Journal ArticleEur Heart J Cardiovasc Pharmacother · February 8, 2025
AIMS: In standard time-to-first event analysis, early aspirin discontinuation followed by ticagrelor monotherapy has been shown to reduce bleeding without increasing ischaemic complications compared with ticagrelor plus aspirin after percutaneous coronary ...
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Journal ArticleJ Card Fail · October 2024
INTRODUCTION: Little is known about the use of cangrelor in patients with myocardial infarction (MI) presenting with cardiogenic shock (CS). METHODS: CAMEO (Cangrelor in Acute MI: Effectiveness and Outcomes) is a multicenter observational registry evaluati ...
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Journal ArticleCatheter Cardiovasc Interv · September 2024
BACKGROUND: Incomplete revascularization (ICR) after percutaneous coronary intervention (PCI) is associated with mortality and morbidity. AIM: We sought to investigate whether ICR in the left anterior descending artery (LAD) is worse than ICR of the right ...
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Journal ArticleAm Heart J · May 2024
BACKGROUND: Mortality after ST-segment elevation myocardial infarction (STEMI) is increased in patients with hypertension. The mechanisms underlying this association are uncertain. We sought to investigate whether patients with STEMI and prior hypertension ...
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Journal ArticleCirc Cardiovasc Interv · May 2024
BACKGROUND: XC001 is a novel adenoviral-5 vector designed to express multiple isoforms of VEGF (vascular endothelial growth factor) and more safely and potently induce angiogenesis. The EXACT trial (Epicardial Delivery of XC001 Gene Therapy for Refractory ...
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ConferenceJournal of the Society for Cardiovascular Angiography & Interventions · February 2024
BackgroundLittle is known about the bleeding risk associated with cangrelor use in patients with myocardial infarction (MI) who are exposed to an oral P2Y12 inhibitor before coronary angiography.MethodsCangrelor in Acute MI: Ef ...
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Journal ArticleJournal of cardiac failure · December 2023
BackgroundHeart failure (HF) may complicate acute coronary syndrome (ACS) and is associated with a high burden of short- and long-term morbidity and mortality. Only limited data regarding future ischemic events and rehospitalization are available ...
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Journal ArticleJACC Cardiovasc Interv · October 23, 2023
BACKGROUND: Nearly 20% of patients on ticagrelor experience dyspnea, which may lead to treatment discontinuation in up to one-third of cases. OBJECTIVES: The authors sought to evaluate the incidence, predictors, and outcomes of dyspnea-related ticagrelor d ...
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Journal ArticleJ Am Coll Cardiol · August 22, 2023
BACKGROUND: In TWILIGHT (Ticagrelor With Aspirin or Alone in High-Risk Patients After Coronary Intervention), among high-risk patients undergoing percutaneous coronary intervention (PCI), ticagrelor monotherapy vs continuation of dual antiplatelet therapy ...
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Journal ArticleCirc Cardiovasc Interv · August 2023
BACKGROUND: New therapies are needed for patients with refractory angina. Encoberminogene rezmadenovec (XC001), a novel adenoviral-5 vector coding for all 3 major isoforms of VEGF (vascular endothelial growth factor), demonstrated enhanced local angiogenes ...
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Journal ArticleCatheter Cardiovasc Interv · January 14, 2023
BACKGROUND: Invasive cardiac catheterization (CC) temporarily increases pain, discomfort, and anxiety. Procedural sedation is deployed to mitigate these symptoms, though practice varies. Research evaluating peri-procedural patient-reported outcomes is lack ...
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Journal ArticleInt J Cardiol · January 1, 2023
AIMS: THEMIS is a double-blind, randomized trial of 19,220 patients with diabetes mellitus and stable coronary artery disease (CAD) comparing ticagrelor to placebo, in addition to aspirin. The present study aimed to describe the proportion of patients elig ...
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Journal ArticleEuroIntervention · December 2, 2022
BACKGROUND: Prior coronary artery bypass graft surgery (CABG) patients undergoing percutaneous coronary intervention (PCI) are often older and present with multiple comorbidities. Ticagrelor monotherapy after a short course of dual antiplatelet therapy (DA ...
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Journal ArticleThe American journal of cardiology · December 2022
Impella was approved by the Food and Drug Administration in 2015 for use during high-risk percutaneous coronary interventions (PCIs); however, its safety and efficacy compared with intra-aortic balloon pump (IABP) has not been evaluated in contemporary pra ...
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Journal ArticleJACC Cardiovasc Interv · October 10, 2022
BACKGROUND: There is a paucity of data regarding the safety and efficacy of different antiplatelet regimens according to standardized body mass index (BMI) categories. OBJECTIVES: The aim of this study was to investigate bleeding and ischemic outcomes acco ...
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Journal ArticleEur Heart J Cardiovasc Pharmacother · September 29, 2022
AIMS: We aimed to evaluate the treatment effects of ticagrelor monotherapy in the very high risk cohort of patients with concomitant diabetes mellitus (DM) and chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI). METHODS AND RE ...
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Journal ArticleAm Heart J · September 2022
INTRODUCTION: The decision to shorten the duration of DAPT following PCI in patients with ACS remains controversial because of the concern for increased ischemic events. METHODS: We performed a comprehensive literature search in seven databases to explore ...
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Journal ArticleThe American journal of cardiology · September 2022
Patients with acute coronary syndrome (ACS) are at risk for recurrent adverse events, and multiple reports suggest that this risk is increased in patients with concomitant diabetes mellitus (DM) and peripheral artery disease (PAD). The aim of this article ...
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Journal ArticleCardiovasc Revasc Med · July 2022
OBJECTIVES: To analyze the characteristics and outcome of Impella mechanical circulatory support (MCS) for Takotsubo syndrome (TS) with cardiogenic shock. BACKGROUND: TS is an acute heart failure syndrome characterized by transient severe reduction of left ...
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Journal ArticleJACC Cardiovasc Interv · June 13, 2022
BACKGROUND: The author recently reported ∼50% excess early mortality in patients with first-presentation ST-segment elevation myocardial infarction (STEMI) without standard modifiable cardiovascular risk factors (SMuRFs); the cause of this is not clear. OB ...
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Journal ArticleJ Am Heart Assoc · June 7, 2022
Background In clinical trials, cangrelor has been shown to reduce percutaneous coronary intervention-related ischemic complications without increasing major bleeding. This study was performed to examine cangrelor use and transition to oral P2Y12 inhibitors ...
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Journal ArticleGeroscience · June 2022
Prolonging survival in good health is a fundamental societal goal. However, the leading determinants of disability-free survival in healthy older people have not been well established. Data from ASPREE, a bi-national placebo-controlled trial of aspirin wit ...
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Journal ArticleCirc Cardiovasc Interv · April 2022
BACKGROUND: The risk/benefit tradeoff of dual antiplatelet therapy after percutaneous coronary intervention may vary in East Asian patients as compared with their non-East Asian counterparts. METHODS: The double-blind, placebo-controlled, randomized TWILIG ...
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ConferenceCoron Artery Dis · March 1, 2022
OBJECTIVES: Incidence and prognosis of ST-segment elevation myocardial infarction (STEMI) vary according to ambient temperature and season. We sought to assess whether season and temperature on the day of STEMI are associated with infarct size, microvascul ...
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Journal ArticleAm Heart J · March 2022
BACKGROUND: Ticagrelor is often administered to patients with acute coronary syndromes. However, when these patients require urgent or emergent cardiothoracic (CT) surgery the presence of ticagrelor significantly increases surgical bleeding. The goal of th ...
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Journal ArticleEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · March 2022
BackgroundIn the TWILIGHT trial, ticagrelor monotherapy after a short course of dual antiplatelet therapy (DAPT) was shown to be a safe bleeding avoidance strategy in high-risk patients undergoing percutaneous coronary intervention (PCI) with drug ...
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Journal ArticleJACC Cardiovasc Interv · February 14, 2022
OBJECTIVES: The aim of this study was to evaluate if patients with prior myocardial infarction (MI) could benefit from ticagrelor monotherapy in terms of bleeding reduction without any compromise in ischemic event prevention. BACKGROUND: Patients with hist ...
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Journal ArticleBMJ · February 9, 2022
Patent foramen ovale (PFO) describes a valve in the interatrial septum that permits shunting of blood or thrombotic material between the atria. PFOs are present in approximately 25% of the healthy population and are not associated with any pathology in the ...
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Journal ArticleEur Heart J · December 1, 2021
AIMS: The aim of this study was to assess the impact of chronic kidney disease (CKD) on the safety and efficacy of ticagrelor monotherapy among patients undergoing percutaneous coronary intervention (PCI). METHODS AND RESULTS: In this prespecified subanaly ...
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Journal ArticleEur Heart J · December 1, 2021
AIMS: Patients at high bleeding risk (HBR) represent a prevalent subgroup among those undergoing percutaneous coronary intervention (PCI). Early aspirin discontinuation after a short course of dual antiplatelet therapy (DAPT) has emerged as a bleeding avoi ...
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Journal ArticleAm Heart J · November 2021
BACKGROUND: Patients with refractory angina (RA) have poor quality of life and new therapies are needed. XC001 is a novel adenoviral vector expressing multiple isoforms of vascular endothelial growth factor (VEGF) promoting an enhanced local angiogenic eff ...
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Journal ArticleJ Am Coll Cardiol · October 12, 2021
Patients undergoing early surgery after coronary stent implantation are at increased risk for mortality from ischemic and hemorrhagic complications. The optimal antiplatelet strategy in patients who cannot discontinue dual antiplatelet therapy (DAPT) befor ...
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Journal ArticleCatheter Cardiovasc Interv · October 2021
OBJECTIVES: To compare in-hospital outcomes of bailout support to prophylactic support with percutaneous ventricular assist devices (pVAD) for high-risk nonemergent percutaneous coronary intervention (HRPCI). BACKGROUND: Prophylactic support with pVAD for ...
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Journal ArticleInt J Cardiol · October 1, 2021
BACKGROUND: The REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial) trial demonstrated that high-dose icosapent-ethyl reduced the risk of ischemic events in statin-treated patients with elevated triglycerides (TG) and eit ...
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Journal ArticleJAMA Cardiol · September 1, 2021
IMPORTANCE: Shortened dual antiplatelet therapy followed by potent P2Y12 receptor inhibitor monotherapy reduces bleeding without increasing ischemic events after percutaneous coronary intervention (PCI). OBJECTIVE: To explore sex differences and evaluate t ...
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Journal ArticleMinerva Cardiol Angiol · August 2021
INTRODUCTION: The optimal choice of oral P2Y12 receptor inhibitors has the potential to significantly influence outcomes. We seek to compare the safety and efficacy of the three most commonly used oral P2Y12 receptor inhibitors (clopi ...
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Journal ArticleJACC Cardiovasc Interv · July 12, 2021
OBJECTIVES: The aim of this study was to assess the impact of age on the safety and efficacy of ticagrelor monotherapy after percutaneous coronary intervention (PCI). BACKGROUND: As the risk for bleeding and ischemic complications after PCI increases with ...
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Journal ArticleCirc Cardiovasc Interv · February 2021
BACKGROUND: Symptom-to-balloon time (SBT) and door-to-balloon time (DBT) are both considered important metrics in patients undergoing primary percutaneous coronary intervention (pPCI) for ST-segment-elevation myocardial infarction (STEMI). We sought to ass ...
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Journal ArticleCirc Cardiovasc Interv · February 2021
The combination of an aging population and improved survival rates among patients with coronary artery disease has resulted in an increase in the number of patients with refractory angina or anginal equivalent symptoms despite maximal medical therapy. Pati ...
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Journal ArticleCatheter Cardiovasc Interv · October 1, 2020
BACKGROUND: Surgical revascularization is associated with improved ventricular function and clinical outcomes among patients with ischemic cardiomyopathy. There are less extensive data on changes in ventricular function among patients with ischemic cardiom ...
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Journal ArticleEur Heart J · October 1, 2020
AIMS: The aim of this study was to determine the effect of ticagrelor monotherapy on clinically relevant bleeding and major ischaemic events in relation to clinical presentation with and without non-ST elevation acute coronary syndromes (NSTE-ACS) among pa ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · September 2020
BACKGROUND: Longitudinal bleeding risk scores have been validated in patients treated with dual antiplatelet therapy (DAPT) following percutaneous coronary intervention. How these scores apply to the population of patients with acute coronary syndrome (ACS ...
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Journal ArticleJ Thromb Thrombolysis · August 2020
Coronary artery disease is a leading cause of morbidity and mortality worldwide. Despite significant advances in revascularization strategies and antiplatelet therapy with aspirin and/or P2Y12 receptor antagonist, patients with acute coronary syndrome (ACS ...
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Journal ArticleCirculation · July 14, 2020
BACKGROUND: New randomized, controlled trials have become available on oral P2Y12 inhibitors in acute coronary syndrome. We aimed to evaluate current evidence comparing the efficacy and safety profile of prasugrel, ticagrelor, and clopidogrel in acute coro ...
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Journal ArticleAm Heart J · July 2020
UNLABELLED: Cardiogenic shock (CS) complicating acute myocardial infarction (MI) is associated with high mortality. In the absence of data to support coronary revascularization beyond the infarct artery and selection of circulatory support devices or medic ...
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Journal ArticleJournal of the American College of Cardiology · July 2020
BackgroundThe long-term prognostic impact of post-discharge bleeding in the unique population of patients with acute coronary syndrome (ACS) treated without percutaneous coronary intervention (PCI) remains unexplored.ObjectivesThe aim of ...
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Journal ArticleCatheter Cardiovasc Interv · June 1, 2020
OBJECTIVES: Patient centeredness is an essential component of high-quality care, yet little is known regarding the patient experience during procedures performed in the cardiac catheterization lab. BACKGROUND: Available literature focuses on the safe deliv ...
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Journal ArticleAm J Cardiol · April 15, 2020
Intraocular bleeding is a devastating clinical event due to its potentially blinding nature. It is not known if determine if dual antiplatelet therapy using aspirin and potent P2Y12 inhibitors increases this risk. We searched MEDLINE and ClinicalTrials.gov ...
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Journal ArticleSci Rep · April 10, 2020
Changes in platelet physiology are associated with simultaneous changes in microRNA concentrations, suggesting a role for microRNA in platelet regulation. Here we investigated potential associations between microRNA and platelet reactivity (PR), a marker o ...
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Journal ArticleCatheter Cardiovasc Interv · April 1, 2020
In this review, we report a contemporary appraisal of the available evidence focusing on adjunctive antithrombotic therapy and technical aspects of percutaneous coronary interventions (PCI) in patients with acute myocardial infarction and cardiogenic shock ...
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Journal ArticleJournal of the American College of Cardiology · April 2020
BackgroundSmoking is a well-established risk factor for ST-segment elevation myocardial infarction (STEMI); however, once STEMI occurs, smoking has been associated with favorable short-term outcomes, an observation termed the "smoker's paradox." I ...
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Journal ArticleFrontiers in cardiovascular medicine · January 2020
Background: Right ventricular failure (RVF) is associated with increased mortality among patients receiving left ventricular mechanical circulatory support (LV-MCS) for cardiogenic shock and requires prompt recognition and management. Increased cent ...
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Journal ArticleESC Heart Fail · December 2019
AIMS: We sought to better understand the role of percutaneous coronary intervention (PCI) in patients with stable coronary artery disease (CAD) and moderate or severe left ventricular systolic dysfunction. METHODS AND RESULTS: Using data from the Duke Data ...
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Journal ArticleN Engl J Med · November 21, 2019
BACKGROUND: Monotherapy with a P2Y12 inhibitor after a minimum period of dual antiplatelet therapy is an emerging approach to reduce the risk of bleeding after percutaneous coronary intervention (PCI). METHODS: In a double-blind trial, we examined the effe ...
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Journal ArticlePhysiological genomics · October 2019
The genomic regulatory networks underlying the pathogenesis of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) are incompletely understood. As intermediate traits, protein biomarkers report on underlying disease severity and prognosis in NSTE-A ...
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Journal ArticleInt J Cardiol · September 15, 2019
BACKGROUND: The STICH trial showed superiority of coronary artery bypass plus medical treatment (CABG) over medical treatment alone (MED) in patients with left ventricular ejection fraction (LVEF) ≤35%. In previous publications, percutaneous coronary inter ...
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Journal ArticleEuropean heart journal · August 2019
Cardiogenic shock (CS) remains the most common cause of death in patients admitted with acute myocardial infarction (AMI) and mortality remained nearly unchanged in the range of 40-50% during the last two decades. Early revascularization, vasopressors and ...
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Journal ArticleJ Am Coll Cardiol · July 2, 2019
BACKGROUND: The COMPASS (Cardiovascular Outcomes for People Using Anticoagulation Strategies) trial found clinical benefit of low-dose rivaroxaban plus aspirin, but at the expense of increased bleeding risk in patients with stable vascular disease. OBJECTI ...
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ConferenceJAMA Cardiol · July 1, 2019
IMPORTANCE: Physician behavior in response to knowledge of a patient's CYP2C19 clopidogrel metabolizer status is unknown. OBJECTIVE: To investigate the association of mandatory reporting of CYP2C19 pharmacogenomic testing, provided to investigators with no ...
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Journal ArticleAm J Cardiol · May 1, 2019
Greater optimism regarding recovery from chronic illness is associated with improved quality of life and clinical outcomes. We performed a post-hoc analysis on the association between optimism and outcomes in Ranolazine in Patients with Incomplete Revascul ...
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Journal ArticleAm J Cardiol · April 15, 2019
The outcomes for patients transferred with cardiogenic shock and later treated with revascularization and Impella support have not previously been studied. To evaluate these outcomes, patients in cardiogenic shock were recruited from the catheter-based ven ...
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Journal ArticleAm J Cardiol · April 1, 2019
International variability in infarct size following acute anterior ST-elevation myocardial infarction without shock treated with primary percutaneous coronary intervention (PCI) has been little studied. Patients enrolled in the Counterpulsation to Reduce I ...
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Journal ArticleCan J Cardiol · April 2019
BACKGROUND: The effect of sex on self-reported frailty in acute coronary syndromes (ACS) is unclear. We examined the prevalence of self-reported frailty and its association with all-cause death among men and women. METHODS: Elderly (≥ 65 years) male (n = 2 ...
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Journal ArticleAnnu Rev Med · January 27, 2019
Atrial fibrillation (AF) increases a patient's stroke risk four- to five-fold. Anticoagulation with the vitamin K antagonist (VKA) warfarin reduces the risk of stroke by 67%, but warfarin carries a significant risk of major bleeding and has unpredictable p ...
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Journal ArticleCirculation. Cardiovascular quality and outcomes · December 2018
Background Cardiovascular clinical trials have traditionally incorporated separate time-to-first-event analyses for their primary efficacy and safety comparisons, but this framework has a number of limitations, including limited patient-centeredness and a ...
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Journal ArticleAcad Med · November 2018
Grateful patients provide substantial philanthropic funding for health care institutions, resulting in important societal benefits. Although grateful patient fundraising (GPFR) is widespread, it raises an array of ethical issues for patients, physicians, d ...
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Journal ArticleAm J Cardiol · October 15, 2018
Patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) are sometimes treated with medical management alone rather than an invasive strategy. Among those medically managed without revascularization and discharged, a proportion will requi ...
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Journal ArticleCatheter Cardiovasc Interv · October 1, 2018
BACKGROUND: The Impella 2.5 axial flow pump, which is positioned across the aortic valve, is widely employed for hemodynamic support. The present study compared structural and functional integrity of the left heart valves in patients undergoing Impella vs ...
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Journal ArticleCoron Artery Dis · September 2018
BACKGROUND: In the Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes (TRILOGY ACS) trial of patients with non-ST-segment elevation acute coronary syndrome managed medically without revascularization, ...
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Journal ArticleAm Heart J · August 2018
BACKGROUND: The Impella percutaneous ventricular assist device (PVAD) rapidly deploys mechanical circulatory support (MCS) in patients with acute myocardial infarction complicated by cardiogenic shock (AMICS). We present findings from a quality improvement ...
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Journal ArticleAmerican heart journal · July 2018
BackgroundPatients with peripheral artery disease (PAD) are known to have an increased risk of ischemic cardiovascular events. However, the influence of concomitant PAD on first and subsequent recurrent ischemic events after an acute coronary synd ...
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Journal ArticleAm Heart J · May 2018
UNLABELLED: Management of patients requiring temporary, mechanical hemodynamic support during high- risk percutaneous coronary intervention (PCI) or in cardiogenic shock is rapidly evolving. With the availability of the Impella 2.5, CP, 5.0, LD, and RP per ...
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Journal ArticleAstrophysical Journal, Supplement Series · January 1, 2018
We present the "Galaxy Cluster Merger Catalog." This catalog provides an extensive suite of mock observations and related data for N-body and hydrodynamical simulations of galaxy cluster mergers and clusters from cosmological simulations. These mock observ ...
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Journal ArticleAm Heart J · December 2017
BACKGROUND: Recent randomized evidence has demonstrated benefit with complete revascularization during the index hospitalization for multivessel coronary artery disease ST-segment elevation myocardial infarction (STEMI) patients; however, this benefit like ...
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Journal ArticleEuropean heart journal · December 2017
AimsMicrovascular obstruction (MVO) is the underlying cause for the no-reflow phenomenon in ST-segment elevation myocardial infarction (STEMI). The association between MVO assessed by cardiac magnetic resonance imaging (CMR) and prognosis has not ...
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Journal ArticleCirculation · October 17, 2017
Cardiogenic shock is a high-acuity, potentially complex, and hemodynamically diverse state of end-organ hypoperfusion that is frequently associated with multisystem organ failure. Despite improving survival in recent years, patient morbidity and mortality ...
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Journal ArticleInt J Cardiol · August 15, 2017
BACKGROUND: Nine oral antithrombotic medications currently available in the United States and Europe have been studied in clinical trials for secondary prevention of cardiac events following acute coronary syndrome (ACS). Few combinations of these medicati ...
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Journal ArticleHeart · August 2017
OBJECTIVES: Dual antiplatelet therapy (DAPT) with aspirin + a P2Y12 inhibitor is recommended for at least 12 months for patients with acute coronary syndrome (ACS), with shorter durations considered for patients with increased bleeding risk. However, there ...
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Journal ArticleAnn Thorac Surg · July 2017
BACKGROUND: Balancing risks and benefits of revascularization in elderly patients with multivessel coronary artery disease (CAD) is challenging. The appropriate revascularization strategy for elderly patients with multivessel CAD is unclear. METHODS: We us ...
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Journal ArticleClin Chem · July 2017
BACKGROUND: There are conflicting data on whether changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity C-reactive protein (hs-CRP) concentrations between time points (delta NT-proBNP and hs-CRP) are associated with a change ...
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Journal ArticleAm Heart J · June 2017
BACKGROUND: While infarct size in patients with ST-segment elevation myocardial infarction (STEMI) has been generally associated with long-term prognosis, whether a therapeutic effect on infarct size has a corresponding therapeutic effect on long-term outc ...
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Journal ArticleEuropean heart journal · June 2017
AimStudies have reported less favourable outcomes in women compared with men after primary percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI). Whether sex-specific differences in the magnitude or prognos ...
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Journal ArticleAm J Cardiol · June 1, 2017
The association between anemia at admission and adverse outcomes in patients with acute coronary syndrome (ACS) has been incompletely studied. Anemia was defined as serum hemoglobin <12 g/dl in women or <13 g/dl in men in 2 large trials of patients with AC ...
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Journal ArticleAm Heart J · June 2017
OBJECTIVE: Patients with diabetes mellitus (DM) presenting with acute coronary syndrome (ACS) and undergoing percutaneous coronary intervention (PCI) derived enhanced benefit with dual antiplatelet therapy (DAPT) with prasugrel vs. clopidogrel. The risk pr ...
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Journal ArticleAtherosclerosis · June 2017
BACKGROUND AND AIMS: Although circulating microRNA (miRNAs) have emerged as biomarkers predicting mortality in acute coronary syndrome (ACS), more data are needed to understand these mechanisms. Mapping miRNAs to high-risk traits may identify miRNAs involv ...
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Journal ArticleJ Am Coll Cardiol · May 9, 2017
BACKGROUND: Chronic angina is more common in patients with diabetes mellitus (DM) with poor glucose control. Ranolazine both treats chronic angina and improves glucose control. OBJECTIVES: This study sought to examine ranolazine's antianginal effect in rel ...
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Journal ArticleCochrane Database Syst Rev · May 3, 2017
BACKGROUND: Multi-vessel coronary disease in people with ST elevation myocardial infarction (STEMI) is common and is associated with worse prognosis after STEMI. Based on limited evidence, international guidelines recommend intervention on only the culprit ...
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Journal ArticleAmerican heart journal · May 2017
ObjectiveAcute coronary syndrome (ACS) trials typically use a composite primary outcome (myocardial infarction [MI], stroke, or cardiovascular death), but differential patient characteristics, timing, and consequences associated with individual co ...
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Journal ArticleLancet (London, England) · May 2017
BackgroundDual antiplatelet therapy (DAPT), aspirin plus a P2Y12 inhibitor, is the standard antithrombotic treatment following acute coronary syndromes. The factor Xa inhibitor rivaroxaban reduced mortality and ischaemic events when added to DAPT, ...
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Journal ArticleJ Am Heart Assoc · April 11, 2017
BACKGROUND: The relationship between troponin level and outcomes among patients with non-ST-segment elevation ACS is established, but the relationship of troponin level with long-term outcomes among medically managed non-ST-segment elevation ACS patients r ...
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Journal ArticleAm J Cardiol · March 15, 2017
The role and timing of percutaneous mechanical circulatory support (MCS) devices in the treatment of acute myocardial infarction complicated by cardiogenic shock (AMICS) are not well understood. We sought to evaluate patient characteristics and predictors ...
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Journal ArticleJournal of the American College of Cardiology · March 2017
BackgroundSex-specific differences in response to antiplatelet therapies have been described. Whether women and men derive comparable benefit from intensification of antiplatelet therapy remains uncertain.ObjectivesThe study investigated ...
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Journal ArticleAm J Med · December 2016
BACKGROUND: Non-infarct-related artery (non-IRA) disease is prevalent in patients with ST-segment elevation myocardial infarction (STEMI). We aimed to assess the impact of non-IRA disease on infarct size and clinical outcomes in patients with acute STEMI. ...
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Journal ArticleAm J Cardiol · December 1, 2016
Women are frequently reported to have increased morbidity after presentation with acute coronary syndromes and myocardial infarction; however, whether a greater thrombotic tendency contributes to gender differences in clinical outcomes of urgent percutaneo ...
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Journal ArticleAm Heart J · December 2016
BACKGROUND: Dual antiplatelet therapy (DAPT) is necessary to prevent thrombosis yet increases bleeding after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Antiplatelet monotherapy with a potent P2Y12 receptor antagonist may reduc ...
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Journal ArticleJ Am Heart Assoc · November 4, 2016
BACKGROUND: The relationship between "on-treatment" low platelet reactivity and longitudinal risks of major bleeding dual antiplatelet therapy following acute coronary syndromes remains uncertain, especially for patients who do not undergo percutaneous cor ...
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Journal ArticleAm Heart J · November 2016
Aspirin was established more than a quarter century ago as an evidence-based therapy to reduce recurrent cardiovascular events in patients with coronary artery disease based on limited data by contemporary standards. Indeed it is unclear how regulatory age ...
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ConferenceEur Heart J Acute Cardiovasc Care · October 2016
AIMS: We aimed to study the relationship of chronic kidney disease stages with long-term ischemic and bleeding outcomes in medically managed acute coronary syndrome patients and the influence of more potent antiplatelet therapies on platelet reactivity by ...
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Journal ArticleJ Am Heart Assoc · September 28, 2016
BACKGROUND: The extent to which angina is associated with future cardiovascular events in patients with coronary artery disease has long been debated. METHODS AND RESULTS: Included were outpatients with established coronary artery disease who were enrolled ...
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Journal ArticleCatheter Cardiovasc Interv · September 2016
Cardiogenic shock is a common clinical condition with high in-hospital mortality. Early application of appropriate interventions for cardiogenic shock-including medical therapies, revascularization, temporary hemodynamic support devices, and durable mechan ...
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Journal ArticleClin Cardiol · September 2016
Associations between atrial fibrillation (AF), outcomes, and response to antiplatelet therapies in patients with acute coronary syndrome (ACS) managed medically without revascularization remain uncertain. We examined these associations for medically manage ...
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Journal ArticleCirculation · August 2, 2016
Patients with severe coronary artery disease with a clinical indication for revascularization but who are at high procedural risk because of patient comorbidities, complexity of coronary anatomy, and/or poor hemodynamics represent an understudied and poten ...
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Journal ArticleHeart · August 1, 2016
OBJECTIVE: We investigated whether prior clopidogrel influenced long-term ischaemic and bleeding risks and modified the randomised treatment effect of clopidogrel versus prasugrel among medically managed patients with acute coronary syndromes (ACS) treated ...
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Journal ArticleAm Heart J · August 2016
BACKGROUND: Few studies have assessed treatment effects on health-related quality of life (HRQoL) in patients with acute coronary syndrome (ACS) treated without revascularization. The TRILOGY ACS trial randomized patients with ACS to either prasugrel or cl ...
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Journal ArticleEur Heart J Acute Cardiovasc Care · June 2016
AIMS: Little is known regarding consequences of frailty in patients with acute coronary syndrome (ACS). We assessed the associations of frailty and outcomes in ACS patients who were participating in a clinical trial. METHODS AND RESULTS: The TaRgeted plate ...
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Journal ArticleClin Cardiol · June 2016
BACKGROUND: Low levels of high-density lipoprotein cholesterol (HDL-C; <40 mg/dL) are associated with increased risk of cardiovascular events, but it is unclear whether lower thresholds (<30 mg/dL) are associated with increased hazard. HYPOTHESIS: Very low ...
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Journal ArticleJACC Cardiovasc Interv · May 9, 2016
Percutaneous mechanical circulatory support has been used to stabilize patients in cardiogenic shock and provide hemodynamic support during high-risk percutaneous coronary interventions for several decades. The goal of this paper is to provide a practical ...
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Journal ArticleInteract J Med Res · April 28, 2016
BACKGROUND: Angina is a clinical syndrome whose recognition relies heavily on self-report, so its identification can be challenging. Most data come from cohorts identified by physicians and nurses at the point of care; however, current widespread access to ...
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Journal ArticleJ Am Coll Cardiol · April 12, 2016
BACKGROUND: Prompt reperfusion in patients with ST-segment elevation myocardial infarction (STEMI) reduces infarct size and improves survival. However, the intuitive link between infarct size and prognosis has not been convincingly demonstrated in the cont ...
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Journal ArticleStroke · April 2016
BACKGROUND AND PURPOSE: The role of more intense, sustained platelet inhibition in preventing stroke after acute coronary syndrome (ACS) is unclear. We observed a signal for reduced stroke risk in the Targeted Platelet Inhibition to Clarify the Optimal Str ...
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Journal ArticleAmerican heart journal · April 2016
BackgroundAdverse event collection in randomized clinical trials establishes drug safety. Although costly and regulated, it is rarely studied.MethodsAdverse event data from 4 clinical trials (APPRAISE-2, PLATO, TRACER, TRILOGY ACS) compri ...
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Journal ArticleAm Heart J · April 2016
BACKGROUND: Despite advances in primary percutaneous coronary intervention (pPCI) and regional systems of care, the development of cardiogenic shock is associated with poor clinical outcomes in patients with ST-segment elevation myocardial infarction (STEM ...
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Journal ArticleAm Heart J · April 2016
Dual antiplatelet therapy (DAPT), the combination of aspirin and a P2Y12 inhibitor, given for 12 months remains the standard of care after presentation with acute coronary syndrome (ACS) because it has been shown to be associated with a significant reducti ...
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Journal ArticleJAMA cardiology · April 2016
ImportanceIn the current therapeutic era, the risk for sudden cardiac death (SCD) after non-ST-segment elevation acute coronary syndrome (NSTE ACS) has not been characterized completely.ObjectiveTo determine the cumulative incidence of SC ...
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Journal ArticleJ Am Coll Cardiol · March 22, 2016
BACKGROUND: Patients with acute coronary syndrome (ACS), especially those receiving medical management without revascularization, are at high risk for spontaneous myocardial infarction (MI), but its frequency and predictors are unknown. OBJECTIVES: This st ...
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Journal ArticleJ Am Coll Cardiol · March 1, 2016
BACKGROUND: Certain alleles of the CYP2C19 gene are associated with higher platelet reactivity and increased ischemic events among patients treated with clopidogrel. However, the relationship of CYP2C19 genotype and outcomes in medically managed patients w ...
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Journal ArticleCirculation · February 16, 2016
Two guidelines from the American College of Cardiology (ACC), the American Heart Association (AHA), and collaborating societies address the risk of aortic dissection in patients with bicuspid aortic valves and severe aortic enlargement: the "2010 ACCF/AHA/ ...
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Journal ArticleJ Am Coll Cardiol · February 2, 2016
BACKGROUND: Pulse pressure (PP) provides valuable prognostic information in specific populations, but few studies have assessed its value on cardiovascular outcomes in a broad, worldwide population. OBJECTIVES: The aim of this study was to determine whethe ...
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Journal ArticleEur Heart J · January 21, 2016
AIMS: Studies have suggested increased cancer incidence associated with long-term dual antiplatelet therapy (DAPT) for acute coronary syndrome (ACS). We evaluated cancer incidence and treatment-related differences in an analysis of DAPT for ACS. METHODS AN ...
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Journal ArticleLancet (London, England) · January 2016
BackgroundIncomplete revascularisation is common after percutaneous coronary intervention and is associated with increased mortality and adverse cardiovascular events. We aimed to assess whether adjunctive anti-ischaemic pharmacotherapy with ranol ...
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Journal ArticleCirculation · January 2016
BackgroundAngina often persists or returns in populations following percutaneous coronary intervention (PCI). We hypothesized that ranolazine would be effective in reducing angina and improving quality of life (QOL) in incomplete revascularization ...
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Journal ArticleCochrane Database of Systematic Reviews · December 17, 2015
This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects of early invasive compared to conservative (medical management) strategy for treating non-infarct related artery lesions in ST elevation myocar ...
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Journal ArticleNat Rev Cardiol · November 2015
Among patients with diabetes mellitus and ischaemic heart disease, high-sensitivity testing effectively identified 39.3% of patients with elevated troponin levels who were at high 5-year risk of cardiovascular death, myocardial infarction, or stroke. Compa ...
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Journal ArticleAm Heart J · November 2015
BACKGROUND: High-risk percutaneous coronary intervention (PCI) supported by percutaneous left ventricular assist devices offers a treatment option for patients with severe symptoms, complex and extensive coronary artery disease, and multiple comorbidities. ...
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Journal ArticleAm Heart J · October 2015
BACKGROUND: Women with acute coronary syndromes (ACS) are less likely to undergo invasive revascularization than men, but sex-specific differences in long-term outcomes and platelet reactivity among medically managed ACS patients remain uncertain. We exami ...
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Journal ArticleAm Heart J · October 2015
UNLABELLED: Concomitant use of proton-pump inhibitors (PPIs) has been implicated in diminished antiplatelet response to clopidogrel and an increased risk of ischemic events, but primarily among patients undergoing percutaneous coronary intervention. We sou ...
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Journal ArticleJ Invasive Cardiol · October 2015
BACKGROUND: The optimal revascularization strategy in patients with acute coronary syndrome (ACS) and proximal left anterior descending (pLAD) coronary artery lesions is not well defined. The aim of this study was to compare the outcomes of ACS patients wi ...
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Journal ArticleCirculation · September 8, 2015
BACKGROUND: Despite the known association of diabetes mellitus with cardiovascular events, there are few contemporary data on the long-term outcomes from international cohorts of patients with diabetes mellitus. We sought to describe cardiovascular outcome ...
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Journal ArticleAm Heart J · September 2015
BACKGROUND: Therapies that reverse pathologic left ventricular (LV) remodeling are often associated with improved outcomes. The incidence and impact of reverse LV remodeling after high-risk percutaneous coronary intervention (PCI) are unknown. METHODS: The ...
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Journal ArticleLancet · August 15, 2015
Chronic angina is a common manifestation of ischaemic heart disease. Medical treatments are the mainstay approach to reduce the occurrence of angina and improve patients' quality of life. This Series paper focuses on commonly used standard treatments (eg, ...
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Journal ArticleCirculation. Cardiovascular quality and outcomes · July 2015
BackgroundAdequate representation by sex in trials allows generalizability of results. We examined representation of women in clinical trials during a 17-year period in which inclusion criteria were broadened and federal mandates for representativ ...
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Journal ArticleCirc Cardiovasc Interv · June 2015
BACKGROUND: The preferred revascularization strategy for diabetic patients with acute coronary syndromes and multivessel coronary artery disease is uncertain. We evaluated the outcomes of diabetic patients with moderate and high-risk acute coronary syndrom ...
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Journal ArticleJournal of the American Heart Association · June 2015
BackgroundLittle is known about the incidence, predictors, or outcomes of intracranial hemorrhage (ICH) in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS). We aimed to determine the incidence and timing of ICH, character ...
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Journal ArticleEuropean heart journal · May 2015
Cardiogenic shock (CS) remains the most common cause of death in patients with acute myocardial infarction although mortality could be reduced from formerly ∼80% to 40-50%. In addition to percutaneous coronary intervention or coronary artery bypass graftin ...
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Journal ArticleCirculation · March 17, 2015
BACKGROUND: Performance metrics currently focus on the measurement of the application of guideline-indicated medications without considering the appropriate dosing of these drugs. METHODS AND RESULTS: We studied 39 291 patients from the Can Rapid Risk Stra ...
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Journal ArticleAm J Cardiol · February 15, 2015
The accuracy of the 12-lead electrocardiogram in detecting coronary artery occlusion is limited. We sought to determine the incidence, distribution, and outcomes of patients who have total occlusion of the culprit artery but present with non-ST-segment ele ...
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Journal ArticleEur Heart J · February 7, 2015
AIMS: Several methods provide new insights into understanding clinical trial composite endpoints, using both conventional and novel methods. The TRILOGY ACS trial is used as a contemporary example to prospectively compare these methods side by side. METHOD ...
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Journal ArticleHeart · February 2015
OBJECTIVE: To study the impact of national economic and human development status on patient profiles and outcomes in the setting of acute coronary syndrome (ACS). METHODS: We conducted a retrospective analysis of the Targeted Platelet Inhibition to Clarify ...
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Journal ArticleJ Am Heart Assoc · January 30, 2015
BACKGROUND: Clinical outcomes in patients with refractory angina (RA) are poorly characterized and variably described. Using the Duke Database for Cardiovascular Disease (DDCD), we explored characteristics that drive clinical endpoints in patients with cla ...
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Journal ArticleClin Cardiol · January 2015
BACKGROUND: Primary percutaneous coronary intervention (PCI) is the most common method of reperfusion in patients with ST-segment elevation myocardial infarction (STEMI) in the United States. The intersection between processes of care and performance measu ...
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Journal ArticleInt J Cardiol · 2015
BACKGROUND: Procedural risk scores facilitate clinical decision making by using individual patient characteristics to estimate the risk of adverse events. The performance of PCI-based risk scores is not well-described among patients undergoing hemodynamica ...
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Journal ArticleCirculation · December 9, 2014
OBJECTIVE: To review the literature systematically to determine whether initiation of beta blockade within 45 days prior to noncardiac surgery reduces 30-day cardiovascular morbidity and mortality rates. METHODS: PubMed (up to April 2013), Embase (up to Ap ...
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Journal ArticleAm J Cardiol · December 1, 2014
Although lesion complexity is predictive of outcomes after balloon angioplasty, it is unclear whether complex lesions continue to portend a worse prognosis in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) w ...
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Journal ArticleEur J Prev Cardiol · December 2014
BACKGROUND: The incidence of metabolic syndrome (MetS), diabetes mellitus (DM), and their coexistence is increasing but whether MetS increases cardiovascular risk beyond component risk factors is controversial. DESIGN: We compared the risk of cardiovascula ...
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Journal ArticleJAMA · November 19, 2014
IMPORTANCE: Little information exists about the anatomical characteristics and clinical relevance of non-infarct-related artery (IRA) disease among patients with ST-segment elevation myocardial infarction (STEMI). OBJECTIVES: To investigate the incidence, ...
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Journal ArticleAm Heart J · November 2014
Mortality and morbidity in acute coronary syndromes (ACSs), caused principally by plaque erosion or rupture leading to thrombus formation and myocardial ischemia, have been reduced by a combination of antithrombotic agents (antiplatelet drugs and anticoagu ...
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Journal ArticleAm Heart J · November 2014
Acute coronary syndromes (ACS), either ST-elevation myocardial infarction or non-ST-elevation ACS, are still one of the most common cardiac emergencies with substantial morbidity and mortality. The availability of evidence-based treatments, such as early a ...
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Journal ArticleEur Heart J · November 1, 2014
AIMS: Due to a high burden of systemic cardiovascular events, current guidelines recommend the use of statins in all patients with peripheral artery disease (PAD). We sought to study the impact of statin use on limb prognosis in patients with symptomatic P ...
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Journal ArticleAm J Cardiol · September 1, 2014
The outcomes of hemodynamic support during high-risk percutaneous coronary intervention in the very elderly are unknown. We sought to compare outcomes between the patients ≥80 years versus patients <80 years enrolled in the PROTECT II (Prospective Randomiz ...
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ConferenceAm Heart J · July 2014
BACKGROUND: To further explore the impact of smoking on antiplatelet activity and treatment response, we evaluated time-dependent relationships between smoking status with on-treatment platelet reactivity and clinical outcomes for prasugrel vs. clopidogrel ...
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Journal ArticleCirc Cardiovasc Interv · June 2014
BACKGROUND: Troponin elevation is a risk factor for mortality in patients with non-ST-segment-elevation acute coronary syndromes. However, the prognosis of patients with troponin elevation and nonobstructive coronary artery disease (CAD) is unknown. Our ob ...
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Journal ArticleCatheter Cardiovasc Interv · June 1, 2014
OBJECTIVE: To study rotational atherectomy (RA) outcomes in patients undergoing high-risk PCI randomized to receive hemodynamic support using either IABP or Impella 2.5 in the PROTECT II trial. BACKGROUND: RA of heavily calcified lesions is often necessary ...
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Journal ArticleAm Heart J · April 2014
BACKGROUND: The introduction of new medical devices may be accompanied by a learning curve. METHODS: To evaluate the impact of the device learning curve on the outcomes of PROTECT II trial, comparing Impella 2.5 versus the intra-aortic balloon pump (IABP) ...
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Journal ArticleJACC Cardiovasc Interv · March 2014
OBJECTIVES: This study evaluated the impact of nonculprit vessel myocardial perfusion on outcomes of non-ST-segment elevation acute coronary syndromes (NSTE-ACS) patients. BACKGROUND: ST-segment elevation myocardial infarction patients have decreased perfu ...
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Journal ArticleJ Interv Cardiol · February 2014
OBJECTIVES: To evaluate the periprocedural characteristics and outcomes of patients supported with Impella 2.5 prior to percutaneous coronary intervention (pre-PCI) versus those who received it after PCI (post-PCI) in the setting of cardiogenic shock (CS) ...
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Journal ArticleCrit Care Med · February 2014
OBJECTIVES: Guidelines recommend β-blockers and renin-angiotensin-aldosterone system blockers to improve long-term survival in hemodynamically stable myocardial infarction patients with a reduced left ventricular ejection fraction. The prevalence and outco ...
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Journal ArticleAm J Cardiol · January 15, 2014
A periprocedural myocardial infarction, defined as the advent of new Q-waves or a creatine kinase-MB elevation >83 normal has been previously validated as predictive of subsequent mortality. We examined the effects of using this clinically relevant definit ...
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Journal ArticleAm J Med · January 2014
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) other than aspirin have been linked to heart failure, salt retention, adverse ventricular remodeling, and thrombosis. We therefore sought to assess their impact on cardiovascular events in outpatien ...
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Journal ArticleInt J Cardiol · January 1, 2014
BACKGROUND: Patients with atrial fibrillation (AF) are at increased risk of thromboembolic events. The long-term prognostic implications of AF in patients with atherothrombosis are unknown. METHODS: We compared 4-year CV outcomes in patients with and witho ...
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Journal ArticleJ Am Coll Cardiol · December 24, 2013
Transcatheter aortic valve implantation (TAVI) has emerged as a therapeutic alternative for patients with symptomatic aortic stenosis at high or prohibitive surgical risk. However, patients undergoing TAVI are also at high risk for both bleeding and stroke ...
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Journal ArticleAm Heart J · December 2013
BACKGROUND: Incomplete revascularization (ICR) after percutaneous coronary intervention (PCI) is common and is associated with increased rates of rehospitalization, revascularization, and mortality. Adjunctive pharmacotherapy with ranolazine, an inhibitor ...
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Journal ArticleClin Cardiol · December 2013
BACKGROUND: Despite overall improvements in cardiovascular-disease therapies and outcomes, medication nonadherence remains an important barrier to effective secondary prevention of atherothrombotic disease. HYPOTHESIS: Long-term medication adherence in out ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · November 2013
BACKGROUND: Cardiogenic shock is a deadly complication of an acute myocardial infarction (MI). We sought to characterize differences in patient features, treatments, and outcomes of cardiogenic shock by MI classification: ST-segment-elevation MI (STEMI) ve ...
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Journal ArticleInt J Cardiol · October 3, 2013
BACKGROUND: We assessed the incidence and timing of post-acute coronary syndrome (ACS) atrial fibrillation (AF) related and not related to coronary artery bypass grafting (CABG); described the use of antithrombotic therapy; and evaluated the association of ...
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Journal ArticleAm J Cardiol · October 1, 2013
The goal of this study was to characterize determinants of infarct size in the multicenter randomized Counterpulsation to Reduce Infarct Size Pre-PCI Acute Myocardial Infarction (CRISP-AMI) trial. Contemporary determinants of infarct size in patients prese ...
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Journal ArticleCirculation · August 20, 2013
BACKGROUND: Dual antiplatelet therapy in older versus younger patients with acute coronary syndromes is understudied. Low-dose prasugrel (5 mg/d) is recommended for younger, lower-body-weight patients and elderly patients with acute coronary syndromes to m ...
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Journal ArticleLancet · August 17, 2013
BACKGROUND: Treatment with prasugrel and aspirin improves outcomes compared with clopidogrel and aspirin for patients with acute coronary syndrome who have had angiography and percutaneous coronary intervention; however, no clear benefit has been shown for ...
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Journal ArticleAm Heart J · August 2013
BACKGROUND: Cardiogenic shock complicating acute myocardial infarction (MI) in older patients is associated with a high risk of inhospital mortality; however, the long-term prognosis among these patients who survive the index hospitalization is uncertain. ...
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Journal ArticleAm J Med · August 2013
BACKGROUND: Although nonadherence with evidence-based secondary prevention medications is common in patients with established atherothrombotic disease, long-term outcomes studies are scant. We assessed the prevalence and long-term outcomes of nonadherence ...
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Journal ArticleInt J Cardiol · July 31, 2013
BACKGROUND: Data are limited on whether clinical trials have randomized higher-risk patients over time and how trends in risk profiles and evidence-based pharmacotherapies have influenced trial outcomes. We quantified changes in baseline risk, treatment, a ...
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Journal ArticleJACC Heart Fail · June 2013
OBJECTIVES: This study sought to describe the occurrence and timing of heart failure (HF), associated clinical factors, and 30-day outcomes in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS). BACKGROUND: Little is known about HF- ...
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Journal ArticleAm Heart J · May 2013
With the large number of antithrombotic therapies available and under investigation for the treatment of non-ST-segment elevation acute coronary syndromes (NSTE ACS), practice guidelines now stress the importance of selecting an antithrombotic strategy acc ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · May 1, 2013
BACKGROUND: Early invasive management is recommended for patients with non-ST-segment elevation myocardial infarction (MI), but the incidence of long-term outcomes after early catheterization among older patients and the relationship of revascularization p ...
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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 ArticleEur Heart J · April 2013
AIMS: The effect of resistant hypertension on outcomes in patients with atherothrombotic disease is currently unknown. Accordingly, we sought to determine the prevalence and outcomes of resistant hypertension in stable hypertensive outpatients with subclin ...
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Journal ArticleEur Heart J · March 2013
Myocardial infarction (MI) is a key endpoint in randomized controlled trials (RCTs), but heterogeneous definitions limit comparisons across RCTs or meta-analyses. The 2000 European Society of Cardiology/American College of Cardiology MI redefinition and th ...
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Journal ArticleCirculation · February 12, 2013
BACKGROUND: Randomized trials of antithrombotics in coronary artery disease have identified previous stroke/transient ischemic attack (TIA) as a marker of increased intracranial bleeding risk. We aimed to further characterize the risk of ischemic and bleed ...
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Journal ArticleCardiol J · 2013
BACKGROUND: Atrial fibrillation (AF) and chronic kidney disease (CKD) have both been shown to portend worse outcomes after acute myocardial infarction (MI); however, the benefit of a rhythm control strategy in patients with CKD post-MI is unclear. METHODS: ...
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Journal ArticleAm J Med · December 2012
BACKGROUND: Heparin is commonly used for venous thromboembolism prophylaxis; however, the incidence of acquired thrombocytopenia in this setting has not been well described. METHODS: The Complications After Thrombocytopenia Caused by Heparin (CATCH) Regist ...
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Journal ArticleJAMA · November 4, 2012
CONTEXT The relationship of platelet function testing measurements with outcomes in patients with acute coronary syndromes (ACS) initially managed medically without revascularization is unknown. OBJECTIVE To characterize the differences and evaluate clinic ...
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Journal ArticleJACC Cardiovasc Interv · November 2012
OBJECTIVES: This study sought to develop a practical risk score to predict the risk of stent thrombosis (ST) after percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS). BACKGROUND: ST is a rare, yet feared complication after PCI with ...
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Journal ArticleN Engl J Med · October 4, 2012
BACKGROUND: The effect of intensified platelet inhibition for patients with unstable angina or myocardial infarction without ST-segment elevation who do not undergo revascularization has not been delineated. METHODS: In this double-blind, randomized trial, ...
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Journal ArticleJAMA · October 3, 2012
CONTEXT: β-Blockers remain the standard of care after a myocardial infarction (MI). However, the benefit of β-blocker use in patients with coronary artery disease (CAD) but no history of MI, those with a remote history of MI, and those with only risk facto ...
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Journal Article · October 3, 2012
The goals of antithrombotic therapy during percutaneous coronary intervention are to mitigate thrombotic complications associated with iatrogenic plaque disruption from the angioplasty balloon or stent and embolization of thrombotic material from procedura ...
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Journal ArticleCirculation · October 2, 2012
BACKGROUND: Although coronary artery bypass grafting is generally preferred in symptomatic patients with severe, complex multivessel, or left main disease, some patients present with clinical features that make coronary artery bypass grafting clinically un ...
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Journal ArticleEur Heart J · August 2012
AIMS: Bleeding complications have been associated with short-term mortality in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Their association with long-term outcomes is less clear. This study examines mortality associated with in- ...
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Journal ArticleArch Intern Med · July 23, 2012
BACKGROUND: Living alone, a proxy for social support, has been inconsistently linked with cardiovascular risk. METHODS: We investigated whether living alone was associated with increased mortality and cardiovascular risk in the global REduction of Atheroth ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · July 1, 2012
BACKGROUND: The impact of polyvascular disease (peripheral arterial disease [PAD] and cerebrovascular disease [CVD]) on long-term cardiovascular outcomes among older patients with acute myocardial infarction has not been well studied. METHODS AND RESULTS: ...
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Journal ArticleThromb Haemost · July 2012
Translational platelet function investigations performed in the percutaneous coronary intervention (PCI)-treated population receiving clopidogrel have identified high platelet reactivity to ADP (HPR) as a major risk factor for both acute as well as long-te ...
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Journal ArticleAm J Med · July 2012
BACKGROUND: Prediction models for cardiovascular events and cardiovascular death in patients with established cardiovascular disease are not generally available. METHODS: Participants from the prospective REduction of Atherothrombosis for Continued Health ...
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Journal ArticleCirculation · April 17, 2012
BACKGROUND: Elevated serum cholesterol accounts for a considerable proportion of cardiovascular disease worldwide. An understanding of the relationship between country-level economic and health system factors and elevated cholesterol may provide insight fo ...
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Chapter · April 1, 2012
Refractory angina is a major clinical challenge in-contemporary cardiovascular medicine. As therapeutic strategies evolve, there is increased life expectancy for ischemic heart disease with more patients reaching advanced stages. Due to a better understand ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · March 1, 2012
BACKGROUND: Regional differences in the profile and prognosis of non-ST-segment elevation acute coronary syndrome (NSTE ACS) patients treated with medical management after angiography remain uncertain. METHODS AND RESULTS: Using data from the Early Glycopr ...
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Journal ArticleJ Am Coll Cardiol · February 14, 2012
Early observations of cardiogenic shock as a systemic clinical syndrome were first described in 1942. Today, cardiogenic shock remains the leading cause of death among patients hospitalized for myocardial infarction (MI). Mortality rates in post-MI cardiog ...
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Journal ArticleClin Chem · January 2012
BACKGROUND: Cardiovascular (CV) clinical trials are instrumental in understanding treatment effects and offer insights into the natural progression of CV disease. Biomarkers are a critical component of patient selection, end point definition, and safety mo ...
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Journal ArticleAm Heart J · November 2011
OBJECTIVES: We sought to develop a long-term mortality risk prediction model and a simplified risk score for use in older patients with non-ST-segment elevation myocardial infarction (NSTEMI). BACKGROUND: Limited data are available regarding long-term mort ...
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Journal ArticleJAMA · September 28, 2011
CONTEXT: Intra-aortic balloon counterpulsation (IABC) is an adjunct to revascularization in patients with cardiogenic shock and reduces infarct size when placed prior to reperfusion in animal models. OBJECTIVE: To determine if routine IABC placement prior ...
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Journal ArticleCochrane Database Syst Rev · July 6, 2011
BACKGROUND: Intra-aortic balloon pump counterpulsation (IABP) is currently the most commonly used mechanical assist device for patients with cardiogenic shock due to acute myocardial infarction.Although there is only limited evidence by randomised controll ...
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Journal ArticleJACC Cardiovasc Interv · July 2011
OBJECTIVES: The objective of this study is to investigate the incidence and clinical implications of thrombus on baseline angiography among patients presenting with non-ST-segment elevation acute coronary syndromes (ACS) undergoing percutaneous coronary in ...
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Journal ArticleAm Heart J · July 2011
BACKGROUND: Despite advances in care processes to improve reperfusion in patients with acute myocardial infarction (AMI), the short-term and 1-year mortality remains high, in part, because of reperfusion injury, microvascular obstruction, and infarct expan ...
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Journal ArticleJACC Cardiovasc Interv · June 2011
OBJECTIVES: This study sought to develop a risk score predictive of bleeding in patients undergoing percutaneous coronary intervention (PCI) and to investigate the impact of bleeding on subsequent mortality. BACKGROUND: Bleeding complications after PCI hav ...
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Journal ArticleCatheter Cardiovasc Interv · April 1, 2011
Subclavian arteriovenous fistula (AVF) is a rare complication of implantable cardioverter-defibrillator (ICD) implantation. This report illustrates the case of a subclavian AVF after ICD implantation in a patient with nonischemic cardiomyopathy and the suc ...
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Journal ArticleEur J Cardiovasc Prev Rehabil · February 2011
AIMS: Presentation with an acute coronary syndrome (ACS) on chronic aspirin therapy is an independent predictor of adverse short-term outcomes. Whether this finding applies to chronic thienopyridine use, and with the contemporary invasive management of ACS ...
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Journal ArticleAm Heart J · February 2011
BACKGROUND: The aim of the study was to investigate the incidence and clinical consequences of acquired thrombocytopenia in patients with acute coronary syndromes (ACS) in the ACUITY trial. METHODS: We examined 10,836 patients with ACS randomized to receiv ...
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Journal ArticleJ Thromb Thrombolysis · February 2011
We sought to evaluate the association between C-reactive protein (CRP) sampled on admission and short- and long-term mortality in patients with acute coronary syndromes (ACS) undergoing early invasive treatment. Baseline levels of CRP were determined in 2, ...
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Journal ArticleAm Heart J · February 2011
BACKGROUND: Thrombocytopenia (TP) is a common abnormality in patients presenting with acute coronary syndrome. Whether baseline TP has any influence on the outcome of patients treated with primary angioplasty for acute myocardial infarction is unknown. MET ...
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Journal ArticleJ Am Coll Cardiol · January 11, 2011
OBJECTIVES: The purpose of this study was to examine the association between lower socioeconomic status (SES), as ascertained by years of education, and outcomes in patients with acute ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Previou ...
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Journal ArticleCritical care medicine · January 2011
ObjectiveFew data exist to guide antiarrhythmic drug therapy for sustained ventricular tachycardia/ventricular fibrillation after acute myocardial infarction. The objective of this analysis was to describe the survival of patients with sustained v ...
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Journal ArticleAm Heart J · December 2010
BACKGROUND: Glycoprotein (GP) IIb/IIIa inhibitors can improve outcomes in patients with non-ST-segment elevation acute coronary syndromes but raise the risk of bleeding, particularly if dosed in excess. The impact of GP IIb/IIIa dosing feedback on safety a ...
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Journal ArticleAm Heart J · December 2010
BACKGROUND: Current American College of Cardiology/American Heart Association guidelines recommend initiation or intensification of statin therapy to achieve low-density lipoprotein cholesterol (LDL-C) goals after an acute coronary syndrome (ACS), yet litt ...
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Journal ArticleExpert Rev Cardiovasc Ther · December 2010
Among the current agents in the class of direct thrombin inhibitors, bivalirudin (Angiomax(®), The Medicines Company, NJ, USA) has seen increased use in cardiovascular medicine over the past decade through its primary indication as an anticoagulant used du ...
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Journal ArticleAm Heart J · October 2010
BACKGROUND: The role of hormone replacement therapy (HRT) in the prevention of cardiovascular disease has been controversial. In large observational studies, HRT appears to lower cardiovascular disease risk. However, prospective randomized trials do not su ...
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Journal ArticleJAMA · September 22, 2010
CONTEXT: Clinicians and trialists have difficulty with identifying which patients are highest risk for cardiovascular events. Prior ischemic events, polyvascular disease, and diabetes mellitus have all been identified as predictors of ischemic events, but ...
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Journal ArticleCirculation · September 21, 2010
BACKGROUND: Studies report a protective effect of higher attained educational level (AEL) on cardiovascular outcomes. However, most of these studies have been conducted in high-income countries (HICs) and lack representation from low- and middle-income cou ...
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Journal ArticleAm Heart J · September 2010
BACKGROUND: Patients with non-ST-segment elevation myocardial infarction (NSTEMI) are frequently transferred to tertiary hospitals for angiography and/or revascularization from hospitals lacking such capabilities. Given that patients who undergo invasive c ...
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Journal ArticleCirc Cardiovasc Interv · August 2010
BACKGROUND: Contemporary adjunctive pharmacology and revascularization strategies have improved the prognosis of patients with acute coronary syndromes (ACSs). We sought to identify the clinical and angiographic predictors of cardiac ischemic events in pat ...
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Journal ArticleAm J Cardiol · July 15, 2010
Abciximab and eptifibatide have been shown to reduce ischemic complications compared with heparin alone in patients with acute coronary syndromes who undergo percutaneous coronary intervention. Whether 1 agent is safer and/or more effective has not been pr ...
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Journal ArticleAm Heart J · July 2010
Practice guidelines recommend dual antiplatelet therapy with aspirin and clopidogrel for patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) regardless of in-hospital management strategy. Prasugrel-a thienopyridine adenosine diphosph ...
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Journal ArticleJ Am Coll Cardiol · June 8, 2010
OBJECTIVES: The aim of this study was to develop a practical risk score to predict the risk and implications of major bleeding in acute coronary syndromes (ACS). BACKGROUND: Hemorrhagic complications have been strongly linked with subsequent mortality in p ...
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Journal ArticleJACC Cardiovasc Interv · June 2010
OBJECTIVES: The aim of this study was to examine the use of and outcomes associated with antithrombotic strategies in patients with non-ST-segment elevation myocardial infarction (NSTEMI) who undergo percutaneous coronary intervention (PCI). BACKGROUND: A ...
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Journal ArticleJ Med Syst · June 2010
Thrombocytopenia is associated with increased patient risk. However, the costs of this complication are not well defined. This study assessed the impact of thrombocytopenia on in-hospital costs using results from CATCH, an observational study that examined ...
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Journal ArticleJ Intern Med · June 2010
OBJECTIVES: Poor blood pressure (BP) control is common amongst patients with symptomatic atherothrombotic disease. It is unclear whether BP control and management differ across atherothrombotic disease subtypes. METHODS: We analysed the baseline data of 44 ...
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Journal ArticleAm Heart J · May 2010
BACKGROUND: Prompt reperfusion for patients with ST-segment elevation myocardial infarction (STEMI) is a class I guideline recommendation and has been shown to reduce mortality. However, many STEMI patients in contemporary practice still do not receive any ...
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Journal ArticleRev Esp Cardiol · May 2010
Refractory angina presents a major clinical challenge for everyday medical practice. Despite the widespread use of statins and improvements in revascularization techniques, a substantial proportion of patients with preserved left ventricular function and n ...
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Journal ArticleEur Heart J · May 2010
AIMS: To develop a risk score to quantify bleeding risk in outpatients with or at risk of atherothrombosis. METHODS AND RESULTS: We studied patients in the REACH Registry, a cohort of 68 236 patients with/at risk of atherothrombosis. The outcome of interes ...
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Journal ArticleJACC Cardiovasc Interv · April 2010
OBJECTIVES: The aim of this study was to examine timing of in-hospital coronary artery bypass graft surgery (CABG) for non-ST-segment elevation myocardial infarction (NSTEMI) patients. BACKGROUND: Although practice guidelines recommend delaying CABG for a ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · March 2010
BACKGROUND: Hospitals use patient satisfaction surveys to assess their quality of care. A key question is whether these data provide valid information about the medically related quality of hospital care. The objective of this study was to determine whethe ...
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Journal ArticleClin Cardiol · March 2010
BACKGROUND: Results from the Superior Yield of the New Strategy of Enoxaparin, Revascularization, and Glycoprotein IIb/IIIa Inhibitors (SYNERGY) trial showed that the low-molecular-weight heparin (LMWH) enoxaparin was non-inferior compared with unfractiona ...
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Journal ArticleJACC Cardiovasc Interv · March 2010
OBJECTIVES: We investigated whether transcutaneous ultrasound (TUS) augments coronary thrombolysis and achieves higher rates of Thrombolysis In Myocardial Infarction (TIMI) flow grade 3 and ST-segment resolution in patients with ST-segment elevation myocar ...
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Journal ArticleAm J Cardiol · March 1, 2010
The objective of this study was to determine cardiovascular event rates in diabetic patients and nondiabetic subjects from the REACH Registry with established coronary artery disease, cerebrovascular disease, peripheral arterial disease, or multiple risk f ...
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Journal ArticleCirculation · February 23, 2010
BACKGROUND: Outcomes of patients presenting with acute coronary syndromes are improved with an early invasive approach; however, approximately one third of these patients are treated medically after angiographic screening. We sought to assess the predictor ...
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Journal ArticleAm J Cardiol · February 15, 2010
Despite its proven efficacy, low cost, and wide availability, aspirin remains underused. We examined current aspirin use and determined factors that influence its use among outpatients in the United States (US). The REduction of Atherothrombosis for Contin ...
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Journal ArticleCirculation · January 5, 2010
BACKGROUND: Both ischemic and hemorrhagic complications increase mortality rate in acute coronary syndromes. Their frequency and relative importance vary according to individual patient risk profiles. We sought to develop prognostic models for the risk of ...
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Journal ArticleAm Heart J · December 2009
BACKGROUND: There are little data regarding outcomes in patients with angina and severe coronary artery disease (CAD) treated with medical management. Using the Duke Databank of Cardiovascular Disease, we describe the prevalence and long-term outcomes of p ...
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Journal ArticleAm Heart J · December 2009
BACKGROUND: Prior investigations to define ethnic-related differences in the risks, medical treatment, and outcomes of patients with peripheral arterial disease (PAD) have been limited. METHODS: The impact of ethnicity on the risk factor profiles, use of e ...
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Journal ArticleAm J Cardiol · November 15, 2009
We evaluated the reported contraindications to early beta-blocker use and associated mortality within and across patient age groups. Contraindications to early beta-blocker use were evaluated in patients with non-ST-elevation acute coronary syndrome in the ...
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Journal ArticleAm Heart J · November 2009
BACKGROUND: Prior studies have demonstrated differences in adherence to non-ST-segment elevation acute coronary syndromes (NSTE ACS) guidelines-recommended therapies among patients managed conservatively without cardiac catheterization compared with those ...
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Journal ArticleJ Am Geriatr Soc · November 2009
OBJECTIVES: To describe the persistent use of evidence-based cardiovascular medications (EBCMs) 3 months after discharge from an acute coronary syndrome (ACS) event and patient-reported reasons for nonpersistence across age groups. DESIGN: Medication Appli ...
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Journal ArticleAm J Cardiol · November 1, 2009
Thrombocytopenia is a predictor of adverse outcomes in patients with acute coronary syndromes and in critically ill patients. The Complications After Thrombocytopenia Caused by Heparin (CATCH) registry was designed to explore the incidence, management, and ...
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Journal ArticleAm Heart J · October 2009
BACKGROUND: Women with non-ST-segment elevation myocardial infarction (NSTEMI) who undergo coronary angiography have no obstructive coronary lesions more often than men. Sex-specific characteristics and outcomes of patients without obstructive coronary art ...
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Journal ArticleEur Heart J · October 2009
AIMS: To determine 3-year event rates in outpatients with vascular disease enrolled in the REduction of Atherothrombosis for Continued Health (REACH) Registry. METHODS AND RESULTS: REACH enrolled 67 888 outpatients with atherothrombosis [established corona ...
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Journal ArticleJ Am Coll Cardiol · September 29, 2009
OBJECTIVES: We assessed the incidence, predictors, and outcomes of gastrointestinal bleeding (GIB) in patients with acute coronary syndromes (ACS). BACKGROUND: GIB is a potential hemorrhagic complication in patients with ACS treated with antithrombotic and ...
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Journal ArticleClin Cardiol · September 2009
BACKGROUND: Hypercholesterolemia is a risk factor for coronary artery disease, yet is associated with lower risk of adverse outcomes in patients with acute coronary syndromes (ACS). HYPOTHESIS: We explored this paradox in 84,429 patients with non-ST-segmen ...
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Journal ArticleClin Cardiol · September 2009
BACKGROUND: Point-of-care (POC) testing may expedite the care of emergency department (ED) patients suspected of having acute coronary syndromes (ACS). We evaluated the use patterns of cardiac bedside markers or POC testing for troponin in patients with no ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · September 2009
BACKGROUND: The risks of late stent thrombosis with drug-eluting stents (DES) were intensely debated after the presentation of a number of studies highlighting this issue in September 2006. We evaluated trends in the use of DES for patients with non-ST-ele ...
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Journal ArticleClin Cardiol · September 2009
BACKGROUND: Acute treatment is associated with improved in-hospital outcomes for patients with non-ST-segment elevation acute coronary syndrome (NSTE ACS). HYPOTHESIS: Patients who receive appropriate acute treatment are more likely to receive guideline-re ...
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Journal ArticleAm Heart J · August 2009
BACKGROUND: The long-term benefits of coronary revascularization are proportional to the severity of underlying coronary artery disease (CAD). We sought to identify patients with a greater probability of severe CAD to target those who could receive the gre ...
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Journal ArticleJACC Cardiovasc Interv · August 2009
OBJECTIVES: In this substudy of the ACUITY (Acute Catheterization and Urgent Intervention Triage strategY) trial, we investigated the relationship between chronic kidney disease (CKD) and clinical outcomes, and compared the safety and efficacy of bivalirud ...
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Journal ArticleJ Am Coll Cardiol · July 28, 2009
OBJECTIVES: The aim of this study was to evaluate the relative impact of spontaneously occurring and periprocedural myocardial infarction (MI) on survival after percutaneous coronary intervention (PCI). BACKGROUND: The clinical significance of periprocedur ...
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Journal ArticleAm J Cardiol · July 15, 2009
In a population of patients experiencing thrombocytopenia while treated with heparin, bleeding and thromboses are well-appreciated complications, but their relative contributions to mortality have been less well described. In this population, the aims of t ...
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Journal ArticleAnn Emerg Med · July 2009
STUDY OBJECTIVE: Since 2003, the Society of Chest Pain Centers (SCPC) has provided hospital accreditation for acute coronary syndrome care processes. Our objective is to evaluate the association between SCPC accreditation and adherence to the American Coll ...
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Journal ArticleAm Heart J · July 2009
BACKGROUND: Although prior data showed an association between chronic kidney disease (CKD) and atherothrombotic events, little is known about the risk profile and specific outcomes of atherothrombotic outpatients with CKD. METHODS: More than 69,000 outpati ...
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Journal ArticlePharmacotherapy · June 2009
STUDY OBJECTIVE: To evaluate how enoxaparin is dosed in contemporary clinical practice as a function of patients' total body weight (TBW) and body mass index (BMI), and to determine any association between dose and major bleeding. DESIGN: Retrospective coh ...
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Journal ArticleEur Heart J · June 2009
AIMS: To evaluate the associations of myocardial infarction (MI) and major bleeding with 1-year mortality. Both MI and major bleeding predict 1-year mortality in patients presenting with acute coronary syndrome (ACS). However, the risk of each of these eve ...
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Journal ArticleJ Am Coll Cardiol · May 26, 2009
OBJECTIVES: This study sought to evaluate the impact of upstream clopidogrel in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) requiring coronary artery bypass grafting (CABG) from the ACUITY (Acute Catheterization and Urgent In ...
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Journal ArticleCirculation · May 12, 2009
BACKGROUND: Prior studies examining thrombocytopenia among patients with acute coronary syndromes (ACS) evaluated highly selected patients in a clinical trial setting using varying definitions of thrombocytopenia. The incidence, severity, and prognostic si ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · May 2009
BACKGROUND: Troponin elevation above the upper limit of normal (ULN) is diagnostic of myocardial infarction, but interpretation of "gray-zone" troponin elevations (1 to 1.5x ULN) remains uncertain. Using the CRUSADE database, we explored relationships betw ...
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Journal ArticleEur Heart J · May 2009
AIMS: The presence of peripheral arterial disease (PAD) or cerebrovascular disease (CVD) is associated with higher likelihood of significant coronary artery disease (CAD). We sought to assess the prevalence of PAD, CVD, prior CAD, or pre-existent disease i ...
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Journal ArticleAm J Cardiol · May 1, 2009
Women with non-ST-elevation acute coronary syndrome are at increased risk for ischemic and bleeding complications compared with men. We examined the impact of gender and antithrombotic therapy for non-ST-elevation acute coronary syndrome on outcomes in pat ...
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Journal ArticleCirculation · April 14, 2009
BACKGROUND: Treatments for non-ST-segment-elevation myocardial infarction (NSTEMI) reduce ischemic events but increase bleeding. Baseline prediction of bleeding risk can complement ischemic risk prediction for optimization of NSTEMI care; however, existing ...
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Journal ArticleAm Heart J · April 2009
BACKGROUND: Thrombocytopenia and heparin-induced thrombocytopenia (HIT) are potentially devastating paradoxical side effects of heparin therapy. We explored the evaluation, management, and clinical consequences of thrombocytopenia occurring during heparin ...
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Journal ArticleJ Am Coll Cardiol · March 24, 2009
OBJECTIVES: This study sought to evaluate the impact of age on outcomes in patients with moderate- and high-risk non-ST-segment elevation acute coronary syndrome (NSTE-ACS) enrolled in the ACUITY (Acute Catheterization and Urgent Intervention Triage Strate ...
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Journal ArticleCrit Pathw Cardiol · March 2009
Evidence-based guidelines call for advanced and definitive therapy for patients with non-ST-elevation myocardial infarction (NSTEMI). It is not known whether these guidelines are follow more diligently when patients arrive in the ED during regular hours, d ...
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Journal ArticleAm J Kidney Dis · March 2009
BACKGROUND: Chronic kidney disease (CKD) is associated with an increased risk of cardiac events and death; however, underuse of guideline-recommended therapies is widespread. The extent to which hospital performance affects the care of patients with CKD an ...
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Journal ArticleJ Cardiovasc Pharmacol Ther · March 2009
Cardiovascular disease is the leading cause of death in men and women older than 65 years; therefore, its prevention is an important public health priority. Although cardiovascular risk is multifactorial, elevated low-density lipoprotein cholesterol levels ...
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Journal ArticleCirculation · February 10, 2009
BACKGROUND: The clinical and angiographic predictors of early (<30 days) stent thrombosis (ST) have not been reported in high-risk patients with acute coronary syndromes. METHODS AND RESULTS: Qualitative and quantitative coronary angiographic analyses were ...
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Journal ArticleEur Heart J · December 2008
AIMS: To evaluate the influence of achieving secondary prevention target treatment goals for cardiovascular (CV) risk factors on clinical outcomes in patients with prior coronary artery bypass surgery (CABG). METHODS AND RESULTS: Accordingly, we analysed t ...
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Journal ArticleJACC Cardiovasc Interv · December 2008
OBJECTIVES: This study sought to determine if the efficacy of bivalirudin alone versus heparin plus a glycoprotein (GP) IIb/IIIa inhibitor is dependent upon the duration of clopidogrel pre-treatment in patients undergoing percutaneous coronary intervention ...
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Journal ArticleJ Am Coll Cardiol · November 25, 2008
OBJECTIVES: The aim of this study was to determine the economic impact of several anticoagulation strategies for moderate- and high-risk non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients managed invasively. BACKGROUND: The ACUITY (Acute ...
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Journal ArticleAm J Cardiol · November 15, 2008
We sought to determine the usage patterns and impact of upstream glycoprotein IIb/IIIa inhibitor and clopidogrel in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). We studied tre ...
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Journal ArticleAm Heart J · November 2008
BACKGROUND: Atrial fibrillation (AF) is a major risk factor (RF) for ischemic stroke. Its prevalence and prognostic impact in patients with atherothrombosis are unclear. METHODS: Risk factors, drug usage, and 1-year cardiovascular (CV) outcomes (CV death, ...
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Journal ArticleEur Heart J · October 2008
AIMS: The patterns and prognostic significance of low high-density lipoprotein (HDL) cholesterol levels have not been well characterized. We sought to determine the prevalence and prognostic significance of low HDL cholesterol levels in patients with non-S ...
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Journal ArticleJ Am Coll Cardiol · September 16, 2008
OBJECTIVES: Because excess adiposity is one of the most important determinants of adipokines and inflammatory factors associated with coronary plaque rupture, we hypothesized that obesity was associated with myocardial infarction at earlier ages. BACKGROUN ...
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Journal ArticleJ Am Coll Cardiol · September 2, 2008
OBJECTIVES: This study was designed to determine the impact of bivalirudin on 1-year outcomes in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). BACKGROUND: The ACUITY (Acute Catheterization and Urgent Interventi ...
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Journal ArticleAm J Med · September 2008
BACKGROUND: Although the use of heparin with fibrinolytics is associated with more rapid ST-segment resolution and increased infarct-related artery patency among patients with ST-segment elevation myocardial infarction (STEMI), its associated increase in b ...
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Journal ArticleAm Heart J · September 2008
BACKGROUND: Although current guidelines recommend early initiation of clopidogrel in patients with non-ST-segment elevation myocardial infarction (NSTEMI), the degree to which it has been adopted in clinical practice remains unclear. We sought to determine ...
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Journal ArticleArch Intern Med · August 11, 2008
BACKGROUND: Patient medical records are important means of communication among health care providers. Limited evaluation has been performed of the quality of the medical records or its association with health care processes or outcomes. METHODS: We perform ...
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Journal ArticleAm Heart J · August 2008
BACKGROUND: Unfractionated heparin (UFH) is a mainstay of treatment for patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS), but the practice of weight-adjusted bolus and infusion dosing has not been carefully evaluated. METHODS: Usi ...
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Journal ArticleExpert Opin Pharmacother · August 2008
BACKGROUND: Guidelines for the management of high-risk non ST-segment elevation acute coronary syndrome (NSTE ACS) recommend antithrombotic and antiplatelet therapy combined with an early invasive strategy. While this strategy reduces ischemic complication ...
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Journal ArticleAm Heart J · July 2008
BACKGROUND: Practice guidelines for non-ST-segment elevation acute coronary syndromes (NSTE ACS) recommend early invasive management (cardiac catheterization and revascularization within 48 hours of hospital presentation) for high-risk patients, but interh ...
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Journal ArticleHeart · July 2008
OBJECTIVE: To assess variables associated with the occurrence of atrial fibrillation (AF) and the relation of AF with short- and long-term outcomes and with other in-hospital complications in patients with acute coronary syndromes (ACS) with and without ST ...
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Journal ArticleAm Heart J · July 2008
BACKGROUND: Advances in coronary angioplasty and adjunct pharmacology have improved patient outcomes after primary percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI). However, several areas for improvement remain. Hemorrhagic com ...
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Journal ArticleAm Heart J · June 2008
OBJECTIVES: To describe the association between transfusion and outcomes as a function of nadir hematocrit (HCT) in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS). BACKGROUND: The adverse outcomes associated with transfusion in ...
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Journal ArticleChest · June 2008
This chapter about fibrinolytic, antiplatelet, and antithrombin treatment for acute ST-segment elevation (STE) myocardial infarction (MI) is part of the American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Grade 1 ...
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Journal ArticleJ Am Coll Cardiol · May 6, 2008
OBJECTIVES: The aim of this study was to compare outcomes in patients receiving consistent unfractionated heparin (UFH)/enoxaparin (ENOX) therapy and in those switched at randomization to bivalirudin monotherapy. BACKGROUND: Crossover between UFH and ENOX ...
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Journal ArticleEur Heart J · May 2008
AIMS: To examine treatment patterns and outcomes of patients with non-ST-segment elevation acute coronary syndrome (NSTE ACS) receiving long-term warfarin anticoagulation. METHODS AND RESULTS: We examined acute medication and invasive cardiac procedure use ...
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Journal ArticleJ Am Coll Cardiol · April 29, 2008
OBJECTIVES: We sought to evaluate clinical outcomes of patients with diabetes mellitus in the ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) trial, overall and by treatment arm. BACKGROUND: In the ACUITY trial, 13,819 patients with ...
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Journal ArticleEur Heart J · April 2008
AIMS: Non-invasive risk stratification of low- and intermediate-risk non-ST-elevation acute coronary syndromes (NSTE ACS) patients has been recommended, but limited data exist about the variation in clinical practice of stress testing in these patients and ...
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Journal ArticleJ Am Coll Cardiol · March 11, 2008
OBJECTIVES: Our purpose was to compare formulae for estimating glomerular filtration rate (GFR) in non-ST-segment elevation acute coronary syndromes (NSTE ACS) patients. BACKGROUND: Assessment of GFR is important for antithrombotic dose adjustment in NSTE ...
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Journal ArticleAm Heart J · March 2008
Despite emphasis on the use of invasive management strategies for patients with non-ST-elevation acute coronary syndromes (NSTE ACS) in recent practice guidelines, 27% to 56% of NSTE ACS patients do not undergo diagnostic angiography, and a further 45% to ...
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Journal ArticleClin Cardiol · March 2008
BACKGROUND: The prognostic value of cardiac troponins (cTn) in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) and chronic kidney disease (CKD) is debated. HYPOTHESIS: We tested the performance of cTnI and cTnT for risk stratific ...
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Journal ArticleAm Heart J · March 2008
The population of patients with advanced coronary artery disease (CAD) is growing as a result of the aging of the general population, the extensive use of revascularization, and the efficacy of therapies that have prolonged the survival of patients with se ...
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Journal ArticleAm Heart J · March 2008
The following report is based on a working group meeting about advanced coronary artery disease for patients with refractory ischemia who cannot receive revascularization. The aims were to review currently available treatment strategies, define unmet clini ...
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Journal ArticleAm Heart J · February 2008
BACKGROUND: Patients experiencing acute coronary syndromes (ACS) with high-risk features frequently undergo percutaneous coronary intervention (PCI) with stent placement, prompting the requisite administration of aspirin and clopidogrel. The current manage ...
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Journal ArticleAm Heart J · February 2008
BACKGROUND: Bleeding and blood transfusion are associated with increased morbidity and mortality among patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS); however, the economic consequences of these complications are not well define ...
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Journal ArticleCirculation · January 15, 2008
BACKGROUND: Although treatment with immediate aspirin reduces morbidity and mortality in ST-elevation myocardial infarction, the optimal dose is unclear. We therefore compared the acute mortality and bleeding risks associated with the initial use of 162 ve ...
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Journal ArticleArch Intern Med · January 14, 2008
BACKGROUND: Despite widespread heparin use in clinical practice, the associated development of thrombocytopenia is an underrecognized and undertreated complication. METHODS: We analyzed data from consecutive hospitalized patients treated with heparin (unfr ...
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Journal ArticleAngiology · 2008
The effect of the contrast agent iohexol on reference vessel size in patients with proximal left anterior descending disease is unknown. Quantitative coronary angiography and intravascular ultrasound were performed in 15 patients with atherosclerotic disea ...
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Journal ArticleProg Cardiovasc Dis · 2008
The management of patients with acute coronary syndromes (ACS) has evolved dramatically over the past decade and, in many respects, represents a rapidly moving target for the cardiologist and internist who seek to integrate these recent advances into conte ...
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Journal ArticleTex Heart Inst J · 2008
We sought to determine U.S. physicians' knowledge and perspectives regarding the 2004 American College of Cardiology/American Heart Association guidelines for management of patients who have ST-segment-elevation myocardial infarction (STEMI). We invited 45 ...
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Journal ArticleCerebrovasc Dis · 2008
BACKGROUND: Cerebrovascular disease (CVD) is a global public health problem. CVD patients are at high risk of recurrent stroke and other atherothrombotic events. Prevalence of risk factors, comorbidities, utilization of secondary prevention therapies and a ...
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Journal ArticleAm J Cardiol · December 15, 2007
Elevated B-type natriuretic peptide (BNP) levels are associated with increased risk for mortality in patients with non-ST-segment-elevation (NSTE) acute coronary syndromes (ACS). However, the optimal use of BNP measurement for the risk stratification of th ...
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Journal ArticleJAMA · December 5, 2007
CONTEXT: At 30-day follow-up, patients with moderate- and high-risk acute coronary syndromes (ACS) undergoing early invasive treatment in the ACUITY trial with bivalirudin monotherapy vs heparin plus glycoprotein (GP) IIb/IIIa inhibitors had noninferior ra ...
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Journal ArticleAm Heart J · December 2007
BACKGROUND: Hospitals are under increasing pressure to improve their quality of care. However, a key question remains: how can hospitals best design and implement successful quality improvement (QI) programs? Hospitals currently employ a variety of QI init ...
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Journal ArticleCan J Cardiol · November 2007
BACKGROUND: Practice guidelines support an early invasive strategy in patients with non-ST segment elevation acute coronary syndromes, particularly in those at higher risk. OBJECTIVES: To compare North American rates of invasive cardiac procedure use strat ...
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Journal ArticleAnn Emerg Med · November 2007
STUDY OBJECTIVE: We evaluate the association of emergency department (ED) length of stay with use of guideline-recommended therapies for acute treatments and clinical outcomes. Prolonged ED stays often reflect ED crowding or limited hospital capacity. We h ...
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Journal ArticleAcad Emerg Med · November 2007
Translating research results into routine clinical practice remains difficult. Guidelines, such as the 2002 American College of Cardiology/American Heart Association Guidelines for the Management of Patients with Unstable Angina and non-ST-segment elevatio ...
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Journal ArticleAm J Cardiol · November 1, 2007
Rapid-assay biomarkers may predict outcomes in patients with decompensated heart failure (HF). This study assessed whether rapid-assay B-type natriuretic peptide (BNP) and troponin I predicts length of stay and mortality and correlates with pulmonary arter ...
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Journal ArticleJ Am Coll Cardiol · October 9, 2007
OBJECTIVES: We sought to determine whether for-profit status influenced hospitals' care or outcomes among non-ST-segment elevation myocardial infarction (NSTEMI) patients. BACKGROUND: While for-profit hospitals potentially have financial incentives to sele ...
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Journal ArticleAm Heart J · October 2007
BACKGROUND: Fibrinolytic therapy for acute myocardial infarction (AMI) results in normal flow in only about half of patients. Adjunctive treatment with potent antiplatelet and antithrombin agents increases arterial patency but is associated with excessive ...
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Journal ArticleCirculation · September 4, 2007
BACKGROUND: Since the broad dissemination of practice guidelines, the association of specialty care with the treatment of patients with acute coronary syndromes has not been studied. METHODS AND RESULTS: We evaluated 55 994 patients with non-ST-segment ele ...
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Journal ArticleCurr Cardiol Rep · September 2007
Accomplishing a successful percutaneous coronary intervention in a patient with a suspected or diagnosed heparin-induced thrombocytopenia (HIT) requires the selection of an appropriate alternative anticoagulant and a thorough assessment of bleeding and thr ...
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Journal ArticleCirculation · August 21, 2007
BACKGROUND: It is not known whether progression of aortic arch (AA) atheroma is associated with vascular events in patients with stroke or transient ischemic attack (TIA). METHODS AND RESULTS: AA atheroma was detected on baseline transesophageal echocardio ...
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Journal ArticleAm J Cardiol · August 1, 2007
It has been suggested that Asians may respond differently to antithrombotic therapy, but contemporary management and outcomes of non-ST-segment elevation (NSTE) acute coronary syndromes (ACSs) in Asian patients have not been well characterized. Using data ...
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Journal ArticleAm J Med · August 2007
PURPOSE: Early use of beta-blockers is a quality indicator for the treatment of patients with non-ST-segment elevation myocardial infarction (NSTEMI), despite limited data from randomized clinical trials in this population. We sought to determine the impac ...
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Journal ArticleArterioscler Thromb Vasc Biol · August 2007
UNLABELLED: OBJECTIVES The objective of this study was to determine whether adjunctive therapy during percutaneous coronary intervention (PCI) affects markers of systemic inflammation or platelet activation. Despite different mechanisms of action, direct-t ...
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Journal ArticleArch Intern Med · July 23, 2007
BACKGROUND: The efficacy of enoxaparin sodium in non-ST-segment elevation acute coronary syndromes is well established; however, concerns remain regarding bleeding risk. The extent to which bleeding risk is attributable to excess dosing of enoxaparin is un ...
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Journal ArticleJAMA · June 6, 2007
CONTEXT: Pay for performance has been promoted as a tool for improving quality of care. In 2003, the Centers for Medicare & Medicaid Services (CMS) launched the largest pay-for-performance pilot project to date in the United States, including indicators fo ...
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Journal ArticleAm J Cardiol · June 1, 2007
Recent studies have suggested that low-dose aspirin has preserved benefit with less bleeding compared with standard-dose aspirin when given with or without clopidogrel in patients with high-risk non-ST-segment elevation acute coronary syndromes (NSTE ACSs) ...
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Journal ArticleACC Cardiosource Review Journal · June 1, 2007
More than 1 trillion units of heparin are used annually in the United States, sometimes leading to heparin-induced thrombocytopenia (HIT), which is an immune-mediated response to the anticoagulant. This serious but treatable prothrombotic disease can prese ...
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Journal ArticleAm J Cardiol · May 15, 2007
Although glycoprotein (GP) IIb/IIIa inhibitors are recommended for patients with unstable angina and non-ST-segment elevation myocardial infarction who undergo percutaneous coronary intervention (PCI), the American College of Cardiology/American Heart Asso ...
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Journal ArticleAm J Cardiol · May 15, 2007
Previous studies of non-ST-segment elevation acute coronary syndromes (NSTE ACSs) complicated by heart failure (HF) have focused primarily on patients with left ventricular systolic dysfunction defined by an ejection fraction (EF) <40%. Little is known abo ...
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Journal ArticleCirculation · May 15, 2007
BACKGROUND: Age is an important determinant of outcomes for patients with acute coronary syndromes. However, community practice reveals a disproportionately lower use of cardiovascular medications and invasive treatment even among elderly patients who woul ...
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Journal ArticleEuropean heart journal · May 2007
AimsPrevious studies suggested haemodynamic benefits and, possibly, mortality reduction with the use of nitric oxide synthase (NOS) inhibition in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS). We assessed pr ...
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Journal ArticleJ Am Coll Cardiol · May 1, 2007
OBJECTIVES: The goal of this work was to explore the treatment and outcomes of patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) age > or =90 years. BACKGROUND: The elderly are often excluded from clinical trials of NSTE-ACS and ar ...
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Journal ArticleAm J Cardiol · May 1, 2007
Since the introduction of drug-eluting stents (DESs), patterns of revascularization strategies for patients with non-ST-segment elevation acute coronary syndromes have not been assessed. We studied 82,924 patients from the CRUSADE Initiative who presented ...
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Journal ArticleCirculation · May 2007
BackgroundAge is an important determinant of outcomes for patients with acute coronary syndromes (ACS); however, community practice reveals a disproportionately lower use of cardiovascular medications and invasive treatment even among elderly pati ...
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Journal ArticleAm Heart J · April 2007
BACKGROUND: Although documented traditional cardiovascular risk factors (hypertension, diabetes, smoking, and dyslipidemia) increase the risk of developing coronary artery disease, their influence on the treatments and outcomes of patients with non-ST-segm ...
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Journal ArticleJ Am Coll Cardiol · March 27, 2007
OBJECTIVES: The purpose of this study was to determine the predictors of major bleeding and the impact of major bleeding on outcomes, including mortality, in acute coronary syndromes (ACS). BACKGROUND: Whether major bleeding independently predicts mortalit ...
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Journal ArticleJAMA · March 21, 2007
CONTEXT: Few data document current cardiovascular (CV) event rates in stable patients with atherothrombosis in a community setting. Differential event rates for patients with documented coronary artery disease (CAD), cerebrovascular disease (CVD), or perip ...
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Journal ArticleLancet · March 17, 2007
BACKGROUND: The aim of this study was to assess anticoagulation with the direct thrombin inhibitor bivalirudin during percutaneous coronary intervention in individuals with moderate and high-risk acute coronary syndromes. METHODS: 13,819 individuals in the ...
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Journal ArticleAm J Cardiol · March 15, 2007
Older age is associated with worse outcomes in patients with cardiogenic shock complicating ST-elevation myocardial infarction (STEMI). However, significant heterogeneity exists in different age groups with respect to outcomes. Identification of factors th ...
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Journal ArticleJAMA · February 14, 2007
CONTEXT: In patients with moderate- and high-risk acute coronary syndromes (ACS) who undergo an early, invasive treatment strategy, current guidelines recommend administration of platelet glycoprotein IIb/IIIa (Gp IIb/IIIa) inhibitors, either upstream to a ...
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Journal ArticleAm J Med · January 2007
PURPOSE: Although adherence to guidelines recommendations is assumed to be more difficult for nonacademic community hospitals, patterns of adherence have not been evaluated by hospital type. We sought to identify hospital characteristics associated with hi ...
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Journal ArticleStroke · December 2006
BACKGROUND AND PURPOSE: Whether a history of carotid endarterectomy influences patient compliance with medical treatments and physician attitude toward treatments after ischemic stroke or transient ischemic attack (TIA) is not well known. METHODS: We studi ...
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Journal ArticleN Engl J Med · November 23, 2006
BACKGROUND: Current guidelines for patients with moderate- or high-risk acute coronary syndromes recommend an early invasive approach with concomitant antithrombotic therapy, including aspirin, clopidogrel, unfractionated or low-molecular-weight heparin, a ...
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Journal ArticleAnn Intern Med · November 21, 2006
BACKGROUND: The impact of insurance coverage on the care of patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) is unclear. OBJECTIVE: To compare NSTE ACS care patterns by insurance type. DESIGN: Comparison of Medicaid patients young ...
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Journal ArticleAm J Cardiol · November 1, 2006
We evaluated temporal trends in the use of early (<48 hours) catheterization in patients with non-ST-segment elevation acute coronary syndromes with respect to baseline risk features since publication of the American College of Cardiology/American Heart As ...
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Journal ArticleArch Intern Med · October 9, 2006
BACKGROUND: The extent to which national health quality improvement initiatives have altered reported treatment gaps among patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) is unknown. We sought to determine recent trends in adhere ...
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Journal ArticleAm Heart J · October 2006
BACKGROUND: We sought to assess the influence of emergency department (ED) structure and care processes on adherence to practice guidelines for the treatment of patients with non-ST-segment elevation acute coronary syndromes. METHODS: We surveyed emergency ...
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Journal ArticleAm Heart J · October 2006
BACKGROUND: Unlike ST-segment elevation myocardial infarction, the degree of stenosis and physiology of ischemia varies in patients with non-ST-segment elevation myocardial infarction (NSTEMI). The prevalence, predictors, and outcomes of patients with NSTE ...
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Journal ArticleCirculation · September 26, 2006
BACKGROUND: Glycoprotein (GP) IIb/IIIa inhibitors are beneficial in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS); their safe use in women, however, remains a concern. The contribution of dosing to the observed sex-related diff ...
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Journal ArticleAm J Cardiol · September 1, 2006
In the case of non-ST-segment elevation acute coronary syndromes (NSTE-ACSs), the acute use of certain antiplatelet agents is complicated by concerns about perioperative bleeding risks in patients requiring coronary artery bypass grafting (CABG) during the ...
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Journal ArticleJ Am Coll Cardiol · July 18, 2006
OBJECTIVES: We sought to characterize patterns of clopidogrel use before coronary artery bypass grafting (CABG) and examine the drug's impact on risks for postoperative transfusions among patients with non-ST-segment elevation acute coronary syndromes (NST ...
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Journal ArticleAm J Med · July 2006
PURPOSE: An analysis of reginal variation across the United States in the treatment and outcomes of patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) has not been previously performed. SUBJECTS AND METHODS: We assessed contemporary ...
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Journal ArticleAm Heart J · July 2006
BACKGROUND: Data regarding the management of non-ST-segment elevation acute coronary syndromes (NSTE ACS) in Hispanic patients, the largest and fastest-growing minority in the United States, are scarce. METHODS: We sought to describe the clinical character ...
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Journal ArticleAm Heart J · July 2006
BACKGROUND: Although obesity is a known risk factor for coronary artery disease, its impact on the presentation, treatment, and outcome of patients with acute coronary syndromes (ACS) has not been well studied. METHODS: Using data from the CRUSADE Initiati ...
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Journal ArticleAm J Cardiol · June 15, 2006
The presence of congestive heart failure (CHF) has been associated with treatment disparities and worse outcomes in patients with ST-segment elevation myocardial infarction, but the incidence and effect of CHF in patients with non-ST-segment elevation acut ...
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Journal ArticleJ Thromb Thrombolysis · June 2006
BACKGROUND: Both heparin and glycoprotein (GP) IIb/IIIa inhibitor therapy and early invasive management strategies are recommended by the American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for the treatment of patients with no ...
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Journal ArticleAm Heart J · June 2006
BACKGROUND: Practice guidelines for patients with non-ST-segment elevation (NSTE) acute coronary syndromes (ACS) recommend targeting evidence-based therapies for the highest-risk patients. We characterized guideline adherence for NSTE ACS by risk status. M ...
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Journal ArticleEur Heart J · May 2006
AIMS: To examine the relationship between revascularization within 7 days and 1-year mortality among ST-elevation myocardial infarction patients enrolled in GUSTO-V trial (n=13 451). To examine the relative contribution of system and patient level factors ...
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Journal ArticleJAMA · April 26, 2006
CONTEXT: Selected care processes are increasingly being used to measure hospital quality; however, data regarding the association between hospital process performance and outcomes are limited. OBJECTIVES: To evaluate contemporary care practices consistent ...
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Journal ArticleArch Intern Med · April 10, 2006
BACKGROUND: Clopidogrel added to aspirin improved outcomes after hospitalization in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) in the Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) trial, regardless of in- ...
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Journal ArticleJ Am Coll Cardiol · April 4, 2006
Despite substantial progress in the diagnosis and treatment of acute ST-segment elevation myocardial infarction (STEMI), implementation of this knowledge into routine clinical practice has been variable. It has become increasing clear that primary percutan ...
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Journal ArticleClin Chem · April 2006
BACKGROUND: There has been considerable debate regarding the impact of assay imprecision on the performance of cardiac biomarkers for diagnosis of acute coronary syndromes (ACS) and risk stratification for future adverse cardiac events. METHODS: Using exis ...
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Journal ArticleAm Heart J · April 2006
BACKGROUND: The risk of atherothrombosis is a large health care burden worldwide. With its global prevalence, there is a need to understand all the associated risk factors, both old and new, and their interdependencies in the development of this complex di ...
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Journal ArticleAm J Med · March 2006
PURPOSE: Chronic kidney disease has been linked to high mortality rates in patients with ST-segment elevation myocardial infarction but has not been well described for patients with non-ST-segment elevation acute coronary syndromes. We examined the treatme ...
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Journal ArticleAm J Cardiol · February 15, 2006
We sought to determine the frequency of electrocardiographic (ECG) acquisition within 10 minutes of hospital arrival, factors associated with delayed ECG acquisition, and any relation among delayed ECG acquisition, treatment patterns, and clinical outcomes ...
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Journal ArticleAm Heart J · February 2006
BACKGROUND: Troponin testing is useful for evaluating patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS); however, a significant percentage of patients are troponin negative at presentation and develop late rise of the marker. METHO ...
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Journal ArticleJ Am Coll Cardiol · January 17, 2006
OBJECTIVES: We sought to evaluate the association between discordant cardiac marker results and in-hospital mortality and treatment patterns in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS). BACKGROUND: Creatine kinase-MB (CK-M ...
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Journal ArticleJAMA · January 11, 2006
CONTEXT: Atherothrombosis is the leading cause of cardiovascular morbidity and mortality around the globe. To date, no single international database has characterized the atherosclerosis risk factor profile or treatment intensity of individuals with athero ...
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Journal ArticleAmerican heart journal · January 2006
BackgroundThe degree to which elevated creatine kinase (CK)-MB in the presence of normal CK is predictive of outcome is not well understood despite having been studied for decades. This analysis examined whether normal CK with elevated CK-MB in pa ...
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Journal ArticleAm J Med · January 2006
PURPOSE: Less is known about the differences in clinical and angiographic features and the outcomes of African Americans with ST-elevation myocardial infarction compared with whites with ST-elevation myocardial infarction. Accordingly, the current study ex ...
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Journal ArticleDiabetes Care · January 2006
OBJECTIVE: The objective of this study was to characterize treatment patterns among patients with diabetes presenting with non-ST-segment elevation (NSTE) acute coronary syndromes (ACSs). RESEARCH DESIGN AND METHODS: We compared adherence to treatment reco ...
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Journal ArticleCatheter Cardiovasc Interv · January 2006
In the ever evolving field of cardiovascular medicine and coronary intervention, the intra-aortic balloon pump (IABP) is a mature technology, which still plays an important role. The balloon pump invasively supports patient hemodynamics by augmenting diast ...
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Journal ArticleJAMA · December 28, 2005
CONTEXT: Effective medical care assumes delivery of evidence-based medicines to appropriate patients with doses comparable to those studied. OBJECTIVE: To investigate dosing of unfractionated heparin (UFH), low-molecular-weight heparin (LMWH), and glycopro ...
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Journal ArticleCirculation · November 15, 2005
BACKGROUND: Recent studies indicate that a routine invasive approach for patients with unstable angina (UA) and non-ST-segment elevation myocardial infarction (NSTEMI) yields improved outcomes compared with a conservative approach, but the optimal timing o ...
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Journal ArticleJ Am Coll Cardiol · October 18, 2005
OBJECTIVES: In a large contemporary population of patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS), we sought to describe blood transfusion rates (overall and in patients who did not undergo coronary artery bypass grafting [CABG]) ...
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Journal ArticleJ Am Coll Cardiol · October 18, 2005
OBJECTIVES: This study evaluated the impact of age on care and outcomes for non-ST-segment elevation acute coronary syndromes (NSTE ACS). BACKGROUND: Recent clinical trials have expanded treatment options for NSTE ACS, now reflected in guidelines. Elderly ...
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Journal ArticleNephrol Dial Transplant · October 2005
BACKGROUND: Chronic kidney disease (CKD) is highly prevalent in patients with cardiovascular disease. We explored the associations of CKD with outcomes using combined data from two large acute coronary syndrome (ACS) trials. We also explored the associatio ...
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Journal ArticleAm J Cardiol · September 15, 2005
Despite the established benefit of drug-eluting stents (DESs) in improving clinical and angiographic outcomes in pivotal, randomized trials, relatively little is known regarding the frequency and patterns of DES use in clinical practice. To characterize DE ...
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Journal ArticleArch Intern Med · September 12, 2005
BACKGROUND: The threshold of troponin elevation that stimulates changes in clinical decision making for patients with non-ST-segment elevation acute coronary syndromes (NSTE ACSs) has not been previously evaluated. METHODS: A total of 23 298 patients with ...
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Journal ArticleCurr Control Trials Cardiovasc Med · August 23, 2005
BACKGROUND: Cardiac biomarkers are routinely obtained in the setting of suspected myocardial ischemia and infarction. Evidence suggests these markers may correlate with functional and clinical outcomes, but the strength of this correlation is unclear. The ...
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Journal ArticleAnn Emerg Med · August 2005
In the United States each year, >5.3 million patients present to emergency departments with chest discomfort and related symptoms. Ultimately, >1.4 million individuals are hospitalized for unstable angina and non-ST-segment elevation myocardial infarction. ...
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Journal ArticleAm Heart J · July 2005
BACKGROUND: The combination of older reduced-dose fibrinolytic agents and platelet glycoprotein IIb/IIIa inhibitors has shown modest improvements in reperfusion and more striking improvements in ST-segment resolution after acute myocardial infarction. We p ...
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Journal ArticleHeart · July 2005
OBJECTIVES: To examine the interaction between ST segment depression on the baseline ECG and subsequent in-hospital revascularisation on six month mortality among patients with non-ST elevation acute coronary syndromes. To examine whether ST segment depres ...
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Journal ArticleThe American journal of cardiology · June 2005
Data were evaluated for patients with acute ST-elevation myocardial infarction (n = 94,182) enrolled in 6 large clinical trials evaluating the efficacy of various reperfusion strategies. It was found that compared with the tallest quartile, incidences of i ...
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Journal ArticleAm Heart J · June 2005
BACKGROUND: Although intravenous morphine is commonly used for the treatment of chest pain in patients presenting with non-ST-segment elevation acute coronary syndromes (NSTE ACS), its safety has not been evaluated. The CRUSADE Initiative is a nonrandomize ...
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Journal ArticleAm J Cardiol · June 1, 2005
Patients who have diabetes mellitus have 2 times the incidence of an acute coronary syndrome (ACS) and 2 times the mortality rate after ACS compared with patients who do not have diabetes. Poor patient understanding of diabetes is believed to impede approp ...
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Journal ArticleCirculation · May 24, 2005
In the United States each year, >5.3 million patients present to emergency departments with chest discomfort and related symptoms. Ultimately, >1.4 million individuals are hospitalized for unstable angina and non-ST-segment elevation myocardial infarction. ...
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Journal ArticleAm J Med · May 2005
PURPOSE: To correlate pulmonary artery catheterization (PAC) use and 30-day outcomes and to characterize the use of pulmonary artery catheters among patients with acute coronary syndromes (ACS). SUBJECTS AND METHODS: We retrospectively studied 26437 ACS pa ...
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Journal ArticleAcad Emerg Med · May 2005
OBJECTIVES: The authors analyzed contemporary use of glycoprotein (GP) IIb/IIIa inhibitors in patients with non-ST-segment elevation acute coronary syndrome (NSTE ACS) to determine patient selection patterns with early (<24 hours) GP IIb/IIIa inhibitor use ...
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Journal ArticleJ Epidemiol Community Health · May 2005
STUDY OBJECTIVE: International variation in the outcomes of patients with acute coronary syndromes (ACS) has been well reported. The relative contributions of patient, hospital, and country level factors on clinical outcomes, however, remain unclear, and t ...
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Journal ArticleAmerican heart journal · April 2005
BackgroundIn the fibrinolytic era, several studies have suggested that the rate of atrioventricular block (AVB) in the setting of acute myocardial infarction (MI) is high and is associated with increased short-term mortality. We sought to delineat ...
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Journal ArticleAnn Emerg Med · April 2005
STUDY OBJECTIVE: Previous studies in clinical trial populations have demonstrated that patients presenting with positive troponin levels have a higher risk of mortality than patients with later positive troponin levels, but the influence of the timing of t ...
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Journal ArticleCirculation · March 15, 2005
BACKGROUND: Black patients with acute myocardial infarction are less likely than whites to receive coronary interventions. It is unknown whether racial disparities exist for other treatments for non-ST-segment elevation acute coronary syndromes (NSTE ACS) ...
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Journal ArticleJ Am Coll Cardiol · March 15, 2005
OBJECTIVES: We hypothesized that significant disparities in gender exist in the management of patients with non-ST-segment elevation (NSTE) acute coronary syndromes (ACS). BACKGROUND: Gender-related differences in the diagnosis and treatment of ACS have im ...
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Journal ArticleAm Heart J · March 2005
BACKGROUND: Clinical trials provide evidence that is formulated into recommendations for practice guidelines, but it remains uncertain whether patients enrolled in trials are similar to those treated in routine practice and whether trial enrollment influen ...
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Journal ArticleAm J Cardiol · February 15, 2005
We sought to characterize current patterns of care for lipid testing and management in a sample of patients in the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the American College of Card ...
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Journal ArticleJ Thromb Thrombolysis · February 2005
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is estimated to occur in 1-5% of all patients receiving heparin, and 25-50% of such cases develop heparin-induced thrombocytopenia with thrombosis (HITT) A conservative estimate based only on cardiovascula ...
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Journal ArticleAm J Cardiol · February 1, 2005
The present study reports outcomes of direct stenting versus conventional stenting, which was performed during adjunctive/rescue percutaneous coronary intervention (n = 556) in the Integrilin and Tenecteplase in Acute Myocardial Infarction trial, the Enoxa ...
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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 ArticleAm J Cardiol · January 15, 2005
Clinical and angiographic data were analyzed from 929 patients who had ST-elevation myocardial infarction and open epicardial arteries after fibrinolytic therapy. Residual angiographically evident thrombus was associated with more frequent Thrombolysis In ...
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Chapter · January 1, 2005
Every year almost 1 million Americans suffer an acute myocardial infarction (AMI), and 225,000 of these patients have a fatal outcome (1). Thrombolytic therapy (TT) is a very effective treatment for AMI, especially if these patients can be identified early ...
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Journal ArticleCongest Heart Fail · 2005
The authors sought to determine the prevalence of diastolic heart failure (DHF) in patients hospitalized with their first stroke, transient ischemic attack, or new onset of peripheral vascular disease. A total of 216 prospective consecutive stroke, transie ...
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Journal ArticleJAMA · November 3, 2004
CONTEXT: The American College of Cardiology/American Heart Association (ACC/AHA) guidelines for the management of non-ST-segment elevation acute coronary syndromes (NSTE ACS) recommend early invasive management for high-risk patients, given the benefits wi ...
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Journal ArticleAm Heart J · November 2004
Acute coronary syndromes (ACS), including non-ST-segment elevation (NSTE) ACS, represent a significant source of morbidity and mortality in the United States. To address this widespread, serious health problem, the American College of Cardiology and the Am ...
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Journal ArticleAm Heart J · November 2004
BACKGROUND: Current methods for risk stratification after acute myocardial infarction (MI) include several noninvasive studies. In this cost-containment era, the development of low-cost means should be encouraged. We assessed the ability of an electrocardi ...
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Journal ArticleAm Heart J · November 2004
BACKGROUND: Patients with acute coronary syndromes (ACS; unstable angina and non-ST-segment elevation myocardial infarction) are at significant risk for death and myocardial infarction. Early angiography followed by revascularization is considered the trea ...
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Journal ArticleChest · September 2004
This chapter about antithrombotic therapy during percutaneous coronary intervention (PCI) is part of the seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy: Evidence Based Guidelines. Grade 1 recommendations are strong and indicate that the ...
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Journal ArticleChest · September 2004
This chapter about antithrombotic therapy for acute myocardial infarction (MI) is part of the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy: Evidence Based Guidelines. Grade 1 recommendations are strong and indicate that the benefits d ...
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Journal ArticleEur Heart J · September 2004
BACKGROUND: Immediate, as well as early, revascularisation is of benefit in patients with acute coronary syndromes (ACS) presenting with ST elevation. However, trials comparing invasive versus medical treatment in patients with an acute coronary syndrome w ...
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Journal ArticleAm J Cardiol · July 15, 2004
We analyzed in-hospital mortality for patients treated with intra-aortic balloon counterpulsation from the Benchmark Counterpulsation Outcomes Registry (n = 25,136). In-hospital mortality was higher in patients who received only medical interventions (32.5 ...
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Journal ArticleCirculation · June 1, 2004
The rapid development of new drugs, therapies, and devices has created a dramatic increase in the number of trials needed to properly evaluate them. The majority of patients treated today, many of whom could be eligible for participation in these studies, ...
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Journal ArticleAm J Cardiol · June 1, 2004
Two patients, treated with enoxaparin and eptifibatide, developed significant guide catheter-associated thrombus while undergoing intravascular ultrasound (IVUS). Using an ex vivo assay, we found that activation of a multielement IVUS catheter resulted in ...
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Journal ArticleHeartDrug · May 24, 2004
Background: Prior studies have produced conflicting results on whether N-acetylcysteine (NAC) reduces the incidence of contrast-induced nephropathy (CIN) in patients undergoing coronary angiography (CA). The dosing regimens of NAC in these studies seemed i ...
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Journal ArticleAm Heart J · May 2004
BACKGROUND: The glycoprotein IIb/IIIa receptor antagonist abciximab reduces the risk of thrombotic complications with percutaneous coronary intervention, but also has been associated with higher bleeding rates. METHODS: In the Global Use of Strategies to O ...
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Journal ArticleAm Heart J · March 2004
BACKGROUND: Elevated concentrations of cardiac troponin T (TnT) have been reported in patients hospitalized for decompensated heart failure (HF). We assessed whether elevated TnT levels are associated with the severity, etiology, and prognosis of HF in sta ...
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Journal ArticleJ Am Soc Nephrol · March 2004
N-acetylcysteine has been recommended for patients with renal insufficiency who are to receive radiocontrast media. However, trials of oral N-acetylcysteine for the prevention of radiocontrast-induced nephropathy have yielded inconsistent results. A system ...
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Journal ArticleCatheter Cardiovasc Interv · March 2004
The appropriate regimen of platelet inhibitors that should be used in patients with immune thrombocytopenia purpura (ITP; formerly called idiopathic thrombocytopenic purpura) who are undergoing percutaneous coronary intervention is unclear. We report the c ...
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Journal ArticleJ Am Coll Cardiol · February 18, 2004
OBJECTIVES: We studied the outcome of diabetics enrolled in the Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) V trial to assess whether the combination of half-dose reteplase and abciximab provides any propitious benefits over standar ...
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Journal ArticleEuropean heart journal · February 2004
AimTo study the relationship between outcomes and peak creatine kinase (CK)-MB levels after percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS).Methods and resultsPeak CK- ...
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Journal ArticleAm Heart Hosp J · 2004
Facilitated percutaneous coronary intervention (PCI) refers to a strategy of immediate PCI following the administration of pharmacological therapies in acute myocardial infarction. It has evolved primarily from the time delays (due to geography or logistic ...
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Journal ArticleThe American journal of medicine · December 2003
PurposeTo investigate the prognostic importance of new small Q waves following an acute coronary syndrome.MethodsWe assessed 6-month mortality in 10501 patients with non-ST-elevation acute coronary syndromes who had survived 30 days and h ...
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Journal ArticleAm Heart J · December 2003
BACKGROUND: The acute benefits of platelet glycoprotein IIb/IIIa inhibitors for non-ST-segment elevation acute coronary syndromes (NSTE ACS) remain unclear. METHODS: In this pilot trial, 311 patients with NSTE ACS were randomly assigned in the emergency de ...
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Journal ArticleJ Invasive Cardiol · November 2003
Up to 5% of patients given heparin develop heparin-induced thrombocytopenia (HIT). These patients may need anticoagulation for acute coronary syndromes (ACS) or percutaneous coronary intervention (PCI), a clinical challenge given the limited alternatives. ...
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Journal ArticleAm Heart J · October 2003
Acute coronary syndromes (ACS) represent a major cause of morbidity and mortality for patients with cardiovascular disease, but evidence-based therapies shown to improve outcomes for ACS are often underused in clinically eligible patients. Although clinica ...
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Journal ArticleEur Heart J · October 2003
AIMS: To examine differences in patient characteristics and outcomes in 19636 patients enrolled in the USA and 3027 patients enrolled in other countries undergoing intra-aortic balloon pump (IABP) counterpulsation. METHODS AND RESULTS: Indications for IABP ...
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Journal ArticleCard Electrophysiol Rev · September 2003
The Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO)-3 atrial fibrillation (AF) substudy assessed the prognostic significance of AF during acute myocardial infarction (AMI), the use of antiarrhythmic therapies, and whether different anti ...
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Journal ArticleCirculation · August 26, 2003
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BACKGROUND: Increasing evidence suggests an inverse relationship between outcome and the total number of invasive cardiac procedures performed at a given hospital. The purpose of the present study was to determine if a similar relationship exists between t ...
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Journal ArticleJAMA · August 20, 2003
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CONTEXT: It is commonly suggested that more than 50% of patients with coronary heart disease (CHD) lack any of the conventional risk factors (cigarette smoking, diabetes, hyperlipidemia, and hypertension). This claim implies that other factors play a signi ...
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Journal ArticleAm J Cardiol · August 1, 2003
We studied stent thrombosis in 4,607 patients with acute coronary syndromes who received a coronary stent as part of routine care during 2 trials of aspirin versus sibrafiban for secondary prevention. In these patients, stent thrombosis occurred more often ...
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Journal ArticleHeartDrug · July 21, 2003
The Benchmark Counterpulsation Outcomes Registry is a computerized database that incorporates prospectively gathered data on indications for intra-aortic balloon counterpulsation (IABP) use, patient demographics, concomitant medications and in-hospital com ...
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Journal ArticleJ Am Coll Cardiol · June 4, 2003
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OBJECTIVES: We sought to examine contemporary utilization patterns and clinical outcomes in patients with acute myocardial infarction (AMI) requiring intra-aortic balloon pump (IABP) counterpulsation. BACKGROUND: Despite increasing experience with and broa ...
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Journal ArticleJ Thromb Thrombolysis · June 2003
BACKGROUND: Shorter distances from the coronary ostia to culprit lesions have been associated with a higher incidence of adverse outcomes in ST elevation acute myocardial infarction (STEMI). As drug-eluting stents are associated with low rates of restenosi ...
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Journal ArticleAm J Cardiol · April 15, 2003
The risk of death or recurrent myocardial infarction (MI) in patients with chest pain and baseline isolated troponin elevation is unclear. To determine the early and short-term risk of death or MI associated with isolated troponin elevation across a spectr ...
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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 ArticleJ Am Coll Cardiol · February 19, 2003
Over the past decade, there has been a progressive evolution of cardiac marker testing in patients with acute coronary syndromes (ACS). This has not only resulted in a dramatic shift in how we view the diagnosis of myocardial infarction (MI), but it has al ...
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Journal ArticleJ Am Coll Cardiol · February 5, 2003
Featured Publication
OBJECTIVES: Our primary objective was to examine the prognostic relationship between baseline quantitative ST-segment depression (ST) and cardiac troponin T (cTnT) elevation. The secondary objectives were to: 1) examine whether ST provided additional insig ...
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Journal ArticleCirculation · January 28, 2003
Featured Publication
BACKGROUND: This study was designed to investigate long-term effects of the glycoprotein IIb/IIIa inhibitor abciximab in patients with acute coronary syndrome without ST elevation who were not scheduled for coronary intervention. METHODS AND RESULTS: A tot ...
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Journal ArticleAm Heart J · January 2003
BACKGROUND: There is a paucity of data on the incidence of mild-to-moderate heart failure (HF) complicating ST-segment elevation acute myocardial infarction (MI) and its impact on short-term outcomes. Our objective was to determine the incidence, timing, a ...
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Journal ArticleAm Heart J · December 2002
BACKGROUND: Cumulative evidence suggests a positive association between Chlamydia pneumoniae (Cpn) infection and risk of future coronary events among patients with stable coronary artery disease. However, its prognostic role in unstable coronary syndromes ...
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Journal ArticleJ Thromb Thrombolysis · December 2002
BACKGROUND: Receptors other than GP IIb/IIIa may mediate leukocyte-platelet-endothelial interactions that obstruct the microvasculature in acute coronary syndromes (ACS) and cause microinfarcts. The effect of eptifibatide on these receptors was investigate ...
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Journal ArticleAcad Emerg Med · November 2002
Although acute coronary syndromes (ACS) represent a well-recognized source of morbidity and mortality for patients with cardiovascular disease, evidence-based therapies shown to improve outcomes for ACS are frequently underused in appropriate patients, esp ...
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Journal ArticleAnn Thorac Surg · October 2002
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BACKGROUND: As the proportion of high-risk patients for cardiac surgery increases, use of intraaortic balloon counterpulsation (IABC) has increased, especially in preoperative therapy. Although the efficacy and cost-effectiveness of IABC have been demonstr ...
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Journal ArticleHeart · October 2002
Featured Publication
OBJECTIVE: To investigate the use of antiarrhythmic agents and electrical cardioversion in the management of patients with atrial fibrillation complicating acute myocardial infarction, and their relation to 30 day and one year mortality. DESIGN: Prospectiv ...
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Journal ArticleCirculation · September 17, 2002
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BACKGROUND: The relative anti-aggregatory effects of currently prescribed platelet glycoprotein IIb/IIIa receptor antagonists during and after percutaneous coronary intervention for acute coronary syndromes have not been established. METHODS AND RESULTS: W ...
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Journal ArticleCirculation · August 20, 2002
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BACKGROUND: Outcomes in patients with mild to moderate renal function (RF) abnormalities presenting with acute coronary syndromes (ACS) are not well defined. METHODS AND RESULTS: A convenience sample of 4 ACS trial databases including all enrolled patients ...
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Journal ArticleAm J Cardiol · August 1, 2002
The definition of acute myocardial infarction (AMI) is increasingly dependent on levels of biochemical markers, including troponin. We aimed to determine the levels of biochemical markers associated with definite evolutionary electrocardiographic (ECG) cha ...
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Journal ArticleAm Heart J · August 2002
BACKGROUND: Women have higher mortality rates than men after coronary angioplasty. Differences in target vessel size may partially account for these differences. We set out to explore the effects of sex, body surface area (BSA), and target coronary vessel ...
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Journal ArticleAm Heart J · July 2002
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BACKGROUND: Resolution of ST-segment elevation after thrombolysis for acute myocardial infarction has been shown to have prognostic significance 3 hours (180 minutes) after the initiation of therapy. Whether prognostically useful information can be achieve ...
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Journal ArticleN Engl J Med · June 27, 2002
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BACKGROUND: Among patients with suspected acute coronary syndromes, cardiac troponin T levels have prognostic value. However, there is concern that renal dysfunction may impair the prognostic value, because cardiac troponin T may be cleared by the kidney. ...
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Journal ArticleJ Am Coll Cardiol · June 5, 2002
Featured Publication
OBJECTIVES: We sought to assess the incidence and clinical significance of elevated cardiac troponin I (cTnI) after percutaneous coronary intervention (PCI). BACKGROUND: Elevated creatine kinase-MB (CK-MB) is prognostically important after PCI, but the pro ...
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Journal ArticleCatheter Cardiovasc Interv · June 2002
The Benchmark intra-aortic balloon counterpulsation (IABC) registry maintains prospectively gathered clinical information on a large cohort of IABC patients. The purpose of the present report is to compare in-hospital outcomes and complications in patients ...
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Journal ArticleJ Am Coll Cardiol · February 6, 2002
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OBJECTIVES: This study was designed to test the hypothesis that eptifibatide and reduced-dose tissue plasminogen activator (t-PA) will enhance infarct artery patency at 60 min in patients with acute myocardial infarction (AMI). BACKGROUND: Combination fibr ...
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Journal ArticleAnn Emerg Med · February 2002
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STUDY OBJECTIVE: Early treatment with fibrinolytic therapy substantially decreases mortality in acute myocardial infarction (AMI). We examined delays to hospital arrival and treatment in 2 large, multinational, randomized trials of fibrinolytic therapy: Gl ...
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Journal ArticleJ Am Coll Cardiol · January 2, 2002
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OBJECTIVES: The study investigated the relationship among creatine kinase (CK) elevations, clinical characteristics and cardiac events across the whole spectrum of acute coronary syndromes (ACS). BACKGROUND: Elevated serum levels of cardiac enzymes have be ...
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Journal ArticleAm Heart J · January 2002
BACKGROUND: Adjunctive therapies that increase the incidence of normal reperfusion after thrombolysis for acute myocardial infarction (MI) could enhance clinical outcomes. Direct thrombin inhibitors may offer an advantage over standard adjunctive therapies ...
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Journal ArticleCurr Interv Cardiol Rep · November 2001
In acute myocardial infarction, reperfusion therapy is needed to restore coronary flow and myocardial perfusion. Thrombolytic therapy is widely available and can be administered rapidly but does not achieve the same degree of reperfusion as primary percuta ...
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Journal ArticleJ Am Coll Cardiol · November 1, 2001
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OBJECTIVES: This study presents clinical data from the first large registry of aortic counterpulsation, a computerized database that incorporates prospectively gathered data on indications for intra-aortic balloon counterpulsation (IABP) use, patient demog ...
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Journal ArticleCirculation · September 11, 2001
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BACKGROUND: Trials report a 2% to 6% incidence of reinfarction after fibrinolysis for acute myocardial infarction (MI). We combined the Global Utilization of Streptokinase and Tissue plasminogen activator (alteplase) for Occluded coronary arteries (GUSTO I ...
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Journal ArticleJ Am Coll Cardiol · September 2001
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OBJECTIVES: This study aimed to determine whether pre-existing angiographic thrombus was associated with adverse in-hospital and six-month outcomes after percutaneous coronary interventions. BACKGROUND: There are conflicting data about whether pre-existing ...
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Journal ArticleCirculation · June 19, 2001
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BACKGROUND: Troponin T (TnT) is valuable for short- and long-term risk stratification of patients with acute coronary syndromes (ACS). It also may predict which ACS patients will benefit from glycoprotein (GP) IIb/IIIa blockade. METHODS AND RESULTS: We pro ...
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Journal ArticleJ Am Coll Cardiol · June 1, 2001
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OBJECTIVES: To predict which patients might not require stent implantation, we identified clinical and angiographic characteristics associated with repeat revascularization after standard balloon angioplasty. BACKGROUND: Stents reduce the risk of repeat re ...
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Journal ArticleCirculation · April 10, 2001
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BACKGROUND: Earlier, rapid evaluation in chest pain units may make patient care more efficient. A multimarker strategy (MMS) testing for several markers of myocardial necrosis with different time-to-positivity profiles also may offer clinical advantages. M ...
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Journal ArticleLancet · April 7, 2001
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BACKGROUND: Lipid-lowering agents are known to reduce long-term mortality in patients with stable coronary disease or significant risk factors. However, the effect of lipid-lowering therapy on short-term mortality immediately after an acute coronary syndro ...
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Journal ArticleAm J Cardiol · February 15, 2001
Among 214 patients treated with abciximab within 24 hours of full-dose thrombolytic therapy, major bleeding occurred in 50 patients (23%; 95% confidence interval [CI] 18% to 30%) and intracranial hemorrhage occurred in 3 patients (1.4%; 95% CI 0.3% to 4%). ...
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Journal ArticleJ Am Coll Cardiol · February 2001
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OBJECTIVES: We aimed to evaluate the benefits of the glycoprotein (GP) IIb/IIIa antagonist, eptifibatide, after patients with acute coronary syndromes (ACS) were admitted to hospitals that approach revascularization for ACS through early transfer to tertia ...
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Journal ArticleCardiovasc Toxicol · 2001
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A new variable termed the falloff constant (k(f)) was derived from the curve fitting of serial CK-MB measurements. k(f) represents the rate constant of maximal decline in serum CK-MB and is determined from the slope of the lognormal curve at the inflection ...
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Journal ArticleCurr Control Trials Cardiovasc Med · 2001
During the past decade considerable research has been conducted into the use of cardiac troponins, their diagnostic capability and their potential to allow risk stratification in patients with acute chest pain. Determination of risk in patients with suspec ...
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Journal ArticleJ Am Coll Cardiol · January 2001
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Successful reperfusion after acute myocardial infarction (MI) has traditionally been considered to be restoration of epicardial patency, but increasing evidence suggests that disordered microvascular function and inadequate myocardial tissue perfusion are ...
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Journal ArticleAm J Crit Care · January 2001
BACKGROUND: Depressive symptoms are an independent risk factor for outcome in patients with cardiac disease, but their effect on outcome among patients undergoing coronary artery bypass grafting is not well understood. OBJECTIVES: To determine whether or n ...
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Journal ArticleCanadian Journal of Cardiology · December 12, 2000
Background: Temporal changes in baseline characteristics, treatment and clinical outcomes of patients presenting with acute ST elevation myocardial infarction in Canada and the United States have not been examined comprehensively over time. Objectives: To ...
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Journal ArticleAm Heart J · December 2000
BACKGROUND: Atrial fibrillation (AF) or flutter occurring after myocardial infarction may occur alone or in association with other complications. Whether the arrhythmia portends a poor prognosis independent of other complications with contemporary therapy ...
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Journal ArticleEur Heart J · December 2000
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AIMS: We used the GUSTO-I and GUSTO-III databases to evaluate our performance in treating cardiogenic shock patients over much of the 1990s. METHODS AND RESULTS: GUSTO-I (1990-1993) and GUSTO-III (1995-1997) prospectively identified all patients with cardi ...
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Journal ArticleEur Heart J · November 2000
AIMS: We examined the characteristics, outcomes, and effects of hirudin vs heparin treatment of diabetic patients across the spectrum of acute coronary syndromes. METHODS AND RESULTS: We studied the 12,142 patients enrolled in the randomized GUSTO-IIb stud ...
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Journal ArticleJ Am Coll Cardiol · November 1, 2000
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OBJECTIVES: We examined the utility of early percutaneous coronary intervention (PCI) in a trial that encouraged its use after thrombolysis and glycoprotein IIb/IIIa inhibition for acute myocardial infarction (MI). BACKGROUND: Early PCI has shown no benefi ...
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Journal ArticleCirculation · October 10, 2000
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BACKGROUND: New recombinant plasminogen activators have been developed to simulate the fibrinolytic action of the physiological serine protease tissue plasminogen activator (alteplase, t-PA), and have prolonged half-life features permitting bolus administr ...
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Journal ArticleJ Am Coll Cardiol · October 2000
Coronary stents reduce the rates of abrupt closure, emergency coronary artery bypass graft surgery and restenosis, but do not prevent myocardial infarction or death at six months. The financial burden of increased stent use and the difficulty in managing i ...
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Journal ArticleCan J Cardiol · October 2000
BACKGROUND: Temporal changes in baseline characteristics, treatment and clinical outcomes of patients presenting with acute ST elevation myocardial infarction in Canada and the United States have not been examined comprehensively over time. OBJECTIVES: To ...
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Journal ArticleCirculation · September 26, 2000
BACKGROUND: Improvement of thrombolysis may be achieved by concomitant strong platelet inhibition. To monitor platelet function in patients with myocardial infarction (n=46) who were treated with the fibrinolytic agent reteplase, the glycoprotein (GP) IIb/ ...
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Journal ArticleCirculation · September 5, 2000
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BACKGROUND: A multinational, randomized, placebo-controlled trial (Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy, PURSUIT) demonstrated that the platelet glycoprotein IIb/IIIa receptor antagonist eptifibat ...
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Journal ArticleCirculation · September 5, 2000
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BACKGROUND: A proportion of patients who present with suspected acute coronary syndrome (ACS) are found to have insignificant coronary artery disease (CAD) during coronary angiography, but these patients have not been well characterized. METHODS AND RESULT ...
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Journal ArticleJournal of the American College of Cardiology · September 2000
Definition of MI. Criteria for acute, evolving or recent MI. Either one of the following criteria satisfies the diagnosis for an acute, evolving or recent MI: 1) Typical rise and gradual fall (troponin) or more rapid rise and fall (CK-MB) of biochemical ma ...
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Journal ArticleEur Heart J · September 2000
This document was developed by a consensus conference initiated by Kristian Thygesen, MD, and Joseph S. Alpert, MD, after formal approval by Lars Rydén, MD, President of the European Society of Cardiology (ESC), and Arthur Garson, MD, President of the Amer ...
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Journal ArticleAm J Cardiol · July 1, 2000
Previous reports indicate that patients who do not develop Q waves after thrombolytic therapy are a different population with a better long-term survival than those who do develop Q waves. However, the use of resources, quality of life, and health status o ...
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Journal ArticleCirculation · June 20, 2000
BACKGROUND: Low-dose alteplase with standard-dose abciximab enhances reperfusion 90 minutes after acute myocardial infarction (MI). We combined standard-dose abciximab with low-dose reteplase for acute MI in 2 phases. Two heparin doses were also explored. ...
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Journal ArticleAm Heart J · May 2000
BACKGROUND: Existing thrombus can complicate percutaneous saphenous vein graft (SVG) intervention. Local delivery of thrombolytics has been used to reduce the thrombus burden often associated with these interventions. We sought to determine whether local d ...
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Journal ArticleAm J Cardiol · April 27, 2000
The goal of therapy in acute myocardial infarction is complete and timely restoration of coronary blood flow. Current strategies for reperfusion fail to achieve ideal results and resolution of ischemia in all patients. The platelet plays a pivotal role in ...
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Journal ArticleCatheter Cardiovasc Interv · April 2000
Bailout stenting for major dissection and threatened closure has high rates of ischemic complications. We performed a randomized trial of local heparin delivery using the infusion sleeve before bailout stenting for suboptimal angioplasty results. In phase ...
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Journal ArticleAm J Cardiol · April 1, 2000
We evaluated cardiac troponin T (cTnT) and creatine kinase-MB (CK-MB) for risk stratification of chest pain unit (CPU) patients. We studied 383 consecutive patients with chest pain assigned to our CPU by emergency department physicians. At baseline all had ...
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Journal ArticleAm J Cardiol · March 1, 2000
Measuring biochemical marker release after acute myocardial infarction helps in estimating infarct size and prognosis. We sought to relate in-hospital outcomes and curve-fitted creatine kinase (CK)-MB variables after thrombolysis. We measured CK-MB mass in ...
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Journal ArticleLancet · January 29, 2000
BACKGROUND: Aspirin lowers risks of death and myocardial infarction in patients with acute coronary syndromes. Intravenous glycoprotein IIb/IIIa receptor antagonists further reduce the rates of ischaemic events in these patients, but the efficacy of long-t ...
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Journal ArticleCardiology · 2000
Each year, at least 5 million patients in the United States present to hospital emergency departments with the complaint of chest pain, and more than 10% of them will be diagnosed with acute myocardial infarction. One of the foremost tasks of the emergency ...
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Journal ArticleJ Thromb Thrombolysis · January 2000
Thrombin activity has been implicated as a mechanism for failed reperfusion and reocclusion following thrombolysis. Aggregating platelets provide a phospholipid surface on which prothrombin is cleaved to form thrombin. We examined markers of thrombin gener ...
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Journal ArticleJ Am Coll Cardiol · January 2000
OBJECTIVES: This study characterized clinical factors predictive of cardiogenic shock developing after thrombolytic therapy for acute myocardial infarction (AMI). BACKGROUND: Cardiogenic shock remains a common and ominous complication of AMI. By identifyin ...
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Journal ArticleJournal of the American Medical Association · 2000
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Context: Controversy surrounds the diagnostic and prognostic importance of slightly elevated cardiac markers in patients with acute coronary syndromes without ST-segment elevation. Objectives: To investigate the relationship between peak creatine kinase (C ...
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Journal ArticleJ Electrocardiol · 2000
The European Society of Cardiology and American College of Cardiology established their initial Joint Consensus Conference in July 1999 to develop a new definition of Acute Myocardial Infarction. This action was deemed necessary because of the development ...
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Journal ArticleAm J Cardiol · December 1, 1999
Troponin T has been used successfully to risk stratify patients with acute coronary syndromes, but the utility of this approach using a rapid bedside assay in patients undergoing thrombolysis for ST-segment elevation acute myocardial infarction has not bee ...
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Journal ArticleJ Am Coll Cardiol · November 15, 1999
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OBJECTIVES: We sought to describe the differences in the process of care and clinical outcomes between Hispanics and non-Hispanics receiving thrombolytic therapy for myocardial infarction (MI). BACKGROUND: Hispanics are the fastest growing and second large ...
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Journal ArticleAm J Cardiol · October 1, 1999
We evaluated the effects of abciximab treatment during early angioplasty after clinically failed thrombolysis for acute myocardial infarction. In the Global Use of Strategies To Open occluded coronary arteries (GUSTO-III) trial of reteplase versus alteplas ...
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Journal ArticleClin Chim Acta · June 30, 1999
Point-of-care (POC) or "near-patient" testing allows diagnostic assays to be performed in locations such as the emergency department or intensive care unit where treatment decisions are made and care is delivered based on the results of these assays. Prese ...
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Journal ArticleAust N Z J Med · June 1999
Many adjuncts to the traditional history, physical examination, and baseline ECG have been developed to improve the differential diagnosis of acute coronary syndromes in the Emergency Department (ED). These include serial ECGs, continuous ST-segment monito ...
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Journal ArticleAm Heart J · June 1999
BACKGROUND: To test whether later intra-aortic balloon pump (IABP) deflation approaching or simultaneous with left ventricular ejection would improve hemodynamics and myocardial efficiency with the use of new balloon deflation methods, 4 IABP timing techni ...
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Journal ArticleJ Thromb Thrombolysis · June 1999
Pharmacological reperfusion therapy for acute myocardial infarction with intravenous fibrinolytic agents improves survival yet fails to achieve early and complete coronary blood flow in nearly half of treated patients. In principle, glycoprotein (GP) IIb/I ...
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Journal ArticleJAMA · February 24, 1999
CONTEXT: The presence of ischemic changes on electrocardiogram (ECG) correlates with poorer outcomes in patients with acute chest pain. OBJECTIVE: To determine the prognostic value of various ECG presentations of acute myocardial ischemia. DESIGN: Retrospe ...
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Journal ArticleCardiol Rev · 1999
Despite significant advances in the treatment of myocardial infarction, morbidity and mortality rates remain high. Recently completed, large, randomized trials have evaluated new therapeutic strategies for the management of ST-segment elevation acute myoca ...
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Journal ArticleEur Heart J · January 1999
AIMS: Reteplase has been reported to achieve better patency of the infarct artery than alteplase. As infarct artery patency is strongly associated with survival among patients with cardiogenic shock, we postulated that treatment with reteplase would improv ...
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Journal ArticleJ Am Coll Cardiol · January 1999
OBJECTIVES: We examined the relations of elevated creatine kinase (CK) and its myocardial band isoenzyme (CK-MB) to clinical outcomes after percutaneous coronary intervention (PCI) in patients enrolled in Integrilin (eptifibatide) to Minimize Platelet Aggr ...
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Journal ArticleCirculation · November 3, 1998
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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 ArticleAm Heart J · October 1998
The pathophysiologic basis for potent platelet inhibition in the acute coronary syndromes has been established. In the setting of PTCA for unstable angina and non-Q-wave myocardial infarction, there are clear data for a benefit of GP IIb/IIIa inhibition, w ...
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Journal ArticleAm Heart J · October 1998
Despite a clinical trials experience in excess of 30,000 randomized patients, there is no definitive answer or agreement as to the relation between the level of inhibition of platelet aggregation and clinical outcome. Work with abciximab in the setting of ...
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Journal ArticleJ Am Coll Cardiol · October 1998
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OBJECTIVES: We sought to determine the prognostic significance of a history of congestive heart failure above that provided by baseline ejection fraction in patients undergoing percutaneous coronary interventions. BACKGROUND: Left ventricular function is a ...
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Journal ArticleAm Heart J · September 1998
BACKGROUND: Platelets play an important role in the natural history of acute myocardial infarction (AMI). METHODS AND RESULTS: Platelet aggregation and receptor expression were studied in 23 patients with AMI before reperfusion therapy and compared with 10 ...
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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 ArticleJ Am Coll Cardiol · June 1998
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OBJECTIVES: We sought to compare platelet characteristics after reteplase and alteplase therapy in the setting of the Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO)-III trial. BACKGROUND: Platelet function may be impaired during thromb ...
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Journal ArticleInt J Cardiol · May 29, 1998
Modern coronary care unit interventions have not reduced the high mortality rate associated with cardiogenic shock due to acute myocardial infarction. Results with thrombolytic therapy have also been disappointing because of poor infarct artery patency rat ...
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Journal ArticleClin Chem · March 1998
We compared cardiac troponins T (cTnT) and I (cTnI) collected within 3.5 h of ischemic symptoms for predicting clinical outcomes in 770 patients. cTnT (cutoff > 0.1 microgram/L) and cTnI (cutoff > 1.5 micrograms/L) were concordant (both positive or negativ ...
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Journal ArticleJ Am Coll Cardiol · February 1998
The detection of elevated cardiac enzyme levels and the occurrence of electrocardiographic (ECG) abnormalities after revascularization procedures have been the subject of recent controversy. This report represents an effort to achieve a consensus among a g ...
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Journal ArticleCoron Artery Dis · 1998
BACKGROUND: Platelets play a pivotal role in the pathogenesis of acute myocardial infarction and their activation can cause thrombolysis to fail. METHODS: Baseline aggregation of platelets and expression of major surface receptors measured by flow cytometr ...
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Journal ArticleStroke · January 1998
BACKGROUND: Impaired platelet function has been reported in acute myocardial infarction (AMI) and stroke. However, prospective data on the changes of platelet status in patients before the occurrence of hemorrhagic stroke after thrombolytic therapy are una ...
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Journal ArticleCirculation · October 21, 1997
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BACKGROUND: Recent subgroup analyses of randomized trials have suggested that percutaneous intervention in diabetic patients with multivessel disease results in higher mortality than coronary artery bypass graft surgery (CABG). We studied the relationship ...
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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 ArticleAm Heart J · October 1997
Patients who cannot be reperfused after thrombolytic therapy have a high mortality rate. Noninvasive clinical markers of reperfusion have been widely studied, yet their prognostic significance remains unclear. To assess the prognostic value of commonly use ...
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Journal ArticleCirculation · September 16, 1997
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BACKGROUND: Several biochemical markers have been investigated for the noninvasive assessment of reperfusion after myocardial infarction. Because myoglobin is released very soon after myocardial injury and clears rapidly after reperfusion, it may prove to ...
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Journal ArticleJ Am Coll Cardiol · September 1997
OBJECTIVES: We sought to examine the use, complications and outcomes with early intraaortic balloon counterpulsation (IABP) in patients presenting with cardiogenic shock complicating acute myocardial infarction and treated with thrombolytic therapy. BACKGR ...
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Journal ArticleCurr Opin Cardiol · July 1997
Exploration of new strategies and therapies to improve survival and outcomes of acute myocardial infarction (AMI) continues. Recently published large clinical trials, including the long-term results from Grampian Region Early Anistreplase Trial, Global Use ...
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Journal ArticleJ Am Coll Cardiol · June 1997
OBJECTIVES: We sought to explore the potential benefit of combining intraaortic balloon counterpulsation (IABP) with thrombolysis for acute myocardial infarction (MI) complicated by cardiogenic shock. BACKGROUND: In community hospitals, this condition is u ...
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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 ArticleAm J Cardiol · March 1, 1997
Intraaortic balloon counterpulsation (IABP) has been shown to improve coronary artery patency and reduce the rates of recurrent myocardial ischemia and its sequelae in selected patients when used within 24 hours of acute myocardial infarction. The economic ...
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Journal ArticleCirculation · February 18, 1997
BACKGROUND: Platelet activation and aggregation may be key components of thrombolytic failure to restore and maintain perfusion in acute myocardial infarction. We performed a placebo-controlled, dose-ranging trial of Integrilin, a potent inhibitor of plate ...
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Journal ArticleMd Med J · 1997
Biochemical markers provide clinicians with an important tool for the assessment of acute coronary syndromes. Biochemical markers, including total creatine kinase (total CK), creatine kinase-MB (CK-MB), the MB isoforms, and myoglobin, as well as the tropon ...
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Journal ArticleJ Am Coll Cardiol · November 1, 1996
OBJECTIVES: We attempted to determine the relation between estrogen replacement therapy and the rate of restenosis after coronary angioplasty and atherectomy. BACKGROUND: Although estrogen replacement therapy in women has been associated with a reduction i ...
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Journal ArticleN Engl J Med · October 31, 1996
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BACKGROUND: The prognosis of patients hospitalized with acute myocardial ischemia is quite variable. We examined the value of serum levels of cardiac troponin T, serum creatine kinase MB (CK-MB) levels, and electrocardiographic abnormalities for risk strat ...
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Journal ArticleChest · October 1, 1996
Purpose: To identify patients (pts.) receiving emergency cardiopulmonary bypass (ECPB) due to angioplasty failure (PTCA-F); to evaluate pt. outcomes which delineate clinical features associated with successful application of CPB. Methods: Consecutive data ...
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Journal ArticleJournal of Intravenous Nursing · May 1, 1996
Background: The abrupt cessation of heparin and other thrombin inhibitors when used to treat acute coronary syndromes has been accompanied by a clustering of thrombotic events. It is unknown whether these events are the result of inadequate antithrombin th ...
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Journal ArticleCathet Cardiovasc Diagn · April 1996
Percutaneous coronary revascularization in patients with unstable angina and coronary thrombus carries a high complication rate. A new strategy to reduce thrombus burden before revascularization was tested in a multicenter prospective trial. Patients with ...
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Journal ArticleAm J Cardiol · March 15, 1996
Intravenous heparin is routinely given after thrombolytic therapy for patients with acute myocardial infarction in the United States and in some, but by no means all, other countries. Several trials have documented improved infarct-artery patency in patien ...
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Journal ArticleJAMA · March 13, 1996
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OBJECTIVE: To compare baseline characteristics, complications, and treatment-specific outcomes of women and men with acute myocardial infarction treated with thrombolytic therapy. DESIGN: Randomized controlled trial. PATIENTS AND SETTING: A total of 10315 ...
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Journal ArticleEur Heart J · March 1996
The ideal non-invasive method for detecting coronary reperfusion has not yet been established. In 63 patients with acute myocardial infarction, serum myoglobin and creatine kinase-MB were measured every 15 min. Thrombolytic treatment was given (n = 52) and ...
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Journal ArticleJ Am Coll Cardiol · January 1996
OBJECTIVES: This study sought to compare the frequency of restenosis, reocclusion and adverse cardiovascular events after angioplasty of occluded versus nonoccluded coronary arteries. BACKGROUND: Angioplasty of chronically occluded coronary arteries is bel ...
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Journal ArticleJournal of Interventional Cardiology · January 1, 1996
Beginning with its inception in 1985, the TAMI group performed randomized clinical trials in both academic and nonacademic settings. The ten TAMI trials not only proved the viability of clinical research in a nontraditional environment, but also contribute ...
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Journal ArticleAm J Cardiol · November 15, 1995
Early postinfarction angina implies an unfavorable prognosis. Most published information on this outcome represents data collected in the prethrombolytic era, in which definitions and populations differed considerably. Our purpose was to evaluate the incid ...
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Journal ArticleEur Heart J · November 1995
Aggregation of platelets leading to thrombosis is one of the hallmarks of unstable angina, acute myocardial infarction, and ischaemic complications following coronary angioplasty. Activated platelets bind to fibrinogen through the glycoprotein IIb/IIIa int ...
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Journal ArticleN Engl J Med · August 31, 1995
BACKGROUND: Differences in the management of acute myocardial infarction have been reported among countries, but few studies have investigated this issue in regions of the United States. METHODS: We compared the management of acute myocardial infarction am ...
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Journal ArticleClin Chem · June 1995
Creatine kinase isoforms markers, including MB2 concentration, MB2/MB1 and MM3/MM1 ratios, and MT index (based on the "tissue" M subunits), were measured in serial specimens from 207 patients receiving thrombolytic therapy followed by acute angiography. Th ...
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Journal ArticleJ Am Coll Cardiol · June 1995
OBJECTIVES: We examined the results of the Coronary Angioplasty Versus Excisional Atherectomy Trial (CAVEAT) to determine the characteristics and consequences of creatine kinase (CK) and creatine kinase, MB myocardial isoenzyme fraction (CK-MB) elevations ...
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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 ArticleJ Interv Cardiol · April 1995
Patients with complex coronary arterial stenoses, decreased ejection fraction, or acute myocardial infarction are at increased risk during percutaneous coronary interventions. Intraaortic balloon counterpulsation (IABP) can provide benefit in such cases by ...
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Journal ArticleCirculation · April 1, 1995
BACKGROUND: The abrupt cessation of heparin and other thrombin inhibitors when used to treat acute coronary syndromes has been accompanied by a clustering of thrombotic events. It is unknown whether these events are the result of inadequate antithrombin th ...
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Journal ArticleUgeskr Laeger · January 23, 1995
Non-invasive methods for evaluation of intravenous thrombolytic treatment in patients with acute myocardial infarction (AMI) are needed, since approximately 30% of the patients never obtain coronary reperfusion. These patients could be candidates for addit ...
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Journal ArticleJ Invasive Cardiol · 1995
The development of more user-friendly and versatile perfusion balloon catheters has increased the use of prolonged dilations as a primary catheter treatment for coronary artery disease. In a multicenter randomized trial, the use of these devices to prolong ...
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Journal ArticleClinical Chemistry · January 1, 1995
Creatine kinase isoforms markers, including MB2 concentration, MB2/MB1 and MM3/MM1 ratios, and M(T) index (based on the 'tissue' M subunits), were measured in serial specimens from 207 patients receiving thrombolytic therapy followed by acute angiography. ...
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Journal ArticleThe American journal of cardiology · December 1994
Individual studies of patency rates and left ventricular (LV) function after thrombolysis have generally been limited by small numbers of observations, wide confidence intervals, and limited numbers of time points. To obtain a more reliable estimate of pat ...
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Journal ArticleCirculation · December 1994
BACKGROUND: A paradoxical increased risk of death has been reported during the first 24 hours after thrombolysis for myocardial infarction. The mechanism of this phenomenon is not known, nor is its relation to the success or failure of reperfusion. The pre ...
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Journal ArticleJournal of Myocardial Ischemia · October 4, 1994
An precedented number of clinical trials are now being conducted in acute myocardial infarction (MI). Three broad avenues of research are being explored: (1) treatment strategies to achieve normal reperfusion in the infarct-related artery as soon as possib ...
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Journal ArticleEur Heart J · October 1994
Routine invasive evaluations are being abandoned, and thus simple non-invasive methods for estimating the extent of jeopardized myocardium during evolving myocardial infarction are needed for risk stratification to guide the appropriate therapeutic interve ...
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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 ArticleCoron Artery Dis · July 1994
BACKGROUND: Patients who have suffered acute myocardial infarction (AMI) and have been treated with intravenous thrombolytic agents resulting in early 'patent' [Thrombolysis in Myocardial Infarction (TIMI) 2-3 flow grade] arteries have been shown not to be ...
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Journal ArticleCoron Artery Dis · May 1994
Soon after the efficacy of thrombolytic agents in recanalizing totally occluded arteries in the setting of AMI was shown, angiographic studies revealed a residual high-grade stenosis in a majority of these patients. To improve clinical outcome further, the ...
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Journal ArticleAm J Cardiol · May 1, 1994
The usefulness of calcium antagonists to reduce restenosis after coronary angioplasty remains uncertain despite 5 randomized trials involving 919 patients. Review and meta-analysis of these trials are performed to provide insight into whether calcium antag ...
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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 ArticleAm J Cardiol · March 1, 1994
Thrombolytic therapy for acute myocardial infarction (AMI) has reduced mortality at the expense of additional intracranial hemorrhages. To determine whether this trade-off has been optimized, a decision analysis was performed using pooled data to determine ...
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Journal ArticleCoron Artery Dis · November 1993
BACKGROUND: The use of thrombolytic therapy in myocardial infarction has been associated with a considerable improvement in survival rate; however, almost 40% of the deaths during hospitalization occur during the first 24 h. Clinical and angiographic chara ...
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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 ArticleAm J Clin Pathol · September 1993
To maximize the information one can obtain from the temporal curves of creatine kinase (CK) after acute myocardial infarct (AMI), the authors tested how well the curves were fit by three functions: the log-normal function, the gamma function, and the funct ...
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Journal ArticleJ Am Coll Cardiol · August 1993
OBJECTIVES: This study was undertaken to establish evidence for physiologic activity and to study the safety of murine-derived monoclonal antibody 7E3 Fab (m7E3 Fab) in patients receiving recombinant tissue-type plasminogen activator (rt-PA). BACKGROUND: P ...
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Journal ArticleAm J Cardiol · April 1, 1993
Despite the proven benefits of thrombolytic therapy in acute myocardial infarction, concern for its complications, especially in patients misdiagnosed with myocardial infarction, has led to hesitancy in its use. Historical, clinical and electrocardiographi ...
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Journal ArticleAm J Cardiol · December 1, 1992
The importance of the timing and completeness of coronary artery reperfusion for limitation of acute myocardial infarction (AMI) size after intravenous thrombolytic therapy was studied in 39 patients. All had electrocardiographic epicardial injury and acut ...
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Journal ArticleUgeskr Laeger · September 21, 1992
Thrombolytic therapy in patients with acute myocardial infarction (AMI) changes the time-concentration curve of serum creatine kinase isoenzyme MB (CK-MB) and serum myoglobin. In this study, 60 AMI patients received thrombolytic therapy and acute coronary ...
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Journal ArticleAm Heart J · September 1992
The results of routine coronary angioplasty using gradual and prolonged balloon inflation with a perfusion balloon catheter were evaluated. One hundred forty patients were treated with inflation of the balloon to 6 atm over 3 minutes, with a median inflati ...
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Journal ArticleJ Am Coll Cardiol · September 1992
OBJECTIVES: The purpose of this study was to further explore the procedural safety of prolonged (15-min) dilation using an autoperfusion coronary angioplasty balloon by assessing the degree of myocardial damage or hemolysis, if any, occurring as a result o ...
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Journal ArticleChest · April 1992
Changes in the economic and therapeutic environment have altered the time frame in which an accurate diagnosis of acute myocardial infarction (AMI) must be made. The advent of effective reperfusion therapies and the increasing emphasis on reducing cost pro ...
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Journal ArticleJ Electrocardiol · 1992
Careful assessment of the ECG and the release patterns of biochemical markers after established reperfusion has made it possible to relate the observed changes to the degree of myocardial salvage, left ventricular function, and clinical outcomes. These obs ...
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Journal ArticleChest · January 1, 1992
Changes in the economic and therapeutic environment have altered the time frame in which an accurate diagnosis of acute myocardial infarction (AMI) must be made. The advent of effective reperfusion therapies and the increasing emphasis on reducing cost pro ...
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Journal ArticleAm J Cardiol · November 15, 1991
The feasibility and applicability of intravascular ultrasound (IVUS) of the coronary arteries were evaluated in 65 patients undergoing 70 coronary interventional procedures. Morphologic and quantitative analyses were performed with a mechanically rotated I ...
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Journal ArticleClin Chim Acta · August 15, 1991
The release sequence of the creatine kinase MM and MB tissue-specific subforms after myocardial reperfusion was elucidated by computer-fitting serial enzyme data from 6 humans in whom coronary flow in the infarct-related artery was angiographically documen ...
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Journal ArticleJ Am Coll Cardiol · May 1991
Despite substantial basic and clinical efforts to address the problem of restenosis after percutaneous coronary intervention, effective preventive therapies have not yet been developed. Nevertheless, the accumulated information has provided much insight in ...
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Journal ArticleAm Heart J · March 1991
To assess the risk and possible benefits of use of the percutaneous IABP in patients given thrombolytic therapy as treatment for acute myocardial infarction, we prospectively evaluated 810 consecutive patients entered into the TAMI trials. During hospitali ...
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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 · September 1990
To determine the clinical consequences of reocclusion of an infarct-related artery after reperfusion therapy, we evaluated 810 patients with acute myocardial infarction. Patients were admitted into four sequential studies with similar entry criteria in whi ...
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Journal ArticleClin Chem · August 1990
We compared relative increases in creatine kinase (EC 2.7.3.2) MB isoenzyme (CK-MB) after reperfusion in myocardial infarction for four popular methods: electrophoresis, immunoinhibition, the "Magic Lite" (Ciba-Corning) system, and the Stratus (Dade). In a ...
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Journal ArticleBr Heart J · June 1990
The value of the 12 lead electrocardiogram, serum total creatine kinase, creatine kinase MB isoenzyme, and myoglobin for the early detection of infarction was evaluated within one hour of admission to the coronary care unit in 82 consecutive patients with ...
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Journal ArticleEur Heart J · April 1990
Regurgitant jets were simulated in vitro and analysed using Doppler colour flow imaging. The regurgitant volumes were estimated using total jet area (JA), variance area (VA), and the maximum area of variance x time to maximum area of variance (MAVT). Both ...
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Journal ArticleCoronary Artery Disease · January 1, 1990
With over 50,000 patients studied in various clinical trials, administration of thrombolytic therapy in acute myocardial infarction is probably the most thoroughly studied pharmacologic intervention in medical history. Since the concept wwas explored that ...
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Journal ArticleClinical Chemistry · January 1, 1990
We compared relative increases in creatine kinase (EC 2.7.3.2) MB isoenzyme (CK-MB) after reperfusion in myocardial infarction for four popular methods: electrophoresis, immunoinhibition, the "Magic Lite" (Ciba-Corning) system, and the Stratus (Dade). In a ...
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Journal ArticleClin Chem · November 1989
Characteristics of CK-MB, the MB1 and MB2 isoforms, and the MB2/MB1 ratio are described in six acute myocardial infarction (AMI) patients in whom the infarct-related artery was identified and, after intervention, normal coronary flow was re-established. Af ...
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Journal ArticleEur Heart J · November 1989
We studied 10 older males during a competitive game and the early post-exercise period to define the metabolic response to squash in veteran players. For comparison, all subjects were also studied during exhaustive treadmill exercise. Squash caused a drama ...
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Journal ArticleJ Cardiovasc Pharmacol · December 1987
Endurance exercise is associated with various cardiovascular adaptations, and these may include changes in sympathoadrenal activity and end-organ responsiveness to norepinephrine (NE). Because beta-adrenoceptor function is a major determinant of sympatheti ...
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Journal ArticleJ R Soc Med · July 1987
The use of topical steroids is associated with adverse systemic effects such as suppression of the hypothalamic-pituitary-adrenal (HPA) axis, and application of more than 50 g per week of clobetasol propionate cream has been shown to cause secondary adrena ...
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Journal ArticleJournal of Cardiovascular Pharmacology · January 1, 1987
Endurance exercise is associated with various cardiovascular adaptations, and these may include changes in sympathoadrenal activity and end-organ responsiveness to norepinephrine (NE). Because (3-adreno-ceptor function is a major determinant of sympathetic ...
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Journal ArticleBr Med J (Clin Res Ed) · November 27, 1982
Serial estimations of activities of creatine kinase and its MB isoenzyme, aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase and of concentrations of alpha(1)-acid glycoprotein were performed in 15 healthy well-trained male mar ...
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