular pacing in patients with bradycardia. No trial has shown a mortality reduction, and only 1 small trial suggested a reduction in stroke. The goa ...
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Journal ArticleJ Am Coll Cardiol · June 6, 2006
OBJECTIVES: We evaluated the impact of treatment crossovers on study results in the Mode Selection Trial (MOST). BACKGROUND: The MOST study, a 2,010-patient, 6-year trial comparing dual-chamber pacing (DDDR) and ventricular pacing (VVIR) in sinus node dysf ...
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Journal ArticleContemp Clin Trials · June 2006
Clinical events committees (CECs) are the current standard for endpoint adjudication in clinical trials. However, little data exist with which to compare CEC and site investigator determinations or to evaluate internal agreement among CEC members. Using da ...
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Journal ArticleHeart Rhythm · June 2006
BACKGROUND: Dual-chamber pacemakers restore AV synchrony compared with ventricular pacemakers, but the effects on health-related quality of life (QOL) are uncertain. OBJECTIVES: The purpose of this study was to assess the effect of pacemaker implantation, ...
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Journal ArticleAm Heart J · March 2006
BACKGROUND: Patient and physician preferences as well as cost favor an increasingly higher threshold for hospital admission for heart failure (HF) treatment. This trend risks masking the severity and prevalence of HF as hospitalization for HF may decrease. ...
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Journal ArticleJ Am Coll Cardiol · November 1, 2005
OBJECTIVES: The purpose of this study was to determine the value of a new anatomic score for prognosis after diagnostic catheterization in patients with previous coronary artery bypass grafting (CABG). BACKGROUND: Previous CABG patients comprise a growing ...
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Journal ArticleAm Heart J · October 2005
BACKGROUND: Coronary artery bypass graft (CABG) surgery with autologous vein graft (VG) conduit is one of the most frequently performed operations in the United States. Unfortunately, many VGs become occluded during long-term follow-up largely because of n ...
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Chapter · August 24, 2005
With the proliferation of clinical data registries and the rising expense of clinical trials, observational data sources are increasingly providing evidence for clinical decision making. These data are viewed as complementary to randomized clinical trials ...
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Chapter · August 24, 2005
Multivariable regression models are powerful tools that are used frequently in studies of clinical outcomes. These models can use a mixture of categorical and continuous variables and can handle partially observed (censored) responses. However, uncritical ...
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Journal ArticlePacing Clin Electrophysiol · August 2005
INTRODUCTION: Permanent pacemakers are capable of increasing heart rate in response to physical activity by a variety of sensors including accelerometers, piezoelectric crystals, or blended sensors. The impact of these different physiologic sensors on card ...
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Journal ArticleLancet · July 16, 2005
BACKGROUND: Data from a pilot study suggested that noetic therapies-healing practices that are not mediated by tangible elements-can reduce preprocedural distress and might affect outcomes in patients undergoing percutaneous coronary intervention. We under ...
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Journal ArticleAm Heart J · June 2005
Although many studies have shown that implantable cardioverter defibrillator (ICD) therapy improves the survival of patients with significant left ventricular dysfunction, the magnitude of effectiveness of ICD therapy in clinically defined subgroups remain ...
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Journal ArticleCirculation · May 17, 2005
BACKGROUND: Prolonged QRS duration (QRSd) is an important prognostic indicator for death and heart failure hospitalization in patients with systolic heart failure. The relationship of baseline QRSd to death and heart failure hospitalization in patients wit ...
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Journal ArticleHeart Rhythm · March 2005
OBJECTIVES: The purpose of this study was to determine whether a prolonged paced QRS duration increases the risk of cardiac dysfunction. BACKGROUND: Right ventricular apical pacing mimics left bundle branch block, results in a prolonged QRS duration of var ...
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Journal ArticleJ Thromb Thrombolysis · February 2005
BACKGROUND: Sustained hypotension, cardiogenic shock, and heart failure all imply a poor prognosis in acute myocardial infarction (MI). We assessed the benefit of adding 48 hours of intra-aortic balloon counterpulsation (IABP) to standard treatment for MI, ...
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Journal ArticleN Engl J Med · January 20, 2005
BACKGROUND: Sudden death from cardiac causes remains a leading cause of death among patients with congestive heart failure (CHF). Treatment with amiodarone or an implantable cardioverter-defibrillator (ICD) has been proposed to improve the prognosis in suc ...
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Journal ArticleCirculation · January 18, 2005
BACKGROUND: Compared with single-chamber ventricular pacing, dual-chamber pacing can reduce adverse events and, as a result, improve quality of life in patients paced for sick sinus syndrome. It is not clear, however, how these benefits compare with the in ...
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Journal ArticleCirculation · September 28, 2004
BACKGROUND: In a previous substudy of the GUSTO-I trial, we observed better functional and quality-of-life outcomes among patients in the United States (US patients) compared with patients in Canada. Rates of invasive therapy were significantly higher in t ...
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Journal ArticleAm J Cardiol · September 15, 2004
In 1,009 patients with atrial fibrillation and congestive heart failure, the 2-year mortality rate was 31% in patients treated with rate control (n = 505) versus 29% in patients treated with rhythm control (n = 504). After adjusting for differences in base ...
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Journal ArticleJ Cardiovasc Electrophysiol · September 2004
INTRODUCTION: Previous studies have demonstrated gender differences in risk of sudden death in patients with ischemic heart disease. The Multicenter UnSustained Tachycardia Trial (MUSTT) evaluated the ability of therapy guided by electrophysiologic (EP) te ...
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Journal ArticleCirculation · August 17, 2004
BACKGROUND: Stratifiers of sudden and total mortality risk are needed to optimally target preventive therapies in patients with coronary artery disease and impaired ventricular function. We assessed the prognostic significance of ECG markers of conduction ...
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Journal ArticleJ Am Coll Cardiol · June 2, 2004
OBJECTIVES: We evaluated the incidence, predictors, and treatment of pacemaker syndrome in patients with sinus node dysfunction treated with ventricular-based (VVIR) pacing in the Mode Selection Trial (MOST). BACKGROUND: Pacemaker syndrome, or intolerance ...
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Journal ArticleJ Am Coll Cardiol · May 5, 2004
OBJECTIVES: This study was an analysis of factors associated with stroke in a population of patients paced for sinus node dysfunction in a large prospective clinical trial (Mode Selection Trial [MOST]). BACKGROUND: The effects of dual-chamber versus single ...
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Journal ArticleAm J Cardiol · February 15, 2004
Of 592 patients in the Global Utilization of Streptokinase and tPA for Occluded Arteries-I trial who had a stroke during initial hospitalization, the risk for intracranial hemorrhage was significantly greater in those with recent facial or head trauma (odd ...
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Journal ArticleJ Cardiovasc Electrophysiol · February 2004
INTRODUCTION: Atrial fibrillation (AF) is common in pacemaker patients with sinus node dysfunction (SND) and may result in rapid ventricular pacing (RVP) in the DDDR mode. Mode switching (MS) reduces RVP, but its clinical benefit in patients with SND is un ...
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Journal ArticleNew Zealand Medical Journal · 2004
Aim: To compare differences in the presentation and management of acute coronary syndrome (ACS) patients presenting to interventional versus non-interventional New Zealand hospitals. Methods: We assessed the data collected by the New Zealand Cardiac Societ ...
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Journal ArticleEur Heart J · December 2003
AIMS: We sought to evaluate international patterns of use and factors influencing use of evidence-based medications early after ACS. METHODS AND RESULTS: Using a database of 15904 ACS patients enrolled in the SYMPHONY and 2nd SYMPHONY trials in 37 countrie ...
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Journal ArticleAm Heart J · November 2003
BACKGROUND: Although more than one million patients in the United States have permanent pacemakers, little is known about their cause of death. We evaluated the cause of death in 404 patients who died in the Mode Selection Trial (MOST). METHODS: In MOST, p ...
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Journal ArticleAm J Cardiol · September 15, 2003
The purpose of this study was to characterize the incidence, time course, frequency, and spectrum of acute and chronic complications arising from dual-chamber pacemaker implantation. This information may serve as a benchmark when comparing complication rat ...
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Journal ArticleCirculation · July 8, 2003
BACKGROUND: The Multicenter UnSustained Tachycardia Trial (MUSTT) demonstrated the benefit of implantable cardioverter-defibrillators (ICDs) in patients with coronary disease, asymptomatic nonsustained ventricular tachycardia, and reduced left ventricular ...
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Journal ArticleCirculation · June 17, 2003
BACKGROUND: Dual-chamber (DDDR) pacing preserves AV synchrony and may reduce heart failure (HF) and atrial fibrillation (AF) compared with ventricular (VVIR) pacing in sinus node dysfunction (SND). However, DDDR pacing often results in prolonged QRS durati ...
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Journal ArticleCirculation · April 1, 2003
BACKGROUND: Some current pacing systems can automatically detect and record atrial tachyarrhythmias that may be asymptomatic. We prospectively studied a 312-patient (pt) subgroup of MOST (MOde Selection Trial), a 2010-patient, 6-year randomized trial of DD ...
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Journal ArticleAm Heart J · March 2003
BACKGROUND: In many patients, ventricular arrhythmias will develop early after acute myocardial infarction. We studied the incidence, timing, and outcomes of such arrhythmias in the international Global Utilization of Streptokinase and TPA (alteplase) for ...
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Journal ArticleCirculation · November 19, 2002
BACKGROUND: Beta-blockers are known to reduce total mortality and sudden death in survivors of recent myocardial infarction. The effects of these agents in patients at high risk for sudden death with remote infarction are not clear. METHODS AND RESULTS: We ...
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Journal ArticleCirculation · November 5, 2002
BACKGROUND: Fifty percent of deaths in patients with coronary disease occur suddenly. Although many factors correlate with increased mortality, there is little information regarding the influence of these factors on mode of death. As such, optimum methods ...
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Journal ArticleJ Cardiovasc Electrophysiol · August 2002
INTRODUCTION: Nonsustained ventricular tachycardia (NSVT) occurs frequently in the postoperative period (< or = 30 days) after coronary artery bypass graft (CABG) surgery, a setting where many factors may play a role in its genesis. The prognosis of NSVT i ...
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Journal ArticleCirculation · July 16, 2002
BACKGROUND: The prognosis of ventricular arrhythmias among patients with non-ST-elevation acute coronary syndromes is unknown. We studied the incidence, predictors, and outcomes of sustained ventricular arrhythmias in 4 large randomized trials of such pati ...
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Journal ArticleAm J Cardiol · July 15, 2002
In this observational treatment comparison in a single center over 25 years, we sought to assess long-term outcomes of coronary artery bypass surgery (CABG) or medical therapy in patients with heart failure, coronary artery disease, and left ventricular sy ...
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Journal ArticleCirculation · July 9, 2002
BACKGROUND: The Multicenter Unsustained Tachycardia Trial (MUSTT) was designed to evaluate an antiarrhythmic treatment strategy, including drugs and implantable defibrillators (ICDs), guided by electrophysiological (EP) testing. We performed several statis ...
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Journal ArticleJ Am Coll Cardiol · June 19, 2002
OBJECTIVES: This study compared a biphasic waveform with a conventional monophasic waveform for cardioversion of atrial fibrillation (AF). BACKGROUND: Biphasic shock waveforms have been demonstrated to be superior to monophasic shocks for termination of ve ...
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Journal ArticleN Engl J Med · June 13, 2002
BACKGROUND: Dual-chamber (atrioventricular) and single-chamber (ventricular) pacing are alternative treatment approaches for sinus-node dysfunction that causes clinically significant bradycardia. However, it is unknown which type of pacing results in the b ...
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Journal ArticleAm Heart J · February 2002
BACKGROUND: Myocardial (re)infarction (MI), a common trial end point, can be difficult to identify because of inconclusive signs and symptoms. We examined disagreement between investigator and clinical events committee (CEC) reporting of MIs in an internat ...
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OtherAnesth Analg · January 2002
UNLABELLED: Neurocognitive dysfunction is a common complication after cardiac surgery. We evaluated in this prospective study the effect of rewarming rate on neurocognitive outcome after hypothermic cardiopulmonary bypass (CPB). After IRB approval and info ...
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Journal ArticleJ Am Coll Cardiol · October 2001
OBJECTIVES: The goal of this study was to describe the influence of the clinical setting (in-hospital vs. out-of-hospital) in which nonsustained ventricular tachycardia (NSVT) is discovered on the rate of inducibility of sustained ventricular tachycardia ( ...
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Journal ArticleStat Med · August 30, 2001
With the proliferation of clinical data registries and the rising expense of clinical trials, observational data sources are increasingly providing evidence for clinical decision making. These data are viewed as complementary to randomized clinical trials ...
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Journal ArticleCirculation · July 24, 2001
BACKGROUND: An abnormal signal-averaged ECG (SAECG) is a noninvasive marker of the substrate of sustained ventricular tachycardia after myocardial infarction. We assessed its prognostic ability in patients with asymptomatic unsustained ventricular tachycar ...
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Journal ArticleCurr Control Trials Cardiovasc Med · July 17, 2001
BACKGROUND: Clinical events committees (CEC) are used routinely to adjudicate suspected end-points in cardiovascular trials, but little information has been published about the various processes used. We reviewed results of the CEC process used to identify ...
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Journal ArticleCurr Control Trials Cardiovasc Med · July 17, 2001
BACKGROUND: Limited information has been published regarding how specific processes for event adjudication can affect event rates in trials. We reviewed nonfatal myocardial infarctions (MIs) reported by site investigators in the international Platelet Glyc ...
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Journal ArticleAm J Cardiol · March 15, 2001
Angiotensin-converting enzyme (ACE) inhibitors have been shown to reduce sudden cardiac death and all-cause mortality. They also may have direct antiarrhythmic properties. We retrospectively analyzed the data from the Multicenter UnSustained Tachycardia Tr ...
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Journal ArticleAm Heart J · October 2000
BACKGROUND: More than 200,000 permanent pacemakers will be implanted in the United States in 2000 at a cost of more than $2 billion. Sick sinus syndrome (SSS) will likely account for approximately half of all cases necessitating implantation. Pacemaker tec ...
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Journal ArticleN Engl J Med · June 29, 2000
BACKGROUND: The mortality rate among patients with coronary artery disease, abnormal ventricular function, and unsustained ventricular tachycardia is high. The usefulness of electrophysiologic testing for risk stratification in these patients is unclear. M ...
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Journal ArticleCirculation · June 6, 2000
BACKGROUND: Appropriate treatment policies should include an accurate estimate of a patient's baseline risk. Risk modeling to date has been underutilized in patients with acute coronary syndromes without persistent ST-segment elevation. METHODS AND RESULTS ...
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Journal ArticleCirculation · May 16, 2000
BACKGROUND: When a patient survives thrombolysis for acute myocardial infarction, little information from large studies exists from which to estimate prognosis during follow-up visits. METHODS AND RESULTS: Baseline, in-hospital, and later survival data wer ...
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Journal ArticleAm Heart J · May 2000
BACKGROUND: Clinical trials concerning acute myocardial infarction often evaluate short-term death. Several baseline characteristics are predictors of death, most notably age. Adjustment for one or more predictors in a multivariable analysis may be conside ...
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Journal ArticleStat Med · January 30, 2000
Prognostic models can be developed with multiple regression analysis of a data set containing individual patient data. Often this data set is relatively small, while previously published studies present results for larger numbers of patients. We describe a ...
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Journal ArticleN Engl J Med · December 16, 1999
BACKGROUND: Empirical antiarrhythmic therapy has not reduced mortality among patients with coronary artery disease and asymptomatic ventricular arrhythmias. Previous studies have suggested that antiarrhythmic therapy guided by electrophysiologic testing mi ...
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Journal ArticleCirculation · April 13, 1999
BACKGROUND: Cardiologists often use clinical variables to determine the need for electrophysiological studies to stratify patients for risk of sudden death. It is not clear whether this is rational in patients with coronary artery disease, left ventricular ...
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Journal ArticleCirculation · November 3, 1998
BACKGROUND: The baseline cardiac troponin T (cTnT) level strongly predicts short-term mortality in acute coronary syndromes, but the added value of later measures to predict short- and long-term outcome and in the context of baseline clinical characteristi ...
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Journal ArticleCirculation · November 3, 1998
BACKGROUND: Recurrent ischemia after an acute coronary syndrome portends an unfavorable outcome and has major resource-use implications. This issue has not been studied systematically among the spectrum of patients with acute coronary presentations, encomp ...
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Journal ArticleJ Am Coll Cardiol · September 1998
OBJECTIVES: We assessed the use and effects of acute intravenous and later oral atenolol treatment in a prospectively planned post hoc analysis of the GUSTO-I dataset. BACKGROUND: Early intravenous beta blockade is generally recommended after myocardial in ...
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Journal ArticleCirculation · June 23, 1998
BACKGROUND: Unstable angina and non-Q-wave myocardial infarction involve coronary arterial plaque rupture, platelet activation, and thrombus formation. This study tested the benefit of different doses of lamifiban (a platelet IIb/IIIa antagonist) alone and ...
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Journal ArticleAm J Cardiol · May 1, 1998
Increased T-wave amplitude is one of the earliest electrocardiographic (ECG) changes following coronary artery occlusion. Therefore, higher T waves in the presenting electrocardiogram should represent earlier time to treatment and thus be associated with l ...
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Journal ArticleAm J Cardiol · April 15, 1998
This report details a prospectively randomized clinical trial comparing mechanical clamp compression to hand applied pressure for attaining vascular hemostasis after coronary intervention. Effectiveness was determined by comparing the incidence of femoral ...
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Journal ArticleN Engl J Med · October 16, 1997
BACKGROUND: Reteplase (recombinant plasminogen activator), a mutant of alteplase tissue plasminogen activator, has a longer half-life than its parent molecule and produced superior angiographic results in pilot studies of acute myocardial infarction. In th ...
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Journal ArticleAnn Intern Med · October 1, 1997
BACKGROUND: Thrombolytic therapy can be life-saving in patients with acute myocardial infarction. However, if given too late or insufficiently selectively, it may provide little benefit but still cause serious complications and incur substantial costs. OBJ ...
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Journal ArticleJ Am Coll Cardiol · October 1997
OBJECTIVES: We sought to characterize the clinical determinants of mortality in patients with angiographically diagnosed ischemic or nonischemic cardiomyopathy. BACKGROUND: Patients with ischemic cardiomyopathy may have a worse prognosis than patients with ...
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Journal ArticleN Engl J Med · June 5, 1997
BACKGROUND: Among physicians who treat patients with acute myocardial infarction, there is controversy about the magnitude of the clinical benefit of primary (i.e., immediate) coronary angioplasty as compared with thrombolytic therapy. METHODS: As part of ...
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Journal ArticleCirculation · June 3, 1997
BACKGROUND: Although the benefit of thrombolytic therapy in reducing mortality in acute myocardial infarction is well established, the types of bleeding and risk factors for bleeding are less well described in large trials. METHODS AND RESULTS: We analyzed ...
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Journal ArticleAm Heart J · June 1997
We developed a logistic regression model with data from the GUSTO-I trial to predict mortality rate differences in individual patients who received accelerated tissue plasminogen activator (TPA) versus streptokinase treatment for acute myocardial infarctio ...
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Journal ArticleAm J Cardiol · May 1, 1997
We evaluated allergic reactions in 20,201 patients randomized to the streptokinase arms of The Global Utilization of Streptokinase and t-PA (Tissue Plasminogen Activator) in Occluded Coronary Arteries (GUSTO-I) trial, and tested the hypothesis that patient ...
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Journal ArticleEur Heart J · May 1997
The physician wishing to estimate the risk of death for a patient experiencing acute myocardial infarction can rapidly use parameters available on first seeing the patient to estimate the expected mortality and can update this risk during the early phase o ...
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Journal ArticleJ Am Coll Cardiol · February 1997
OBJECTIVES: This study sought to investigate the impact of surgical revascularization on outcome after myocardial infarction. BACKGROUND: Small variations in rates of coronary artery bypass graft surgery (CABG) were noted among thrombolytic regimens in the ...
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Journal ArticleJ Electrocardiol · January 1997
Formulas for predicting final acute myocardial infarction (MI) size from ST-segment deviation on an initial electrocardiogram were proposed by Aldrich et al. for anterior and inferior infarct locations. This study of 529 patients who did not receive thromb ...
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Journal ArticleCirculation · October 15, 1996
BACKGROUND: Elderly patients with acute myocardial infarction have much to gain from reperfusion with thrombolytic therapy but are also at increased risk of adverse events. We examined outcomes according to age of patients receiving thrombolysis in an inte ...
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Journal ArticleCirculation · September 15, 1996
BACKGROUND: In the randomized Global Utilization of t-PA and Streptokinase for Occluded Coronary Arteries (GUSTO-I) trial, 41021 patients received one of four thrombolytic regimens. Patients treated with accelerated tissue plasminogen activator (TPA) had a ...
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Journal ArticleCirculation · August 15, 1996
BACKGROUND: In the EPIC trial, c7E3 Fab, an antiplatelet IIb/ IIIa receptor antibody, reduced 30-day ischemic end points after high-risk coronary angioplasty by 35% and 6-month ischemic events by 23% but increased in-hospital bleeding episodes. METHODS AND ...
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Journal ArticleAnn Intern Med · July 1, 1996
BACKGROUND: Many physicians believe that electrocardiographic characteristics of nonsustained ventricular tachycardia correlate with the risk for sudden death in survivors of myocardial infarction. Sustained ventricular tachycardia induced by programmed el ...
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Journal ArticleJ Am Coll Cardiol · June 1996
OBJECTIVES: This study sought to examine the relations among patient characteristics, time to thrombolysis and outcomes in the international GUSTO-I trial. BACKGROUND: Studies have shown better left ventricular function and decreased infarct size as well a ...
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Journal ArticleCirculation · March 1, 1996
BACKGROUND: Although intravenous heparin is commonly used after thrombolytic therapy, few reports have addressed the relationship between the degree of anticoagulation and clinical outcomes. We examined the activated partial thromboplastin time (aPTT) in 2 ...
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Journal ArticleStat Med · February 28, 1996
Multivariable regression models are powerful tools that are used frequently in studies of clinical outcomes. These models can use a mixture of categorical and continuous variables and can handle partially observed (censored) responses. However, uncritical ...
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Journal ArticleCirculation · August 1, 1995
BACKGROUND: It has been hypothesized that jobs that have both high psychological demands and low decision latitude ("job strain") can lead to coronary disease. The objective of this study was to test whether job strain was correlated with the presence of c ...
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Journal ArticleAm J Cardiol · July 1, 1995
Enrollment in cardiac rehabilitation has been reported to improve exercise capacity, psychological well-being, and survival. However, participation rates are low and the reasons for nonparticipation have not been adequately defined. The purpose of this stu ...
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Journal ArticleN Engl J Med · May 25, 1995
BACKGROUND: Patients with acute myocardial infarction who were treated with accelerated tissue plasminogen activator (t-PA) (given over a period of 1 1/2 hours rather than the conventional 3 hours, and with two thirds of the dose given in the first 30 minu ...
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Journal ArticleJAMA · May 24, 1995
OBJECTIVE: To examine differences in outcomes and patient management between patients in the United States and outside the United States undergoing thrombolysis for acute myocardial infarction. DESIGN, SETTING, AND PATIENTS: Patients in the United States ( ...
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Journal ArticleAm J Cardiol · May 1, 1995
To determine whether pharmacologic reperfusion to Thrombolysis in Myocardial Infarction (TIMI) grade 2 flow during acute myocardial infarction confers the same clinical benefit as restoration of TIMI 3 flow, in-hospital clinical and angiographic outcomes i ...
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Journal ArticleCirculation · April 1, 1995
BACKGROUND: Directional coronary atherectomy and percutaneous transluminal coronary angioplasty have both been used in symptomatic patients with coronary saphenous vein bypass graft stenoses. The relative merits of plaque excision and removal versus balloo ...
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Journal ArticleCirculation · March 15, 1995
BACKGROUND: Despite remarkable advances in the treatment of acute myocardial infarction, substantial early patient mortality remains. Appropriate choices among alternative therapies and the use of clinical resources depend on an estimate of the patient's r ...
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Journal ArticleHealth Serv Res · February 1995
OBJECTIVE: As part of a project to estimate physician requirements for the Department of Veterans Affairs, the Institute of Medicine (IOM) developed and tested empirically based models of physician staffing, by specialty, that could be applied to each VA f ...
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Journal ArticleMed Decis Making · 1995
The thrombolytic predictive instrument (TPI) was developed to identify those patients most likely to benefit from thrombolytic therapy for acute myocardial infarction as well as to facilitate the earliest possible administration of this treatment. The TPI ...
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Journal ArticleCardiovascular Reviews and Reports · January 1, 1995
Intravenous thrombolytic therapy has now been established as the standard approach for all eligible patients who present early with acute myocardial infarction. Relatively little clinical investigation however, has been addressed to the potential differenc ...
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Journal ArticleN Engl J Med · October 27, 1994
BACKGROUND: Much attention has been directed to the use of medical resources and to patients' outcomes in Canada as compared with the United States. We compared U.S. and Canadian patients with respect to their use of medical resources and their quality of ...
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Journal ArticleCirculation · October 1994
BACKGROUND: In selecting patients with acute myocardial infarction for thrombolytic therapy, it is important to identify patients who are at high risk for intracranial hemorrhage, for whom thrombolytic therapy is ill advised. We hypothesized that presentin ...
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Journal ArticleCirculation · August 1994
BACKGROUND: Aortic counterpulsation has been observed to reduce the rate of reocclusion of the infarct-related artery after patency has been restored during acute myocardial infarction in observational studies. To evaluate the benefit-to-risk ratio of aort ...
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Journal ArticleAnn Intern Med · May 15, 1994
The Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) trial, a recent randomized "megatrial" of thrombolytic therapies in acute myocardial infarction, showed a statistically significant decrease of ...
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Journal ArticleCirculation · May 1994
BACKGROUND: Survival after coronary artery bypass graft surgery (CABG) and medical therapy in patients with coronary artery disease (CAD) has been studied in both randomized trials and observational treatment comparisons. Over the past decade, the use of c ...
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Journal ArticleLancet · April 9, 1994
Restenosis after coronary angioplasty occurs in at least 30% of patients in the first six months and, as yet, there is no known treatment to decrease this event. We tested a monoclonal antibody Fab fragment (c7E3) directed against the platelet glycoprotein ...
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Journal ArticleJ Am Coll Cardiol · March 15, 1994
OBJECTIVES: The purpose of this study was to examine the incidence and clinical implications of thrombocytopenia that occurs in hospital after administration of thrombolytic therapy for acute myocardial infarction. BACKGROUND: The use of thrombolytic thera ...
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Journal ArticleCirculation · March 1994
BACKGROUND: Observational studies have suggested that prolonged balloon inflation during coronary angioplasty is associated with a high clinical success rate. This randomized clinical trial sought to evaluate the impact of primary gradual and prolonged inf ...
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Journal ArticleAnn Intern Med · January 15, 1994
OBJECTIVE: To compare return-to-work rates after coronary angioplasty, coronary bypass surgery, and medical therapy in patients with coronary disease. DESIGN: Prospective cohort study. SETTING: Tertiary care referral center. PATIENTS: Between March 1986 an ...
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Journal ArticleJ Am Coll Cardiol · January 1994
OBJECTIVES: We designed a randomized trial to evaluate the effects of heparin administration in conjunction with anistreplase (anisoylated plasminogen streptokinase activator complex [APSAC]) on arterial patency and clinical end points. BACKGROUND: The rol ...
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Journal ArticleJ Am Coll Cardiol · December 1993
OBJECTIVES: The goal of this study was to investigate whether female gender portends an adverse prognosis independent of the severity of the underlying disease after acute myocardial infarction treated by thrombolysis. A total of 348 women were compared wi ...
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Journal ArticleN Engl J Med · November 25, 1993
BACKGROUND: Although it is known that thrombolytic therapy improves survival after acute myocardial infarction, it has been debated whether the speed with which coronary-artery patency is restored after the initiation of therapy further affects outcome. ME ...
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Journal ArticleAm Heart J · October 1993
Coronary artery patency after thrombolytic therapy has important prognostic implications for survival after acute myocardial infarction. The ability to noninvasively identify patients early after thrombolysis may therefore allow other strategies, such as a ...
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Journal ArticleN Engl J Med · September 2, 1993
BACKGROUND: The relative efficacy of streptokinase and tissue plasminogen activator and the roles of intravenous as compared with subcutaneous heparin as adjunctive therapy in acute myocardial infarction are unresolved questions. The current trial was desi ...
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Journal ArticleCirculation · August 1993
BACKGROUND: If a practical, reliable, noninvasive marker of failed reperfusion was available in real time, the benefits of further therapy in this patient subgroup could be tested. We developed a method of 12-lead ST-segment recovery analysis using continu ...
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Journal ArticleN Engl J Med · July 22, 1993
BACKGROUND: Directional coronary atherectomy is a new technique of coronary revascularization by which atherosclerotic plaque is excised and retrieved from target lesions. With respect to the rate of restenosis and clinical outcomes, it is not known how th ...
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Journal ArticleCirculation · May 1993
BACKGROUND: Contrast ventriculograms of 542 patients treated with intravenous thrombolytic agents for acute myocardial infarction were examined to define changes in left ventricular ejection fraction and regional wall motion that occur during the first wee ...
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Journal ArticleAnn Intern Med · January 15, 1993
OBJECTIVE: To determine whether information from the physician's initial evaluation of patients with suspected coronary artery disease predicts coronary anatomy at catheterization and 3-year survival. DESIGN: Prospective validation of regression model esti ...
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Journal ArticleProg Cardiovasc Dis · 1993
This trial will significantly advance our understanding of the prognostic and therapeutic usefulness of electrophysiologic studies in patients with coronary artery disease. Several features of this trial are worth emphasizing. First, the protocol for perfo ...
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Journal ArticleCirculation · November 1992
BACKGROUND: Work disability is common in patients with coronary artery disease and adversely affects both economic well-being and quality of life. The purpose of this study was to construct a model to predict premature departure from the work force of pati ...
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Journal ArticleCirculation · November 1992
BACKGROUND: The purpose of this study was to describe the long-term event-free survival patterns of patients with significant coronary artery disease treated medically versus patterns of those treated surgically and to evaluate the factors associated with ...
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Journal ArticleCirculation · June 1992
BACKGROUND: Experimental and observational clinical studies of acute coronary occlusion have suggested that late reperfusion prevents infarct expansion and facilitates myocardial healing. The purpose of this trial was to assess whether infarct vessel paten ...
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Journal ArticleAnn Intern Med · May 15, 1992
OBJECTIVE: To determine whether a gender bias exists in referral for coronary bypass graft surgery among patients with catheterization-documented coronary artery disease. DESIGN: Historical cohort study (1969 to 1984). SETTING: A referral medical center. P ...
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Journal ArticleJournal of the American College of Cardiology · May 1, 1992
The Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) trial is a large scale international trial of new myocardial reperfusion strategies. The primary hypothesis is that early and sustained coronary ...
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Journal ArticleAnn Epidemiol · 1992
The Duke Data Bank for Cardiovascular Diseases is an observational data bank capturing baseline, treatment, and follow-up information on patients referred for evaluation of suspected coronary artery disease. From 6829 patients referred between 1969 and 199 ...
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Journal ArticleCirculation · January 1, 1992
Background. The purpose of this study was to describe the long-term event-free survival patterns of patients with significant coronary artery disease treated medically versus patterns of those treated surgically and to evaluate the factors associated with ...
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Journal ArticleCirculation · November 1991
Most analyses of risk factors affecting survival after coronary artery bypass graft surgery have not differentiated among factors that influence early and late survival. For this reason, a multiphase model was applied to survival data from 2,967 patients u ...
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Journal ArticleN Engl J Med · September 19, 1991
BACKGROUND: The treadmill exercise test identifies patients with different degrees of risk of death from cardiovascular events. We devised a prognostic score, based on the results of treadmill exercise testing, that accurately predicts outcome among inpati ...
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Journal ArticleCirculation · September 1991
The purpose of this investigation was to document the relative importance of three clinical and three radionuclide variables for prediction of cardiac death in a consecutive group of patients evaluated for coronary artery disease. During a 6 1/2-year perio ...
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Journal ArticleCirc Res · September 1991
The role of myocardial anisotropy in determining change in left ventricular shape during diastolic filling has not yet been demonstrated. Therefore, 11 conscious dogs were instrumented with global ultrasonic dimension transducers to measure left ventricula ...
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Journal ArticleAm J Cardiol · May 1, 1991
The prognostic value of radionuclide angiocardiography was examined in patients with suspected coronary artery disease. Nine hundred and eight patients who underwent rest and exercise radionuclide angiocardiography without subsequent cardiac catheterizatio ...
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Journal ArticleCirculation · May 1991
Recent trials of myocardial reperfusion using single-agent thrombolytic therapy and sequential cardiac catheterization have supported a conservative approach to the patient with acute myocardial infarction. To evaluate combination thrombolytic therapy and ...
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Journal ArticleAm J Med · May 1991
PURPOSE: To determine which clinical characteristics obtained by a physician during an initial clinical examination are important for estimating the likelihood of severe coronary artery disease, and to determine whether estimates based on these characteris ...
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Journal ArticleAm Heart J · April 1991
Results of recent studies have suggested that routine cardiac catheterization may be unnecessary after reperfusion therapy for acute myocardial infarction. Therefore to better define the short-term prognostic value of early coronary angiography, and specif ...
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Journal ArticleStat Med · April 1991
Innovative approaches to analysing clinical databases can be considered from a perspective of innovations that improve the analytical approach or from a more global perspective in which clinical databases themselves are evaluated as a technology. The analy ...
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Journal ArticleAm J Cardiol · February 1, 1991
Previous studies report larger myocardial infarcts and increased in-hospital mortality rates in patients with inferior wall acute myocardial infarction (AMI) and complete atrioventricular block (AV), but the clinical implications of these complications in ...
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Journal ArticleCirculation · January 1, 1991
The purpose of this investigation was to document the relative importance of three clinical and three radionuclide variables for prediction of cardiac death in a consecutive group of patients evaluated for coronary artery disease. During a 61/2-year period ...
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Journal ArticleJ Clin Epidemiol · 1991
The utility of ordinal logistic regression in the prediction of colorectal neoplasia was demonstrated in a group of 461 consecutive patients undergoing colonoscopy in a community practice. One hundred twenty-nine patients had adenomatous polyps and 34 had ...
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Journal ArticleAm J Cardiol · December 15, 1990
The ability of the electrocardiographic ST segment to predict successful reperfusion after thrombolytic therapy remains controversial. To evaluate whether angiographically determined reperfusion could be predicted from changes in ST-segment elevation, the ...
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Journal ArticleCirculation · November 1990
To evaluate the usefulness of multiple measures from rest and exercise radionuclide angiography (RNA) in predicting cardiovascular death and cardiovascular events (death or nonfatal myocardial infarction) and to assess the prognostic usefulness of the RNA ...
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Journal ArticleAm J Cardiol · October 1, 1990
Reperfusion therapy has been clearly shown to decrease the early mortality after acute myocardial infarction, but the impact of this therapy on long-term survival has been less extensively evaluated. This study reports the extended follow-up of a large coh ...
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Journal ArticleAm Heart J · April 1990
To evaluate the long-term effects of reperfusion with tissue plasminogen activator (t-PA) and an aggressive strategy of revascularization with angioplasty and coronary artery bypass grafting, we obtained 1-year follow-up results from 386 consecutive patien ...
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Journal ArticleAm Heart J · February 1990
The relationship between preinfarction clinical status and short-term outcome was prospectively evaluated in 775 patients hospitalized with acute myocardial infarction after reperfusion therapy. It was anticipated that a history of angina preceding myocard ...
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Journal ArticleJ Am Coll Cardiol · January 1990
Clinical decision making is under increased scrutiny due to concerns about the cost and quality of medical care. Variability in physician decision making is common, in part because of deficiencies in the knowledge base, but also due to the difference in ph ...
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Journal ArticleAm J Cardiol · January 1, 1990
To determine the value of a 6-month exercise treadmill test for detecting restenosis after elective percutaneous transluminal coronary angioplasty (PTCA), 303 consecutive patients with successful PTCA and without a recent myocardial infarction were studied ...
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Journal ArticleCirculation · November 1989
Ischemic events after successful thrombolysis have been reported to occur in 18-32% of patients treated for acute myocardial infarction with thrombolytic therapy, and previous studies in which patients received streptokinase suggest that risk of early recu ...
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Journal ArticleAnnual International Conference of the IEEE Engineering in Medicine and Biology Proceedings · November 1, 1989
It is shown how to use the bootstrap to construct a nonparametric confidence interval for a receiver operating characteristic (ROC) curve. The method is used to perform a statistical comparison of a detectors curve with a particular point in ROC space or t ...
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Journal ArticleJ Am Coll Cardiol · October 1989
Current limitations of recombinant tissue-type plasminogen activator (rt-PA) therapy for acute myocardial infarction include failure to achieve recanalization in 25% of patients, reocclusion and reperfusion injury. Iloprost, a stable analogue of prostacycl ...
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Journal ArticleJ Am Coll Cardiol · October 1989
To evaluate the clinical correlates and long-term prognostic significance of silent ischemia during exercise, 1,698 consecutive symptomatic patients with coronary artery disease who had both treadmill testing and cardiac catheterization were studied. These ...
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Journal ArticleAm J Cardiol · September 15, 1989
To develop a brief, self-administered questionnaire that accurately measures functional capacity and assesses aspects of quality of life, 50 subjects undergoing exercise testing with measurement of peak oxygen uptake were studied. All subjects were questio ...
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Journal ArticleAm J Cardiol · May 15, 1989
The dynamic QRS amplitude changes that appear during 1-vessel percutaneous transluminal coronary angioplasty of the right and left circumflex coronary arteries were studied in 20 patients using continuous 3-lead electrocardiographic recordings representing ...
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Journal ArticleArch Intern Med · May 1989
To study the accuracy with which long-term prognosis can be predicted in patients with coronary artery disease, prognostic predictions obtained from a large, diverse sample of practicing cardiologists were compared with predictions from a multivariable sta ...
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Journal ArticleJAMA · April 14, 1989
To elucidate the factors associated with improved survival following coronary artery bypass surgery, we studied 5809 patients receiving medical or surgical therapy for coronary artery disease. Three factors were associated with a significant surgical survi ...
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Journal ArticleCirculation · February 1989
To evaluate the coronary thrombolytic efficacy of tissue plasminogen activator (t-PA) and early intravenous heparin, 134 patients with acute myocardial infarction were randomly assigned to combination therapy or t-PA only. At a median of 2.78 hours from sy ...
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Journal ArticleJ Am Coll Cardiol · December 1988
In the first three phases of Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) multicenter trials, 708 patients received intravenous recombinant tissue-type plasminogen activator (rt-PA) and underwent detailed assessment of clinical, angiographi ...
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Journal ArticleAm J Cardiol · November 15, 1988
Using continuous 3-lead electrocardiographic (ECG) recordings in 19 patients undergoing elective percutaneous transluminal coronary artery angioplasty (PTCA) of the left anterior descending (LAD) artery, this study described the dynamic changes of the ST s ...
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Journal ArticleJ Natl Cancer Inst · October 5, 1988
Multiple regression models are increasingly being applied to clinical studies. Such models are powerful analytic tools that yield valid statistical inferences and make reliable predictions if various assumptions are satisfied. Two types of assumptions made ...
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Journal ArticleCirculation · September 1988
Controversy still exists about the proper selection of patients with coronary artery disease and left ventricular dysfunction for coronary bypass surgery. To examine this issue, we studied 710 patients with significant coronary artery disease and left vent ...
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Journal ArticleCirculation · September 1988
To evaluate the potential impact of patient selection for coronary artery bypass graft surgery on long-term survival, the outcomes of 5,809 consecutive patients with symptomatic coronary disease documented by angiography at Duke University Medical Center w ...
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Journal ArticleAm J Cardiol · August 25, 1988
Paroxysmal atrial tachycardia is a familiar arrhythmia that has been studied extensively for the past decade using intracardiac recording and programmed electrical stimulation. These studies have thoroughly documented the mechanisms of this arrhythmia and ...
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Journal ArticleCirculation · May 1988
To determine whether tissue-type plasminogen activator (t-PA) and urokinase (UK) act synergistically to achieve coronary thrombolysis, incremental doses of both drugs were infused intravenously over 60 min. In 146 consecutive patients treated 3.0 +/- 1.0 h ...
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Journal ArticleCirculation · May 1988
To examine the outcome of patients with persistent coronary artery occlusion despite treatment with intravenous tissue-type plasminogen activator (t-PA), the clinical course of 96 patients with persistent occlusion after 90 min of therapy was evaluated. Al ...
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Journal ArticleAm J Cardiol · April 1, 1988
Each of the 54 criteria in the Selvester 32-point QRS scoring system for estimation of myocardial infarct (MI) size has attained greater than or equal to 95% specificity in normal subjects. This study was performed to identify a subset of those criteria wi ...
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Journal ArticleAm J Cardiol · April 1, 1988
The decision to administer thrombolytic therapy for limitation of acute myocardial infarction (AMI) size must occur when only the history, physical examination and 12-lead electrocardiogram of a patient are available. A method that could quickly assess the ...
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Journal ArticleJ Am Coll Cardiol · February 1988
Clinical decisions are most secure when based on findings from several large randomized clinical trials, but relevant randomized trial data are often unavailable. Analyses using clinical data bases might provide useful information if statistical methods ca ...
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Journal ArticleJ Am Coll Cardiol · January 1988
To examine the value of clinical measures of ischemia for stratifying prognosis, 5,886 consecutive patients who had symptomatic significant (greater than or equal to 75% stenosis) coronary artery disease were studied. Using the Cox regression model in a ra ...
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Journal ArticleJ Clin Epidemiol · 1988
Paroxysmal atrial tachycardia may be useful as a model for designing clinical trials of paroxysmal tachycardia. Individual occurrences of paroxysmal atrial tachycardia are clinically independent events, and the time periods between events follow an exponen ...
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Journal ArticleCirculation · 1988
Controversy still exists about the proper selection of patients with coronary artery disease and left ventricular dysfunction for coronary bypass surgery. To examine this issue, we studied 710 patients with significant coronary artery disease and left vent ...
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Journal ArticleCirculation · January 1, 1988
Controversy still exists about the proper selection of patients with coronary artery disease and left ventricular dysfunction for coronary bypass surgery. To examine this issue, we studied 710 patients with significant coronary artery disease and left vent ...
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Journal ArticleCirculation · January 1, 1988
To evaluate the potential impact of patient selection for coronary artery bypass graft surgery on long-term survival, the outcomes of 5,809 consecutive patients with symptomatic coronary disease documented by angiography at Duke University Medical Center w ...
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Journal ArticleProceedings Annual Symposium on Computer Applications in Medical Care · December 1, 1987
The suggestion that computerized diagnostic and prognostic predictions from statistical models would improve the ability of medical housestaff to estimate outcomes in patients with coronary artery disease (CAD) was experimentally tested. Interns made estim ...
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Journal ArticleCirculation · November 1987
Previous comparisons of medical and surgical therapy for coronary artery disease were performed in the 1970s and may need to be updated to reflect current treatment efficacy. The purpose of this investigation was to determine the impact on long-term patien ...
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Journal ArticleN Engl J Med · September 3, 1987
We compared the efficacy of immediate coronary angioplasty after acute myocardial infarction with that of elective angioplasty at 7 to 10 days in patients treated initially with intravenous tissue plasminogen activator. The plasminogen activator (150 mg) w ...
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Journal ArticleAnn Intern Med · June 1987
To determine the prognostic value of the treadmill exercise test, we evaluated 2842 consecutive patients with chest pain who had both treadmill testing cardiac catheterization. The population was randomly divided into two equal-sized groups and the Cox reg ...
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Journal ArticleAm J Cardiol · April 1, 1987
The incidence and prognostic effect of the development of new perioperative ventricular conduction abnormalities were examined in all patients undergoing coronary artery bypass surgery at Duke University Medical Center between 1976 and 1981. Of the 913 pat ...
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Journal ArticleJ Am Coll Cardiol · April 1987
Although amiodarone is effective in the treatment of ventricular arrhythmias, it is associated with serious toxic effects. In addition, the prognosis of patients with malignant ventricular arrhythmias and coronary artery disease treated with amiodarone rem ...
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Journal ArticleAm J Cardiol · January 1, 1987
Current coronary care electrocardiographic (ECG) monitoring techniques are aimed at detection of cardiac arrhythmias rather than myocardial ischemia. However, in patients with acute myocardial infarction (AMI) who undergo reperfusion therapy, monitoring ST ...
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Journal ArticleAnn Intern Med · January 1987
To determine if patterns of ST depression or elevation during exercise testing provide reliable information about the location of an underlying coronary lesion, we studied 452 consecutive patients with one-vessel disease who underwent treadmill testing. Ex ...
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Journal ArticleCirculation · January 1, 1987
Previous comparisons of medical and surgical therapy for coronary artery disease were performed in the 1970s and may need to be updated to reflect current treatment efficacy. The purpose of this investigation was to determine the impact on long-term patien ...
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Journal ArticleAm J Cardiol · December 1, 1986
The clinical presentation and prognosis of 1,977 consecutive patients with normal coronary arteries or "insignificant" coronary artery disease (CAD) (no major epicardial artery with 75% or more luminal diameter narrowing) were examined. Compared with patie ...
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Journal ArticleArch Intern Med · November 1986
The purpose of this article is to investigate the occurrence of symptomatic paroxysmal supraventricular tachycardia (PSVT) in untreated patients and to assess factors that influenced its occurrence. We studied 34 patients with this arrhythmia during an obs ...
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Journal ArticleAm J Med · April 1986
To study the accuracy with which long-term prognosis can be predicted in patients with coronary artery disease, prognostic predictions from a data-based multivariable statistical model were compared with predictions from senior clinical cardiologists. Test ...
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Journal ArticleAm J Obstet Gynecol · March 1986
The evaluation of comparative pregnancy data in clinical studies is subject to a variety of biases. One such bias, when treated patients are retrospectively compared with untreated control subjects, results from the fact that treated patients must remain i ...
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Journal ArticleAm J Cardiol · March 1, 1986
Paroxysmal supraventricular tachycardia (PSVT) and atrial fibrillation (AF) are both supraventricular arrhythmias, but their mechanisms are completely different. This study determines the incidence of symptomatic AF in a group of patients followed closely ...
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Journal ArticlePsychosom Med · 1986
This study was undertaken to identify psychosocial and physical characteristics that independently predict anginal pain relief. The original study group comprised over 570 patients in whom the characteristics were identified at the time of coronary arterio ...
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Journal ArticleCirculation · December 1, 1985
Trends in practice patterns at Duke University Medical Center were assessed in patient groups comparable to those enrolled in the three major randomized trials of coronary artery bypass grafting (CABG). In addition, changes in practice patterns that appear ...
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Journal ArticleCancer Treat Rep · October 1985
Multiple regression models have wide applicability in predicting the outcome of patients with a variety of diseases. However, many researchers are using such models without validating the necessary assumptions. All too frequently, researchers also "overfit ...
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Journal ArticleJ Am Coll Cardiol · May 1985
The prognostic value of a coronary artery jeopardy score was evaluated in 462 consecutive nonsurgically treated patients with significant coronary artery disease, but without significant left main coronary stenosis. The jeopardy score is a simple method fo ...
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Journal ArticleAm J Cardiol · February 1, 1985
To study the mechanism and prognostic importance of precordial ST-segment depression during inferior acute myocardial infarction, 162 patients admitted during 1969 through 1982 were identified. Patients with ST depression in leads V1, V2 and V3 had signifi ...
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Journal ArticleAm J Cardiol · August 1, 1984
A simple method for the assessment of regional left ventricular (LV) function using gated radionuclide angiography is described. The method divides the LV region of interest in the left anterior oblique view into quadrants using a count-weighted center poi ...
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Journal ArticleCirculation · July 1984
The seemingly unpredictable occurrence of paroxysmal supraventricular tachycardia has impeded understanding of its clinical course. We documented recurring tachycardia by telephone transmission of the electrocardiogram in 14 patients and measured the "tach ...
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Journal ArticleAm J Cardiol · June 1, 1984
The clinical characteristics and nonsurgical prognosis of 55 patients with "left main (LM) equivalent" coronary artery disease (CAD) were evaluated and defined as: (1) greater than or equal to 75% diameter reduction of the left anterior descending coronary ...
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Journal ArticleJ Am Coll Cardiol · May 1984
The accuracy of interpretation of coronary cineangiography by two independent observers was tested against postmortem findings in 27 patients who died within 6 months of cardiac catheterization. Variations in cineangiographic interpretations between the an ...
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Journal ArticleCirculation · May 1984
We studied 109 consecutive patients with variant angina who underwent cardiac catheterization over an 11 year period. All patients were followed for at least 6 months or until death, and 46 patients (22 treated medically and 24 treated surgically) were fol ...
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Journal ArticleStat Med · 1984
Regression models such as the Cox proportional hazards model have had increasing use in modelling and estimating the prognosis of patients with a variety of diseases. Many applications involve a large number of variables to be modelled using a relatively s ...
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Journal ArticleAm J Cardiol · January 1, 1984
The purpose of this investigation was to determine which variables obtained when performing radionuclide angiography predict subsequent survival or total events (cardiovascular death or nonfatal myocardial infarction) in stable patients with symptomatic co ...
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Journal ArticleJ Chronic Dis · 1984
Among 1661 consecutive patients with significant coronary artery disease treated medically at the Duke University Medical Center, 239 have undergone aortocoronary bypass surgery after at least 6 months of medical management. The purpose of this investigati ...
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Journal ArticleJ Am Coll Cardiol · December 1983
The prognostic information provided by ventricular arrhythmias associated with treadmill exercise testing was evaluated in 1,293 consecutive nonsurgically treated patients undergoing an exercise test within 6 weeks of cardiac catheterization. The 236 patie ...
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Journal ArticleAm J Med · November 1983
Among 23 clinical characteristics examined in 3,627 consecutive, symptomatic patients referred for cardiac catheterization between 1969 and 1979, nine were found to be important for estimating the likelihood a patient had significant coronary artery diseas ...
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Journal ArticleCirculation · November 1983
We investigated the prognostic significance of new-onset angina in patients in whom coronary anatomic characteristics were known. New onset angina was defined as angina of less than 3 months duration. Consecutive patients (n = 1727) with significant corona ...
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Journal ArticleAm J Cardiol · November 1, 1983
Spontaneous variability in the occurrence of paroxysmal arrhythmias has made it difficult to apply objective and quantitative methods to describe their clinical course. In this study of paroxysmal atrial tachycardia, the "tachycardia-free interval" was use ...
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Journal ArticleCirculation · October 1983
We applied logistic regression analysis to a group of 736 patients with chest pain to determine which radionuclide angiographic (RNA) parameters were most useful in the diagnosis of significant coronary artery disease. The most useful parameters were exerc ...
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Journal ArticleArch Intern Med · October 1983
Health maintenance organizations (HMOs) have lower than average medical care costs, but the reasons remain controversial. The diagnostic practices of cardiologists from an HMO, a university, and a community were therefore surveyed. First, cardiologists def ...
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Journal ArticleAm J Cardiol · September 1, 1983
The national mortality rate from coronary heart disease has decreased during the past decade, for reasons that are not yet clear. The mortality rate and the total number of cardiovascular events both decreased during the last 10 years in 1,911 medically tr ...
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Journal ArticleBiometrics · June 1983
In data analysis involving the proportional-hazards regression model due to Cox (1972, Journal of the Royal Statistical Society, Series B 34, 187-220), the test criteria commonly used for assessing the partial contribution to survival of subsets of concomi ...
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Journal ArticleCirculation · February 1983
We analyzed the clinical outcomes in 688 patients with isolated stenosis of one major coronary artery. The survival rate among patients with disease of the right coronary artery (RCA) was higher than that among patients with left anterior descending (LAD) ...
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Journal ArticleAm J Cardiol · December 1982
The use of the age- and sex-specific U.S. population as a control group for analysis of survival in coronary artery disease was assessed. Population-based survival rates were calculated for nonsurgically treated patients evaluated for coronary artery disea ...
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Journal ArticleCirculation · November 1982
To determine the incremental value of the exercise test (ETT) for diagnosing coronary artery disease (CAD), we derived a multivariate logistic regression model for the pre-ETT prediction of CAD using data from 3840 patients at Duke University. We then appl ...
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Journal ArticleCirculation · September 1982
We studied the ejection fraction (EF) response to upright exercise using first-pass radionuclide angiography (RNA) in 281 patients with chest pain, significant coronary artery disease and normal resting ventricular function. A wide range of resting functio ...
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Journal ArticleClin Pharmacol Ther · August 1982
We examined the hemodynamic effects of pirmenol, a new antiarrhythmic drug, for the first time in man. Right and left heart pressures, Fick cardiac output, and radionuclide ejection fraction were measured before and during infusion of pirmenol in 10 patien ...
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Journal ArticleAm J Cardiol · July 1982
The prognostic importance of ventricular arrhythmias detected during 24 hour ambulatory monitoring was evaluated in 395 patients with and 260 patients without significant coronary artery disease. Ventricular arrhythmias were found to be strongly related to ...
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Journal ArticleCirculation · June 1982
In this report, we summarize the strengths and problems of an observational data base approach to evaluating therapy and studying patient outcomes in long-term chronic disease. Because this approach includes a greater spectrum of patients than randomized c ...
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Journal ArticleCirculation · June 1982
We evaluated the survival rates of medically and surgically treated patients with one-, two- or three-vessel coronary disease (CAD), stable pain, and normal left ventricular function observed at the Duke University Medical Center over an 11-year period. Th ...
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Journal ArticleJAMA · May 14, 1982
A method is presented for evaluating the amount of information a medical test provides about individual patients. Emphasis is placed on the role of a test in the evaluation of patients with a chronic disease. In this context, the yield of a test is best in ...
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Journal ArticleCancer Treat Rep · May 1982
Accurately assessing the effect of a clinical intervention is a complex task based on observing patients and their outcomes. Two strategies, the randomized trial and the observational data bank, represent different approaches toward detecting an outcome gr ...
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Journal ArticleCirculation · 1982
We evaluated the survival rates of medically and surgically treated patients with one-, two- or three-vessel coronary artery disease (CAD), stable pain, and normal left ventricular function observed at the Duke University Medical Center over an 11-year per ...
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Journal ArticleCirculation · 1982
In this report, we summarize the strengths and problems of an observational data base approach to evaluating therapy and studying patient outcomes in long-term chronic disease. Because this approach includes a greater spectrum of patients than randomized c ...
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Journal ArticleJ Allergy Clin Immunol · January 1982
Cutaneous reactions to allergens exhibit a sigmoid dose-response relationship. Available methods for evaluating the allergen skin-test response do not adequately account for the sigmoid curve. Methodologic factors handicap quantitative studies of allergens ...
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Journal ArticleCirculation · January 1, 1982
In this report, we summarize the strengths and problems of an observational data base approach to evaluating therapy and studying patient outcomes in long-term chronic disease. Because this approach includes a greater spectrum of patients than randomized c ...
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Journal ArticleCirculation · November 1981
In this study we describe the ejection fraction response to upright exercise using first-pass radionuclide angiocardiography in a group of 60 patients with chest pain, normal coronary arteriograms and normal resting ventricular function. A wide range of re ...
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Journal ArticleAm J Cardiol · December 1, 1980
The purpose of this study was to identify patient characteristics associated with nonfatal myocardial infarction as the first event after cardiac catheterization in medically treated patients with coronary artery disease. Multiple logistic risk analysis of ...
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Journal ArticlePsychosom Med · November 1980
Type A behavior pattern was assessed using the structured interview and hostility level was assessed using a subscale of the Minnesota Multiphase Personality Inventory in 424 patients who underwent diagnostic coronary arteriography for suspected coronary h ...
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Journal ArticleCirculation · October 1980
In this study we extended the characterization of outcome in 1214 medically treated patients with coronary disease by considering nonfatal infarction and death together as ischemic events. At 7 years, the cumulative event rate was 47% (18% for nonfatal inf ...
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Journal ArticleBiometrics · June 1980
Chronic diseases are in many ways more complex than acute diseases. In chronic diseases, response times to environmental effects are long, and confounding variables are numerous and may fluctuate with time. Treatment schedules are complicated and may be un ...
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Journal ArticleAm J Obstet Gynecol · May 1, 1980
A retrospective study was carried out on 431 patients with endometrial cancer and 431 control subjects matched as to age, race, and parity. They were seen at Duke University Medical Center from 1940 to 1975. The study was performed in order to evaluate the ...
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Journal ArticleCirculation · March 1980
A simulated randomized clinical trial in coronary artery disease was conducted to illustrate the need for clinical judgment and modern statistical methods in assessing therapeutic claims in studies of complex diseases. Clinicians should be aware of problem ...
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Journal ArticleAm J Obstet Gynecol · March 1, 1979
Two groups of hypoestrogenic women are analyzed by retrospective comparison. Patients were observed by a single group of physicians for at least five years -- 301 patients treated with replacement estrogen and 309 untreated patients. Of each group, 207 wom ...
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Journal ArticleAm J Obstet Gynecol · March 1, 1979
Two groups of hypoestrogenic women are analyzed by retrospective comparisons. Patients were observed by a single group of physicians for at least five years; 301 patients were treated with replacement estrogen and 309 patients were untreated. Incidence fig ...
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Journal ArticleInstitution of Mechanical Engineers Conference Publications · January 1, 1979
Stabilizing clinical decisions can be aided by incorporating outcome data into treatment decisions. Feedback of outcome data can be managed manually for acute illnesses. When the time between intervention and outcome becomes long as in chronic disease, the ...
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Journal ArticleCirculation · May 1978
Three-year survival for 163 consecutive medically treated patients with 50% or greater left main stenosis was 50%. Survival was significantly higher for patients with 50 to 70% left main stenosis (one and three-year survivals of 91% and 66%) than for patie ...
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Journal ArticleCirculation · January 1978
A cohort of 1472 patients who underwent both exercise stress testing and coronary angiography within six weeks was examined. The data indicated that a combination of exercise parameters is both diagnostically and prognostically important. Almost all patien ...
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Journal ArticleTrans Am Clin Climatol Assoc · 1978
The current series represents the total experience of one institution that has treated concurrently a large number of patients with medical or surgical therapy. As previously reported, surgery offers a greater chance for pain relief but no obvious protecti ...
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Journal ArticleAm J Cardiol · January 1977
Eleven percent of 905 consecutive patients with acute myocardial infarction admitted to the coronary care unit at Duke University Medical Center experienced cardiac arrest. Subgroups of patients at high and low risk for cardiac arrest were identified. Card ...
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Journal ArticlePostgrad Med J · December 1976
This analysis attempts to utilize natural history controls to answer the question as to whether coronary surgery prolongs life in comparison to medical management. Selected natural history studies are compared and contrasted in an effort to obtain an avera ...
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