Scholars@Duke
Nishant Shah

Nishant Shah

Assistant Professor of Medicine
Medicine, Cardiology

Selected Publications

Achievement of LDL-C <55 mg/dL among US adults: Findings from the cvMOBIUS2 registry.

Journal Article Am Heart J · January 2025 BACKGROUND: Reflecting clinical trial data showing improved outcomes with lower LDL-C levels, guidelines across the globe are increasingly recommending a goal of LDL-C <55 mg/dL in persons with atherosclerotic cardiovascular disease (ASCVD). What proportio ... Full text Link to item Cite

Real-world exploration of LDL-cholesterol management in patients with atherosclerotic cardiovascular disease.

Journal Article Am Heart J · January 2025 BACKGROUND: Although guidelines recommend low-density lipoprotein cholesterol (LDL-C) to be < 70 mg/dL in patients with atherosclerotic cardiovascular disease (ASCVD), the rate of achieving this goal remains suboptimal. We sought to understand real world c ... Full text Link to item Cite

Optimizing cardiometabolic risk in people living with human immunodeficiency virus: A deep dive into an important risk enhancer.

Journal Article Am J Prev Cardiol · December 2024 Effective antiretroviral therapy (ART) is now nearly ubiquitous. However, the survival benefits conferred with ART contribute to an aging human immunodeficiency virus (HIV) population and increased risk of chronic diseases, like atherosclerotic cardiovascu ... Full text Link to item Cite

Association Between Lipoprotein(a) and Obstructive Coronary Artery Disease and High-Risk Plaque: Insights From the PROMISE Trial.

Journal Article Am J Cardiol · November 15, 2024 The role of lipoprotein (a) (Lp[a]) in the development of obstructive coronary artery disease (CAD) and high-risk plaque (HRP) in primary prevention patients with stable chest pain is unknown. We sought to evaluate the relation of Lp(a), independent of low ... Full text Link to item Cite

Lipoprotein (a) Testing in Patients With Atherosclerotic Cardiovascular Disease in 5 Large US Health Systems.

Journal Article J Am Heart Assoc · November 5, 2024 BACKGROUND: Lipoprotein (a) is an independent risk factor for atherosclerotic cardiovascular disease. However, lipoprotein (a) testing remains variable and it is unclear what factors influence testing and if testing changes clinical management. METHODS AND ... Full text Link to item Cite

GLP-1 Receptor Agonists and Cardiovascular Disease: What Do Clinicians Need to Know?

Journal Article Curr Atheroscler Rep · August 2024 PURPOSE OF REVIEW: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are gaining importance due to their effects on cardiovascular parameters. This review discusses the findings of dedicated cardiovascular outcome trials of GLP-1RAs and summarizes their ... Full text Link to item Cite

Relationship between body mass index and cardiometabolic health in a multi-ethnic population: A project baseline health study.

Journal Article Am J Prev Cardiol · June 2024 OBJECTIVE: Obesity is associated with a higher risk of cardiovascular disease. Understanding the associations between comprehensive health parameters and body mass index (BMI) may lead to targeted prevention efforts. METHODS: Project Baseline Health Study ... Full text Link to item Cite

Sustainable Approach to Justice, Equity, Diversity, and Inclusion Through Better Quality Measurement.

Journal Article Circ Cardiovasc Qual Outcomes · May 2024 The US health care industry has broadly adopted performance and quality measures that are extracted from electronic health records and connected to payment incentives that hope to improve declining life expectancy and health status and reduce costs. While ... Full text Link to item Cite

End-Of-Life Care for Patients With End-Stage Heart Failure, Comparisons of International Guidelines.

Journal Article Am J Hosp Palliat Care · January 2024 Heart failure (HF) is a chronic, debilitating condition associated with significant morbidity, mortality, and socioeconomic burden. Patients with end-stage HF (ESHF) who are not a candidate for advanced therapies will continue to progress despite standard ... Full text Link to item Cite

Sex differences in trends and outcomes of acute myocardial infarction with mechanical complications in the United States.

Journal Article Expert Rev Cardiovasc Ther · 2024 BACKGROUND: Mechanical complications (MC) are rare but significant sequelae of acute myocardial infarction (AMI). Current data on sex differences in AMI with MC is limited. METHODS: We queried the National Inpatient Sample database to identify adult patien ... Full text Link to item Cite

Sex differences in trends and in-hospital outcomes of acute myocardial infarction in patients with familial hypercholesterolemia: insights from a large national database.

Journal Article Expert Rev Cardiovasc Ther · 2024 BACKGROUND: Sex differences in clinical outcomes following acute myocardial infarction (AMI) are well known. However, data on sex differences among patients with familial hypercholesterolemia (FH) are limited. We aimed to explore sex differences in outcome ... Full text Link to item Cite

Abstract 16059: Real-World Exploration of Low Density Lipoprotein Cholesterol Management in Patients With Atherosclerotic Cardiovascular Disease

Conference Circulation · November 7, 2023 Introduction: Although guidelines recommend low-density lipoprotein cholesterol (LDL-C) to bel <70mg/dL in patients with atherosclerotic cardiovascular disease (ASCVD), implementation of these reco ... Full text Cite

Abstract 16164: Lipoprotein (a) Testing in Patients With Atherosclerotic Cardiovascular Disease in Five Large U.S. Health Systems

Conference Circulation · November 7, 2023 Introduction: Lipoprotein (a) [Lp(a)] is an independent, causal risk factor for atherosclerotic cardiovascular disease (ASCVD). Screening patterns remain variable and it is unclear what factors are as ... Full text Cite

Sex Differences in Cardiovascular Outcomes and Cholesterol-Lowering Efficacy of PCSK9 Inhibitors: Systematic Review and Meta-Analysis.

Journal Article JACC Adv · November 2023 BACKGROUND: Guideline-recommended low-density lipoprotein cholesterol (LDL-C) thresholds are often not achieved in women. The proprotein convertase subtilisin/kexin type-9 inhibitor (PCSK9i) monoclonal antibodies can help further reduce LDL-C and major adv ... Full text Link to item Cite

Generalizability of an EHR-network dataset to the United States for cardiovascular disease conditions: Comparison of Cerner real world data with the national inpatient sample.

Journal Article Am Heart J · September 2023 BACKGROUND: Electronic Health Record (EHR) data from health systems are increasingly being combined for clinical research purposes. Yet, it remains unclear whether these large EHR data sources provide a representative assessment of national disease prevale ... 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

Bending the Cardiovascular Event Curve by Evaluating the Potential Impact of Achieving Low-Density Lipoprotein Cholesterol Goal Across a Large Health System Among Secondary Prevention Patients.

Journal Article Am J Cardiol · January 1, 2023 Guidelines recommend aggressive low-density lipoprotein cholesterol (LDL-C) lowering in patients with atherosclerotic cardiovascular disease (ASCVD). However, the recommended threshold of LDL-C ≤70 mg/dL is often not achieved. We used data from the Duke Un ... Full text Link to item Cite

Uptake of non-statin lipid-lowering therapies for secondary prevention in community practice.

Journal Article J Clin Lipidol · 2023 Nearly two-thirds of individuals with atherosclerotic cardiovascular disease (ASCVD) do not reach target low-density lipoprotein cholesterol despite statin therapy. Three novel lipid-lowering therapies have proven to further reduce ASCVD beyond statins, in ... Full text Link to item Cite

Lipoprotein(a) in clinical practice: A guide for the clinician.

Journal Article Prog Cardiovasc Dis · 2023 Cardiovascular disease (CVD) remains the leading cause of death worldwide. Serum lipoprotein(a) (Lp(a)) has been shown to be an independent and causative risk factor for atherosclerotic CVD and calcific aortic valvular disease. Lp(a) continues to be studie ... Full text Link to item Cite

Emerging role of positron emission tomography (PET) imaging in cardiac surgery.

Journal Article J Card Surg · December 2022 Historically, structural and anatomical imaging has been the mainstay in the diagnosis and management of cardiovascular diseases. In recent years there has been a shift toward increased use of functional imaging studies, including positron emission tomogra ... Full text Link to item Cite

Trends in Oral Anticoagulant Use Among 436 864 Patients With Atrial Fibrillation in Community Practice, 2011 to 2020.

Journal Article J Am Heart Assoc · November 15, 2022 Background Among patients with nonvalvular atrial fibrillation (AF) and an elevated stroke risk, guidelines recommend direct oral anticoagulants (DOACs) over warfarin for stroke prevention. Changes in DOAC use over the past decade have not been well descri ... 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

Cardiometabolic Comorbidities in Cancer Survivors: JACC: CardioOncology State-of-the-Art Review.

Journal Article JACC CardioOncol · June 2022 There are nearly 17 million cancer survivors in the United States, including those who are currently receiving cancer therapy with curative intent and expected to be long-term survivors, as well as those with chronic cancers such as metastatic disease or c ... Full text Open Access Link to item Cite

Trends of blood pressure control in the U.S. during the COVID-19 pandemic.

Journal Article Am Heart J · May 2022 IMPORTANCE: COVID-19 altered lifestyles and disrupted routine health care. Whether blood pressure (BP) control worsened during COVID-19 is unknown. OBJECTIVE: To understand whether home BP control worsened during COVID-19 across the United States (US) . DE ... Full text Link to item Cite

Low-touch, team-based care for co-morbidity management in cancer patients: the ONE TEAM randomized controlled trial.

Journal Article BMC Fam Pract · November 18, 2021 BACKGROUND: As treatments for cancer have improved, more people are surviving cancer. However, compared to people without a history of cancer, cancer survivors are more likely to die of cardiovascular disease (CVD). Increased risk for CVD-related mortality ... Full text Link to item Cite

The Impact of Physical Activity on Pericarditis.

Journal Article Curr Cardiol Rep · August 27, 2021 PURPOSE OF REVIEW: To discuss the possible harmful effects and pathophysiology of exercise in cases of pericarditis, explore the role of multi-modality imaging to help guide exercise recommendations, and compare U.S. with European guideline recommendations ... Full text Link to item Cite

Inflammatory cardiac disorders in the athlete

Chapter · May 6, 2021 Inflammatory disorders of the heart can lead to significant complications in an athlete if not diagnosed and managed in a timely fashion. The two primary cardiac inflammatory diseases are myocarditis and pericarditis. Both American and European athletic pa ... Full text Cite

Risk Factor Burden and Long-Term Prognosis of Patients With Premature Coronary Artery Disease.

Journal Article J Am Heart Assoc · December 15, 2020 Background Coronary artery disease (CAD) is increasing among young adults. We aimed to describe the cardiovascular risk factors and long-term prognosis of premature CAD. Methods and Results Using the Duke Databank for Cardiovascular Disease, we evaluated 3 ... Full text Link to item Cite

Association of Serum Lipoprotein (a) Levels and Coronary Atheroma Volume by Intravascular Ultrasound.

Journal Article J Am Heart Assoc · December 2020 Background Lp(a) (lipoprotein (a)) is a risk factor for cardiovascular events, but the mechanism of increased risk is uncertain. This study evaluated the relationship between Lp(a) and coronary atheroma volume by intravascular ultrasound. Methods and Resul ... Full text Link to item Cite

Usefulness of Interleukin-1 Receptor Antagonists in Patients With Recurrent Pericarditis.

Journal Article Am J Cardiol · July 15, 2020 Nonsteroidal anti-inflammatory drugs and colchicine remain the standard of care as the initial treatment of acute pericarditis. Corticosteroids and traditional immunosuppressive medications are often added if patients develop recurrent symptoms and remain ... Full text Link to item Cite

Lipoprotein (a): An Update on a Marker of Residual Risk and Associated Clinical Manifestations.

Journal Article Am J Cardiol · July 1, 2020 Lipoprotein (a) [Lp(a)] is a low-density, cholesterol-containing lipoprotein that differs from other low-density lipoproteins due to the presence of apolipoprotein(a) bound to its surface apolipoprotein B100. Multiple epidemiologic studies, including Mende ... Full text Link to item Cite

Strategies to Prevent Cardiovascular Toxicity in Breast Cancer: Is It Ready for Primetime?

Journal Article J Clin Med · March 25, 2020 Cardio-oncology is an emerging field tasked with identifying and treating cancer therapy related cardiac dysfunction (e.g., cytotoxic agents, immunotherapies, radiation, and hormone therapies) and optimizing the cardiovascular health of cancer patients exp ... Full text Open Access Link to item Cite

Familial hypercholesterolemia: Detect, treat, and ask about family.

Journal Article Cleve Clin J Med · February 2020 Familial hypercholesterolemia is an autosomal dominant disorder that affects the metabolism of low-density lipo-protein cholesterol (LDL-C) through mutations in the gene for LDL receptor (LDLR), and less commonly in those for apolipoprotein B (APOB), propr ... Full text Link to item Cite

Case series, contemporary review and imaging guided diagnostic and management approach of congenital pericardial defects

Journal Article Open Heart · January 8, 2020 Objective Congenital pericardial defect (CPD) is a rare entity with an estimated frequency of 0.01%-0.04%. The recognition of this anomaly is important since it can be associated with serious complications. The aim of this study and review was to describe ... Full text Open Access Cite

Purpura fulminans manifesting with Staphylococcus aureus endocarditis: A case report

Journal Article European Heart Journal - Case Reports · June 1, 2019 Background Purpura fulminans (PF) is a haematologic emergency that can occur in the setting of severe septic shock. Its pathophysiology is not well-understood; however, some evidence suggests it may be mediated by excessive protein C consumption. Case summ ... Full text Cite

Pericardial Cysts: a Contemporary Comprehensive Review.

Journal Article Curr Cardiol Rep · May 30, 2019 PURPOSE OF REVIEW: This is an in-depth review on the etiology, clinical manifestation, differential diagnosis, diagnostic modalities, complications, and management of pericardial cysts (PCs). RECENT FINDINGS: PCs are the third most common type of mediastin ... Full text Link to item Cite

Effects of high-density lipoprotein targeting treatments on cardiovascular outcomes: A systematic review and meta-analysis.

Journal Article Eur J Prev Cardiol · March 2019 BACKGROUND: The effects of increasing high-density lipoprotein cholesterol on cardiovascular outcomes remain uncertain. DESIGN: We conducted a meta-analysis to investigate the effects of high-density lipoprotein cholesterol modifiers (niacin, fibrates and ... Full text Link to item Cite

Correction: Hypertension guidelines.

Journal Article Cleve Clin J Med · March 2019 In Aleyadeh W, Hutt-Centeno E, Ahmed HM, Shah NP. Hypertension guidelines: treat patients, not numbers. Cleve Clin J Med 2019; 86(1):47-56. doi:10.3949/ccjm.86a.18027, on page 50, the following statement was incorrect: "In 2017, the American College of Phy ... Link to item Cite

Predictors of cardiorespiratory fitness improvement in phase II cardiac rehabilitation.

Journal Article Clin Cardiol · December 2018 BACKGROUND: Cardiac rehabilitation (CR) improves cardiorespiratory fitness (CRF) and has been shown to reduce cardiovascular events and death. However, data about predictors of fitness improvement during CR are limited and conflicting. The objective of thi ... Full text Link to item Cite

Association Between Obesity and Cardiovascular Outcomes: A Systematic Review and Meta-analysis of Mendelian Randomization Studies.

Journal Article JAMA Netw Open · November 2, 2018 IMPORTANCE: Although dyslipidemia has been consistently shown to be associated with atherogenesis, an association between obesity and cardiovascular disease outcomes remains controversial. Mendelian randomization can minimize confounding if variables are r ... Full text Open Access Link to item Cite

Randomized Evaluation of Heart Failure With Preserved Ejection Fraction Patients With Acute Heart Failure and Dopamine: The ROPA-DOP Trial.

Journal Article JACC Heart Fail · October 2018 OBJECTIVES: This study sought to compare a continuous infusion diuretic strategy versus an intermittent bolus diuretic strategy, with the addition of low-dose dopamine (3 μg/kg/min) in the treatment of hospitalized patients with heart failure with preserve ... Full text Link to item Cite

Coronary artery calcium scoring: Its practicality and clinical utility in primary care.

Journal Article Cleve Clin J Med · September 2018 Coronary artery calcium scoring is useful as a risk-stratification tool in coronary artery disease, and it outperforms other risk-assessment methods. American College of Cardiology/American Heart Association guidelines give the test a IIB recommendation in ... Full text Link to item Cite

Cardiac Rehabilitation: Current Review of the Literature and Its Role in Patients with Heart Failure

Journal Article Current Treatment Options in Cardiovascular Medicine · February 1, 2018 Purpose of review: Cardiovascular (CV) disease remains the leading cause of death in the USA despite major advances in its treatment. With time, cardiac rehabilitation (CR) programs have gathered interest to help increase CV health and improve functional s ... Full text Cite

Acute decompensated heart failure as the initial presentation of isolated aortitis.

Journal Article Future Cardiol · July 2016 Decompensated heart failure affects 5 million Americans and nearly 15 million individuals worldwide. Heart failure can be attributed to numerous etiologies, with autoimmune conditions representing a rare category of acute decompensations. Here, we report o ... Full text Link to item Cite

Cardiovascular Disease Prevention in Men with Vascular Erectile Dysfunction: The View of the Preventive Cardiologist.

Journal Article Am J Med · March 2016 Vascular erectile dysfunction is a powerful marker of increased cardiovascular risk. However, current guidelines lack specific recommendations on the role that the evaluation of vascular erectile dysfunction should play in cardiovascular risk assessment, a ... Full text Link to item Cite

Relationship Between Sedentary Behavior and Cardiovascular Risk.

Journal Article Curr Cardiol Rep · January 2016 The majority of adults do not meet current guideline recommendations for moderate to vigorous physical activity. Recent research has linked a high amount of sedentary behavior with an increased risk of obesity, diabetes, the metabolic syndrome, cardiovascu ... Full text Link to item Cite

Pleomorphic Adenoma of the Parotid Gland: Report of a Case With Review of Literature.

Journal Article Ethiop J Health Sci · April 2015 BACKGROUND: Pleomorphic adenomas are benign salivary gland tumors, which predominantly affect the superficial lobe of the parotid gland. The "pleomorphic" nature of the tumor can be explained on the basis of its epithelial and connective tissue origin. The ... Full text Link to item Cite

Impact on cognitive function-are all statins the same?

Journal Article Curr Atheroscler Rep · January 2015 Dementia is a major public health concern, affecting an estimated 7% of the population over 65 and 30% over 80 years of age. There is mounting evidence in the literature from meta-analyses of high-quality prospective cohort studies that statins may have a ... Full text Link to item Cite

Monitoring of international diabetes federation-recommended clinical diabetes indicators in a public health centre in southwest Trinidad

Journal Article West Indian Medical Journal · January 1, 2014 Objectives: To examine availability of International Diabetes Federation (IDF)-recommended diabetes indicators in the medical charts of patients in active care at a public health centre in southwest Trinidad and Tobago, and to determine clinical status of ... Full text Cite

Effect of single dose intramuscular methylprednisolone injection into the masseter muscle on the surgical extraction of impacted lower third molars: a randomized controlled trial.

Journal Article Kathmandu Univ Med J (KUMJ) · 2014 BACKGROUND: Lower impacted third molar surgical extraction usually causes post-surgical sequelae like pain, trismus and swelling as a result of postoperative inflammatory response. OBJECTIVE: The aim of this study was to evaluate and compare the efficacy o ... Full text Link to item Cite