Scholars@Duke
Michelle Diane Kelsey

Michelle Diane Kelsey

Assistant Professor of Medicine
Medicine, Cardiology
michelle.kelsey@duke.edu
DUMC 3845, Durham, NC 27710
200 Morris Street, Durham, NC 27701

Selected Publications

In patients with acute MI, spironolactone did not reduce cardiac events at 3 y.

Journal Article Ann Intern Med · March 2025 Cardiology: [Formula: see text]. ... Full text Link to item Cite

In patients with acute MI, colchicine did not reduce cardiac events at 3 y.

Journal Article Ann Intern Med · March 2025 GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text]. ... Full text Link to item Cite

Sex Differences in the Safety and Efficacy of Different Durations of DAPT After PCI.

Journal Article JACC Adv · February 2025 BACKGROUND: Randomized controlled trials (RCTs) have examined the clinical impact of abbreviating the duration of dual antiplatelet therapy (DAPT) and have reported outcomes in men and women. OBJECTIVES: The authors examined the safety and efficacy of diff ... Full text Link to item Cite

Economic Outcomes With Precision Diagnostic Testing Versus Usual Testing in Stable Chest Pain: Results From the PRECISE Randomized Trial.

Journal Article Circ Cardiovasc Qual Outcomes · February 2025 BACKGROUND: The PRECISE (Prospective Randomized Trial of the Optimal Evaluation of Cardiac Symptoms and Revascularization) demonstrated that a precision diagnostic strategy reduced the primary composite of death, nonfatal myocardial infarction, or catheter ... Full text Link to item Cite

Quality of Life Outcomes With a Risk-Based Precision Testing Strategy Versus Usual Testing in Stable Patients With Suspected Coronary Disease: Results From the PRECISE Randomized Trial.

Journal Article Circ Cardiovasc Qual Outcomes · February 2025 BACKGROUND: The PRECISE (Prospective Randomized Trial of the Optimal Evaluation of Cardiac Symptoms and Revascularization) trial compared an investigational precision diagnostic testing strategy (n=1057) with usual testing (n=1046) in patients with stable ... Full text Link to item Cite

Sex differences in in-hospital outcomes and readmission rates after percutaneous coronary intervention.

Journal Article Proc (Bayl Univ Med Cent) · 2025 BACKGROUND: Previous studies have reported worse outcomes in women following percutaneous coronary intervention (PCI), but contemporary studies examining sex differences in in-hospital outcomes and 90-day readmission risk are lacking. Therefore, we sought ... Full text Link to item Cite

Prescription Fills Among Patients With Type 2 Diabetes After Hospitalization for Acute Coronary Syndrome.

Journal Article JAMA Netw Open · November 4, 2024 IMPORTANCE: Individuals with type 2 diabetes (T2D) have high rates of mortality following myocardial infarction (MI). Hospitalization is an opportunity to initiate or continue evidence-based treatment to reduce risk in individuals with T2D and acute corona ... Full text Link to item Cite

Duration of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Patients With Type 2 Diabetes Mellitus: A Systematic Review and Network Meta-analysis

Journal Article Journal of the Society for Cardiovascular Angiography and Interventions · July 1, 2024 Background: Patients with type 2 diabetes mellitus (DM) comprise more than a quarter of all patients undergoing percutaneous coronary intervention and are at higher risk of adverse events. We sought to reexamine the optimal duration of dual antiplatelet th ... Full text Cite

Diagnosing Coronary Artery Disease in the Patient Presenting with Stable Ischemic Heart Disease: The Role of Anatomic versus Functional Testing.

Journal Article Med Clin North Am · May 2024 There are unique advantages and disadvantages to functional versus anatomic testing in the work-up of patients who present with symptoms suggestive of obstructive coronary artery disease. Evaluation of these individuals starts with an assessment of pre-tes ... Full text Link to item Cite

In higher-risk, statin-intolerant adults with diabetes, bempedoic acid reduced MACE at a median 3 y.

Journal Article Ann Intern Med · April 2024 Ray KK, Nicholls SJ, Li N, et al; CLEAR OUTCOMES Committees and Investigators. Efficacy and safety of bempedoic acid among patients with and without diabetes: prespecified analysis of the CLEAR Outcomes randomised trial. Lancet Diabetes Endocrinol. 2024;12 ... Full text Link to item Cite

Shorter Dual Antiplatelet Therapy for Older Adults After Percutaneous Coronary Intervention: A Systematic Review and Network Meta-Analysis.

Journal Article JAMA Netw Open · March 4, 2024 IMPORTANCE: The optimal duration of dual antiplatelet therapy (DAPT) for older adults after percutaneous coronary intervention (PCI) is uncertain because they are simultaneously at higher risk for both ischemic and bleeding events. OBJECTIVE: To investigat ... Full text Link to item Cite

Closing the Last Mile Gap in Access to Multimodality Imaging in Rural Settings: Design of the Imaging Core of the Risk Underlying Rural Areas Longitudinal Study.

Journal Article Circ Cardiovasc Imaging · February 2024 Achieving optimal cardiovascular health in rural populations can be challenging for several reasons including decreased access to care with limited availability of imaging modalities, specialist physicians, and other important health care team members. The ... Full text Link to item Cite

Should We "RESPECT EPA" More Now? EPA and DHA for Cardiovascular Risk Reduction.

Journal Article Curr Cardiol Rep · November 2023 PURPOSE OF REVIEW: There has been much debate surrounding the use of omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), for cardiovascular (CV) risk reduction. RECENT FINDINGS: Recent trials of EPA and DHA have offered conflic ... Full text Link to item Cite

Comparison of an Initial Risk-Based Testing Strategy vs Usual Testing in Stable Symptomatic Patients With Suspected Coronary Artery Disease: The PRECISE Randomized Clinical Trial.

Journal Article JAMA Cardiol · October 1, 2023 IMPORTANCE: Trials showing equivalent or better outcomes with initial evaluation using coronary computed tomography angiography (cCTA) compared with stress testing in patients with stable chest pain have informed guidelines but raise questions about overte ... Full text Link to item Cite

Deferred Testing in Stable Outpatients With Suspected Coronary Artery Disease: A Prespecified Secondary Analysis of the PRECISE Randomized Clinical Trial.

Journal Article JAMA Cardiol · October 1, 2023 IMPORTANCE: Guidelines recommend deferral of testing for symptomatic people with suspected coronary artery disease (CAD) and low pretest probability. To our knowledge, no randomized trial has prospectively evaluated such a strategy. OBJECTIVE: To assess pr ... Full text Link to item Cite

Clinical and cost implications of deferred testing in low-risk patients with stable chest pain: a simulation using the PROMISE trial.

Journal Article Am Heart J · July 2023 Current guidelines recommend a deferred testing approach in low-risk patients presenting with stable chest pain. After simulating a deferred testing approach using the PROMISE Minimal Risk Score to identify 915 minimal risk participants with cost data from ... Full text Link to item Cite

In statin-intolerant adults with, or at risk for, CV disease, bempedoic acid reduced MACE at a median 41 mo.

Journal Article Ann Intern Med · July 2023 Nissen SE, Lincoff MA, Brennan D, et al; CLEAR Outcomes Investigators. Bempedoic acid and cardiovascular outcomes in statin-intolerant patients. N Engl J Med. 2023;388:1353-1364. 36876740. ... Full text Link to item Cite

Contemporary patterns of lipoprotein(a) testing and associated clinical care and outcomes.

Conference Am J Prev Cardiol · June 2023 OBJECTIVE: Elevated lipoprotein(a) [Lp(a)] is associated with atherosclerotic cardiovascular disease, yet little is known about Lp(a) testing patterns in real-world practice. The objective of this analysis was to determine how Lp(a) testing is used in clin ... Full text Link to item Cite

Call to action: Understanding the differences in the use of SGLT-2 inhibitors and GLP-1 receptor agonists.

Journal Article Am J Prev Cardiol · March 2023 Cardiovascular disease remains one of the most prominent global health problems and has been demonstrated to disproportionally affect certain communities. Despite an increasing collective effort to improve health inequalities, a multitude of disparities co ... Full text Open Access Link to item Cite

Coordinating Cardiology clinics randomized trial of interventions to improve outcomes (COORDINATE) - Diabetes: rationale and design.

Journal Article Am Heart J · February 2023 Several medications that are proven to reduce cardiovascular events exist for individuals with type 2 diabetes mellitus (T2DM) and atherosclerotic cardiovascular disease, however they are substantially underused in clinical practice. Clinician, patient, an ... Full text Link to item Cite

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

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

In ASCVD, moderate-intensity statin + ezetimibe was noninferior to high-intensity statin alone at 3 y.

Journal Article Ann Intern Med · November 2022 Kim BK, Hong SJ, Lee YJ, et al. Long-term efficacy and safety of moderate-intensity statin with ezetimibe combination therapy versus high-intensity statin monotherapy in patients with atherosclerotic cardiovascular disease (RACING): a randomised, open-labe ... Full text Link to item Cite

Neighborhood Socioeconomic Disadvantage and Hospitalized Heart Failure Outcomes in the American Heart Association Get With The Guidelines-Heart Failure Registry.

Journal Article Circ Heart Fail · November 2022 BACKGROUND: Neighborhood socioeconomic status (SES) is associated with worse health outcomes, yet its relationship with in-hospital heart failure (HF) outcomes and quality metrics are underexplored. We examined the association between socioeconomic neighbo ... Full text Link to item Cite

Lipid-Lowering Therapy in Women of Childbearing Age: a Review and Stepwise Clinical Approach.

Journal Article Curr Cardiol Rep · October 2022 PURPOSE OF REVIEW: Women are less often recognized to have cardiovascular disease (CVD) risk and are underrepresented in randomized trials of lipid-lowering therapy. Here, we summarize non-pharmacologic and pharmacologic strategies for lipid-lowering in wo ... Full text Link to item Cite

Eradicating Atherosclerosis: Should We Start Statins at Younger Ages and at Lower LDL-Cs.

Journal Article Curr Cardiol Rep · October 2022 PURPOSE OF REVIEW: Given the increasing burden of cardiovascular disease, we review the literature for earlier initiation of statin therapy at younger ages and lower low-density lipoprotein cholesterol (LDL-C) levels, with the goal of preventing the develo ... Full text Link to item Cite

Imaging Considerations and Clinical Implications of Mitral Annular Disjunction.

Journal Article Circ Cardiovasc Imaging · September 2022 Mitral annular disjunction is increasingly recognized as an important anatomic feature of mitral valve disease. The presence of mitral annular disjunction, defined as separation between the left atrial wall at the point of mitral valve insertion and the le ... Full text Link to item Cite

Recommendations for use of ezetimibe and/or PCSK9 inhibitors in patients with elevated LDL-C.

Journal Article Ann Intern Med · August 2022 Hao Q, Aertgeerts B, Guyatt G, et al. PCSK9 inhibitors and ezetimibe for the reduction of cardiovascular events: a clinical practice guideline with risk-stratified recommendations. BMJ. 2022;377:e069066. 35508320. ... Full text Link to item Cite

Guidelines for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes: JACC Guideline Comparison.

Journal Article J Am Coll Cardiol · May 10, 2022 Cardiovascular disease is a leading cause of morbidity and mortality in individuals with type 2 diabetes mellitus. These high-risk patients benefit from aggressive risk factor management, with blood pressure and low-density lipoprotein-cholesterol treatmen ... Full text Link to item Cite

Inclusion and diversity in clinical trials: Actionable steps to drive lasting change.

Journal Article Contemp Clin Trials · May 2022 BACKGROUND: Improving diversity in clinical trials is essential in order to produce generalizable results. Although the importance of representation has become increasingly recognized, identifying strategies to approach this work remains elusive. This arti ... Full text Link to item Cite

The prospective randomized trial of the optimal evaluation of cardiac symptoms and revascularization: Rationale and design of the PRECISE trial.

Journal Article Am Heart J · March 2022 BACKGROUND: Clinicians vary widely in their preferred diagnostic approach to patients with non-acute chest pain. Such variation exposes patients to potentially avoidable risks, as well as inefficient care with increased costs and unresolved patient concern ... Full text Link to item Cite

In CV disease, GLP-1 RAs and SGLT2 inhibitors reduce CV mortality.

Journal Article Ann Intern Med · March 2022 Kanie T, Mizuno A, Takaoka Y, et al. Dipeptidyl peptidase-4 inhibitors, glucagon-like peptide 1 receptor agonists and sodium-glucose co-transporter-2 inhibitors for people with cardiovascular disease: a network meta-analysis. Cochrane Database Syst Rev. 20 ... Full text Link to item Cite

Use of Lipid-, Blood Pressure-, and Glucose-Lowering Pharmacotherapy in Patients With Type 2 Diabetes and Atherosclerotic Cardiovascular Disease.

Journal Article JAMA Netw Open · February 1, 2022 IMPORTANCE: Based on contemporary estimates in the US, evidence-based therapies for cardiovascular risk reduction are generally underused among patients with type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD). OBJECTIVE: To determine the us ... Full text Link to item Cite

Lipoprotein(a) Testing Patterns in a Large Health System.

Journal Article Am J Cardiol · August 15, 2021 Lipoprotein (a) [Lp(a)] is associated with increased risk of atherosclerotic cardiovascular disease (ASCVD). As directed therapy for Lp(a) emerges, it is important to understand patterns of Lp(a) testing in routine clinical practice. We set out to characte ... Full text Link to item Cite

Acute cardiovascular hospitalizations and illness severity before and during the COVID-19 pandemic.

Journal Article Clin Cardiol · May 2021 BACKGROUND: Cardiovascular disease (CVD) hospitalizations declined worldwide during the COVID-19 pandemic. It is unclear how shelter-in-place orders affected acute CVD hospitalizations, illness severity, and outcomes. HYPOTHESIS: COVID-19 pandemic was asso ... Full text Link to item Cite

LOW-HARM score predicted mortality in patients hospitalized with COVID-19 in Mexico.

Journal Article Ann Intern Med · May 2021 Soto-Mota A, Marfil-Garza BA, Martinez Rodriguez E, et al. The low-harm score for predicting mortality in patients diagnosed with COVID-19: a multicentric validation study. J Am Coll Emerg Physicians Open. 2020;1:1436-43. 33230506. ... Full text Link to item Cite

In patients at high CV risk receiving simvastatin, the Myopathy Risk Score predicted statin-related myopathy.

Journal Article Ann Intern Med · December 15, 2020 Hopewell JC, Offer A, Haynes R, et al. Independent risk factors for simvastatin-related myopathy and relevance to different types of muscle symptom. Eur Heart J. 2020;41:3336-42. 32702748. ... Full text Link to item Cite

In older patients with NSTE-ACS, clopidogrel safely reduced bleeding compared with ticagrelor at 1 year.

Journal Article Ann Intern Med · September 15, 2020 Gimbel M, Qaderdan K, Willemsen L, et al. Clopidogrel versus ticagrelor or prasugrel in patients aged 70 years or older with non-ST-elevation acute coronary syndrome (POPular AGE): the randomised, open-label, non-inferiority trial. Lancet. 2020;395:1374-81 ... Full text Link to item Cite

Aporia in Medicine.

Journal Article Conn Med · 2015 Link to item Cite