Scholars@Duke
Robert M. Califf

Robert M. Califf

Instructor in the Department of Medicine
Medicine, Cardiology
robert.califf@duke.edu
Box 3533 Med Ctr, Durham, NC 27710
100 Trent Drive, SUITE401, Davison Building, Durham, NC 27710

Selected Publications

Recent Updates to the Declaration of Helsinki: A View from the U.S. Food and Drug Administration.

Journal Article Ther Innov Regul Sci · September 2025 This commentary provides the perspective of the U.S. Food and Drug Administration (FDA) on the World Medical Association's (WMA) recent updates to the Declaration of Helsinki, a foundational document in biomedical research ethics. We highlight the value of ... Full text Link to item Cite

Modernizing Research and Evidence Consensus Definitions: A Food and Drug Administration-National Institutes of Health Collaboration.

Journal Article JAMA Netw Open · June 2, 2025 IMPORTANCE: The US Food and Drug Administration (FDA) and National Institutes of Health (NIH) share a mutual interest in facilitating efficient, well-designed clinical studies of drugs, devices, and biological products. Recent advances in science and techn ... Full text Link to item Cite

A Unified Approach to Health Data Exchange: A Report From the US DHHS.

Journal Article JAMA · March 25, 2025 IMPORTANCE: Health information technology, such as electronic health records (EHRs), has been widely adopted, yet accessing and exchanging data in the fragmented US health care system remains challenging. To unlock the potential of EHR data to improve pati ... Full text Link to item Cite

FDA Perspective on the Regulation of Artificial Intelligence in Health Care and Biomedicine.

Journal Article JAMA · January 21, 2025 IMPORTANCE: Advances in artificial intelligence (AI) must be matched by efforts to better understand and evaluate how AI performs across health care and biomedicine as well as develop appropriate regulatory frameworks. This Special Communication reviews th ... Full text Link to item Cite

When Diversity Goals Meet Multiregional Trials.

Journal Article N Engl J Med · December 28, 2024 Full text Link to item Cite

The role of FDA advisory committees.

Journal Article Nat Med · November 2024 Full text Link to item Cite

Why Evidence Generation Should Matter to Payers and How They Can Help.

Journal Article JAMA · August 6, 2024 IMPORTANCE: The US leads the world in bringing new medical products to market, but the ability to generate evidence to inform clinical practice in postmarket settings needs improvement. Although a diverse group of stakeholders is working to improve postmar ... Full text Link to item Cite

The Integration of Clinical Trials With the Practice of Medicine: Repairing a House Divided.

Journal Article JAMA · July 9, 2024 IMPORTANCE: Optimal health care delivery, both now and in the future, requires a continuous loop of knowledge generation, dissemination, and uptake on how best to provide care, not just determining what interventions work but also how best to ensure they a ... Full text Link to item Cite

The FDA and the Cardiovascular Community.

Journal Article J Am Coll Cardiol · July 2, 2024 Full text Link to item Cite

Over-the-counter Hearing Aids-Reply.

Journal Article JAMA · April 11, 2023 Full text Link to item Cite

Bivalent Covid-19 Vaccines. Reply.

Journal Article N Engl J Med · March 23, 2023 Full text Link to item Cite

Now is the time to fix the evidence generation system.

Journal Article Clin Trials · February 2023 Despite enormous advances in biomedical science, corresponding improvements in health outcomes lag significantly. This is particularly true in the United States, where life expectancy trails far behind that of other high-income countries. In addition, subs ... Full text Link to item Cite

Our National Approach to Diabetes.

Journal Article Diabetes Care · February 1, 2023 Full text Link to item Cite

Biological therapies need definitive randomized controlled clinical trials.

Journal Article Sci Transl Med · January 25, 2023 Adequate and well-controlled clinical trials remain critical tools for helping to bring benefit to patients in medical need. ... Full text Link to item Cite

General Anxiety Disorder-7 Questionnaire as a marker of low socioeconomic status and inequity.

Journal Article J Affect Disord · November 15, 2022 BACKGROUND: The General Anxiety Disorder-7 (GAD-7) questionnaire is a standard tool used for screening and follow-up of patients with Generalized Anxiety Disorder (GAD). Although it is generally accepted that anxiety correlates with clinical and psychosoci ... Full text Link to item Cite

The FDA and the Clinical Community.

Journal Article JAMA · September 20, 2022 Full text Link to item Cite

The FDA and scientific priorities.

Journal Article Science · August 26, 2022 Earlier this year, when I was confirmed as the new commissioner of the US Food and Drug Administration (FDA), the world faced ongoing public health issues related to the pandemic and war in Ukraine, among other challenges. Most notably, the US is experienc ... Full text Link to item Cite

Importance of Social Determinants in Screening for Depression.

Journal Article J Gen Intern Med · August 2022 IMPORTANCE: The most common screening tool for depression is the Patient Health Questionnaire-9 (PHQ-9). Despite extensive research on the clinical and behavioral implications of the PHQ-9, data are limited on the relationship between PHQ-9 scores and soci ... Full text Link to item Cite

Roadmap to 2030 for Drug Evaluation in Older Adults.

Journal Article Clin Pharmacol Ther · August 2022 Changes that accompany older age can alter the pharmacokinetics (PK), pharmacodynamics (PD), and likelihood of adverse effects (AEs) of a drug. However, older adults, especially the oldest or those with multiple chronic health conditions, polypharmacy, or ... Full text Link to item Cite

Clinical Evidence Generation During a Pandemic: Lessons Learned for Sustaining Progress.

Journal Article Cancer J · March 2022 Because of significant adaptations forced by the COVID-19 pandemic, resultant changes within health care delivery and clinical research introduced the potential for evaluation of novel evidence generation approaches in oncology. On July 26 and 27, 2021, th ... Full text Link to item Cite

Biological and clinical correlates of the patient health questionnaire-9: exploratory cross-sectional analyses of the baseline health study.

Journal Article BMJ Open · January 4, 2022 OBJECTIVES: We assessed the relationship between the Patient Health Questionnaire-9 (PHQ-9) at intake and other measurements intended to assess biological factors, markers of disease and health status. DESIGN, SETTING AND PARTICIPANTS: We performed a cross ... Full text Link to item Cite

When Are Treatment Blinding and Treatment Standardization Necessary in Real-World Clinical Trials?

Journal Article Clin Pharmacol Ther · January 2022 Concerns regarding both the limited generalizability and the slow pace of traditional randomized trials have led to calls for greater use of real-world evidence in the evaluation of new treatments or products. Real-world clinical trials or pragmatic trials ... Full text Link to item Cite

When Can Nonrandomized Studies Support Valid Inference Regarding Effectiveness or Safety of New Medical Treatments?

Journal Article Clin Pharmacol Ther · January 2022 The randomized controlled trial (RCT) is the gold standard for evaluating the causal effects of medications. Limitations of RCTs have led to increasing interest in using real-world evidence (RWE) to augment RCT evidence and inform decision making on medica ... Full text Link to item Cite

When Can We Rely on Real-World Evidence to Evaluate New Medical Treatments?

Journal Article Clin Pharmacol Ther · January 2022 Concerns regarding both the limited generalizability and the slow pace of traditional randomized trials have led to calls for greater use of real-world evidence (RWE) in the evaluation of new treatments or products. The RWE label has been used to refer to ... Full text Link to item Cite

When Can We Trust Real-World Data To Evaluate New Medical Treatments?

Journal Article Clin Pharmacol Ther · January 2022 Concerns regarding both the limited generalizability and the slow pace of traditional randomized trials have led to calls for greater use of real-world evidence (RWE) in the evaluation of new treatments or products. RWE studies often rely on real-world dat ... Full text Link to item Cite

Association of left ventricular diastolic function with coronary artery calcium score: A Project Baseline Health Study.

Journal Article J Cardiovasc Comput Tomogr · 2022 BACKGROUND: Coronary artery calcium (CAC) and left ventricular diastolic dysfunction (LVDD) are strong predictors of cardiovascular events and share common risk factors. However, their independent association remains unclear. METHODS: In the Project Baseli ... Full text Link to item Cite

Termination Based on Event Accrual in Per Protocol Versus Intention to Treat in the ROCKET AF Trial.

Journal Article J Am Heart Assoc · October 5, 2021 Background In event-driven clinical trials, study termination is based on accrual of a target number of primary efficacy events. For noninferiority trials in which superiority is conditionally examined, the ideal cohort in which to track event accrual is u ... Full text Link to item Cite

Opioid Use and Its Relationship to Cardiovascular Disease and Brain Health: A Presidential Advisory From the American Heart Association.

Journal Article Circulation · September 28, 2021 The misuse of opioids continues to be epidemic, resulting in dependency and a recent upsurge in drug overdoses that have contributed to a significant decrease in life expectancy in the United States. Moreover, recent data suggest that commonly used opioids ... Full text Link to item Cite

Life expectancy and voting patterns in the 2020 U.S. presidential election.

Journal Article SSM Popul Health · September 2021 INTRODUCTION: In the 2016 U.S. Presidential election, voters in communities with recent stagnation or decline in life expectancy were more likely to vote for the Republican candidate than in prior Presidential elections. We aimed to assess the association ... Full text Link to item Cite

Mapping and quantification of the twitter footprint of cardiologists

Journal Article European Heart Journal Digital Health · September 1, 2021 Aims: The increasing importance placed by medical journals for dissemination of published articles on social media, such as posting Altmetric scores, has further expedited the need for differentiating bona fide science from pseudo-science. The 'Kardashian ... Full text Cite

Toward a mobile platform for real-world digital measurement of depression: User-centered design, data quality, and behavioral and clinical modeling

Journal Article Jmir Mental Health · August 1, 2021 Background: Although effective mental health treatments exist, the ability to match individuals to optimal treatments is poor, and timely assessment of response is difficult. One reason for these challenges is the lack of objective measurement of psychiatr ... Full text Cite

Trial Reporting and the Clinical Trials Enterprise.

Journal Article JAMA Intern Med · August 1, 2021 Full text Link to item Cite

A Call to Action for New Global Approaches to Cardiovascular Disease Drug Solutions.

Journal Article Circulation · July 13, 2021 While we continue to wrestle with the immense challenge of implementing equitable access to established evidence-based treatments, substantial gaps remain in our pharmacotherapy armament for common forms of cardiovascular disease including coronary and per ... Full text Link to item Cite

Assessment of North American Clinical Research Site Performance During the Start-up of Large Cardiovascular Clinical Trials.

Journal Article JAMA Netw Open · July 1, 2021 IMPORTANCE: Randomized clinical trials (RCTs) are critical in advancing patient care, yet conducting such large-scale trials requires tremendous resources and coordination. Clinical site start-up performance metrics can provide insight into opportunities f ... Full text Link to item Cite

Severe Acute Respiratory Syndrome Coronavirus 2 Convalescent Plasma Versus Standard Plasma in Coronavirus Disease 2019 Infected Hospitalized Patients in New York: A Double-Blind Randomized Trial.

Journal Article Crit Care Med · July 1, 2021 OBJECTIVES: Four peer-reviewed publications have reported results from randomized controlled trials of convalescent plasma for coronavirus disease 2019 infection; none were conducted in the United States nor used standard plasma as a comparator. To determi ... Full text Link to item Cite

Rural-Urban Disparity in Mortality in the US From 1999 to 2019.

Journal Article JAMA · June 8, 2021 This study analyzes all deaths occurring in the US using the US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database from 1999-2019 and the National Center for Health Statistics Urban-Rural Classification ... Full text Link to item Cite

Avoiding the Coming Tsunami of Common, Chronic Disease: What the Lessons of the COVID-19 Pandemic Can Teach Us.

Journal Article Circulation · May 11, 2021 During the past year, clinicians and the public have been focused on the coronavirus disease 2019 (COVID-19) pandemic and its associated societal and economic effects. However, once the acute phase of this crisis has passed, we will face an enormous wave o ... Full text Link to item Cite

A call to action for new global approaches to cardiovascular disease drug solutions.

Journal Article Eur Heart J · April 14, 2021 Whilst we continue to wrestle with the immense challenge of implementing equitable access to established evidence-based treatments, substantial gaps remain in our pharmacotherapy armament for common forms of cardiovascular disease including coronary and pe ... Full text Link to item Cite

Plasma Volume Status and Its Association With In-Hospital and Postdischarge Outcomes in Decompensated Heart Failure.

Journal Article J Card Fail · March 2021 BACKGROUND: Prior analyses suggest an association between formula-based plasma volume (PV) estimates and outcomes in heart failure (HF). We assessed the association between estimated PV status by the Duarte-ePV and Kaplan Hakim (KH-ePVS) formulas, and in-h ... Full text Link to item Cite

Return of individual research results: What do participants prefer and expect?

Journal Article PLoS One · 2021 Newer data platforms offer increased opportunity to share multidimensional health data with research participants, but the preferences of participants for which data to receive and how is evolving. Our objective is to describe the preferences and expectati ... Full text Link to item Cite

A holistic approach for suppression of COVID-19 spread in workplaces and universities.

Journal Article PLoS One · 2021 As society has moved past the initial phase of the COVID-19 crisis that relied on broad-spectrum shutdowns as a stopgap method, industries and institutions have faced the daunting question of how to return to a stabilized state of activities and more fully ... Full text Link to item Cite

COVID-19 Clinical Trials: A Teachable Moment for Improving Our Research Infrastructure and Relevance.

Journal Article Ann Intern Med · October 20, 2020 The authors posit the need for rapid evaluation of therapies for COVID-19 as an inflection point spurring a much-needed rethinking of our research enterprise. ... Full text Link to item Cite

Benchmarking the Cost-Effectiveness of Interventions Delaying Diabetes: A Simulation Study Based on NAVIGATOR Data.

Journal Article Diabetes Care · October 2020 OBJECTIVE: To estimate using the UK Prospective Diabetes Study Outcomes Model Version 2 (UKPDS-OM2) the impact of delaying type 2 diabetes onset on costs and quality-adjusted life expectancy using trial participants who developed diabetes in the NAVIGATOR ... Full text Link to item Cite

Development and Validation of a Natural Language Processing Tool to Generate the CONSORT Reporting Checklist for Randomized Clinical Trials.

Journal Article JAMA Netw Open · October 1, 2020 IMPORTANCE: Adherence to the Consolidated Standards of Reporting Trials (CONSORT) for randomized clinical trials is associated with improvingquality because inadequate reporting in randomized clinical trials may complicate the interpretation and the applic ... Full text Link to item Cite

Prospective Evaluation of Malignancy in 17,708 Patients Randomized to Ezetimibe Versus Placebo: Analysis From IMPROVE-IT.

Journal Article JACC CardioOncol · September 2020 BACKGROUND: An increased risk of malignancy was reported with simvastatin/ezetimibe in 1,873 patients in the SEAS (Simvastatin and Ezetimibe in Aortic Stenosis) trial. OBJECTIVES: The purpose of this study was to clarify this unexpected finding in a larger ... Full text Link to item Cite

Randomized Trials Versus Common Sense and Clinical Observation: JACC Review Topic of the Week.

Journal Article J Am Coll Cardiol · August 4, 2020 Concerns about the external validity of traditional randomized clinical trials (RCTs), together with the widespread availability of real-world data and advanced data analytic tools, have led to claims that common sense and clinical observation, rather than ... Full text Open Access Link to item Cite

Levels of evidence supporting drug, device, and other recommendations in the American Heart Association/American College of Cardiology guidelines.

Journal Article Am Heart J · August 2020 UNLABELLED: Clinical guideline documents reflect the evidence supporting clinical practice, but few recommendations in cardiovascular guidelines are supported by evidence from randomized controlled trials (RCTs), the highest level of evidence. Incentives f ... Full text Link to item Cite

Precision Health Analytics With Predictive Analytics and Implementation Research: JACC State-of-the-Art Review.

Journal Article J Am Coll Cardiol · July 21, 2020 Emerging data science techniques of predictive analytics expand the quality and quantity of complex data relevant to human health and provide opportunities for understanding and control of conditions such as heart, lung, blood, and sleep disorders. To real ... Full text Link to item Cite

Understanding the use of observational and randomized data in cardiovascular medicine.

Journal Article Eur Heart J · July 14, 2020 The availability of large datasets from multiple sources [e.g. registries, biobanks, electronic health records (EHRs), claims or billing databases, implantable devices, wearable sensors, and mobile apps], coupled with advances in computing and analytic tec ... Full text Link to item Cite

Improving Cardiovascular Drug and Device Development and Evidence Through Patient-Centered Research and Clinical Trials: A Call to Action From the Value in Healthcare Initiative's Partnering With Regulators Learning Collaborative.

Journal Article Circ Cardiovasc Qual Outcomes · July 2020 The pipeline of new cardiovascular drugs is relatively limited compared with many other clinical areas. Challenges causing lagging drug innovation include the duration and expense of cardiovascular clinical trials needed for regulatory evaluation and appro ... Full text Link to item Cite

Rural-Urban Differences in Cardiovascular Mortality in the US, 1999-2017.

Journal Article JAMA · May 12, 2020 This study used data from the US Centers for Disease Control and Prevention WONDER database to examined temporal trends in cardiovascular disease age-adjusted mortality rates overall and across subgroups stratified by rural-urban area designation in the US ... Full text Link to item Cite

Reimagining What We Measure in Atherosclerosis-a "Phenotype Stack".

Journal Article Circ Res · April 24, 2020 The term phenotype is so commonly used that we often assume that we each mean the same thing. The general definition, the set of observable characteristics of an individual resulting from the interaction of their genotype with the environment, is often lef ... Full text Link to item Cite

Impact of Regulatory Guidance on Evaluating Cardiovascular Risk of New Glucose-Lowering Therapies to Treat Type 2 Diabetes Mellitus: Lessons Learned and Future Directions.

Journal Article Circulation · March 10, 2020 Responding to concerns about the potential for increased risk of adverse cardiovascular outcomes, specifically myocardial infarction, associated with certain glucose-lowering therapies, the US Food and Drug Administration and the Committee for Medicinal Pr ... Full text Link to item Cite

Call to Action: Rural Health: A Presidential Advisory From the American Heart Association and American Stroke Association.

Journal Article Circulation · March 10, 2020 Understanding and addressing the unique health needs of people residing in rural America is critical to the American Heart Association's pursuit of a world with longer, healthier lives. Improving the health of rural populations is consistent with the Ameri ... Full text Link to item Cite

New Approaches to Conducting Randomized Controlled Trials.

Journal Article J Am Coll Cardiol · February 11, 2020 Full text Link to item Cite

Big Data in the Assessment of Pediatric Medication Safety.

Journal Article Pediatrics · February 2020 Big data (BD) in pediatric medication safety research provides many opportunities to improve the safety and health of children. The number of pediatric medication and device trials has increased in part because of the past 20 years of US legislation requir ... Full text Link to item Cite

A Perspective on the K-Index.

Journal Article JACC Case Rep · February 2020 Full text Link to item Cite

Impact of baseline covariate imbalance on bias in treatment effect estimation in cluster randomized trials: Race as an example.

Journal Article Contemp Clin Trials · January 2020 Individual-level baseline covariate imbalance could happen more frequently in cluster randomized trials, and may influence the observed treatment effect. Using computer and real-data simulations, this paper quantifies the extent and impact of covariate imb ... Full text Link to item Cite

The Project Baseline Health Study: a step towards a broader mission to map human health.

Journal Article NPJ Digit Med · 2020 The Project Baseline Health Study (PBHS) was launched to map human health through a comprehensive understanding of both the health of an individual and how it relates to the broader population. The study will contribute to the creation of a biomedical info ... Full text Open Access Link to item Cite

Digitizing clinical trials.

Journal Article NPJ Digit Med · 2020 Clinical trials are a fundamental tool used to evaluate the efficacy and safety of new drugs and medical devices and other health system interventions. The traditional clinical trials system acts as a quality funnel for the development and implementation o ... Full text Link to item Cite

Claims-based cardiovascular outcome identification for clinical research: Results from 7 large randomized cardiovascular clinical trials.

Journal Article Am Heart J · December 2019 BACKGROUND: Medicare insurance claims may provide an efficient means to ascertain follow-up of older participants in clinical research. We sought to determine the accuracy and completeness of claims- versus site-based follow-up with clinical event committe ... Full text Link to item Cite

It is time to learn from patients like mine

Journal Article Npj Digital Medicine · December 1, 2019 Clinicians are often faced with situations where published treatment guidelines do not provide a clear recommendation. In such situations, evidence generated from similar patients’ data captured in electronic health records (EHRs) can aid decision making. ... Full text Cite

Representativeness of a Heart Failure Trial by Race and Sex: Results From ASCEND-HF and GWTG-HF.

Journal Article JACC Heart Fail · November 2019 OBJECTIVES: This study sought to determine the degree to which U.S. patients enrolled in a heart failure (HF) trial represent patients in routine U.S. clinical practice according to race and sex. BACKGROUND: Black patients and women are frequently under-re ... Full text Link to item Cite

Technology-Enabled Clinical Trials: Transforming Medical Evidence Generation.

Journal Article Circulation · October 22, 2019 The complexity and costs associated with traditional randomized, controlled trials have increased exponentially over time, and now threaten to stifle the development of new drugs and devices. Nevertheless, the growing use of electronic health records, mobi ... Full text Link to item Cite

Oral Fluoroquinolones.

Journal Article J Am Coll Cardiol · September 17, 2019 Full text Link to item Cite

Proposals to Lower Medication Costs-Reply.

Journal Article JAMA · September 10, 2019 Full text Link to item Cite

Effect of Simvastatin-Ezetimibe Compared With Simvastatin Monotherapy After Acute Coronary Syndrome Among Patients 75 Years or Older: A Secondary Analysis of a Randomized Clinical Trial.

Journal Article JAMA Cardiol · September 1, 2019 IMPORTANCE: Limited evidence is available regarding the benefit and hazard of higher-intensity treatment to lower lipid levels among patients 75 years or older. As a result, guideline recommendations differ for this age group compared with younger patients ... Full text Link to item Cite

Biomarkers and Clinical Cardiovascular Outcomes With Ezetimibe in the IMPROVE-IT Trial.

Journal Article J Am Coll Cardiol · August 27, 2019 BACKGROUND: Addition of ezetimibe to statin therapy reduces the risk of recurrent cardiovascular (CV) events in patients with prior acute coronary syndrome (ACS). The role of biomarkers in identifying subsets of patients who may derive greater clinical ben ... Full text Link to item Cite

Implementation of a responsible conduct of research education program at Duke University School of Medicine.

Journal Article Account Res · July 2019 Academic medical centers rarely require all of their research faculty and staff to participate in educational programs on the responsible conduct of research (RCR). There is also little published evidence of RCR programs addressing high-profile, internal c ... Full text Link to item Cite

Levels of Evidence Supporting American College of Cardiology/American Heart Association and European Society of Cardiology Guidelines, 2008-2018.

Journal Article JAMA · March 19, 2019 IMPORTANCE: Clinical decisions are ideally based on evidence generated from multiple randomized controlled trials (RCTs) evaluating clinical outcomes, but historically, few clinical guideline recommendations have been based entirely on this type of evidenc ... Full text Link to item Cite

Call to Action: Urgent Challenges in Cardiovascular Disease: A Presidential Advisory From the American Heart Association.

Journal Article Circulation · February 26, 2019 Although advances in care have spurred improvements in cardiovascular outcomes, cardiovascular disease remains the leading cause of death in the United States and around the world. Previous declines in cardiovascular disease mortality have slowed and even ... Full text Link to item Cite

Frequency, Regional Variation, and Predictors of Undetermined Cause of Death in Cardiometabolic Clinical Trials: A Pooled Analysis of 9259 Deaths in 9 Trials.

Journal Article Circulation · February 12, 2019 BACKGROUND: Modern cardiometabolic clinical trials often include cardiovascular death as a component of a composite primary outcome, requiring central adjudication by a clinical events committee to classify cause of death. However, sometimes the cause of d ... Full text Link to item Cite

Medication Discontinuation in the IMPROVE-IT Trial.

Journal Article Circ Cardiovasc Qual Outcomes · January 2019 BACKGROUND: Although cholesterol-lowering medications can reduce the risk of recurrent cardiovascular events, premature discontinuation limits effectiveness. Discontinuation rates have not been systematically reported for lipid-lowering trials. METHODS AND ... Full text Link to item Cite

Seven Former FDA Commissioners: The FDA Should Be An Independent Federal Agency.

Journal Article Health Aff (Millwood) · January 2019 Seven former commissioners of the Food and Drug Administration (FDA) from both sides of the political aisle recommend that the FDA be moved out of the Department of Health and Human Services and reconfigured as an independent federal agency. We believe tha ... Full text Link to item Cite

Assessing heterogeneity of treatment effect analyses in health-related cluster randomized trials: A systematic review.

Journal Article PLoS One · 2019 BACKGROUND: Cluster-randomized trials (CRTs) are being increasingly used to test a range of interventions, including medical interventions commonly used in clinical practice. Policies created by the NIH and the Food and Drug Administration (FDA) require th ... Full text Link to item Cite

Future of Personalized Cardiovascular Medicine: JACC State-of-the-Art Review.

Journal Article J Am Coll Cardiol · December 25, 2018 Previous decades have seen significant progress in the biological understanding of cardiovascular disease, as well as major advances in computational and information technologies. However, anticipated improvements in outcomes, quality, and cost of cardiova ... Full text Link to item Cite

Natural History of Patients Postacute Coronary Syndrome Based on Heart Failure Status.

Journal Article Am J Cardiol · November 1, 2018 The natural history of patients hospitalized for acute coronary syndrome (ACS) with pre-existing versus (vs) de novo heart failure (HF) has not been previously reported over an extended duration of follow-up. The IMPROVE-IT trial enrolled 18,144 patients h ... Full text Link to item Cite

Work and Cardiovascular Disease in China.

Journal Article JAMA network open · November 2018 Full text Cite

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

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

Reply.

Journal Article Clin Gastroenterol Hepatol · October 2018 Full text Open Access Link to item Cite

Relationship Between Enrolling Country Income Level and Patient Profile, Protocol Completion, and Trial End Points.

Journal Article Circ Cardiovasc Qual Outcomes · October 2018 BACKGROUND: Globalization of clinical trials fosters inclusion of higher and lower income countries, but the influence of enrolling country income level on heart failure trial performance is unclear. This study sought to evaluate associations between enrol ... Full text Link to item Cite

Stroke prevention in atrial fibrillation: re-defining 'real-world data' within the broader data universe.

Journal Article Eur Heart J · August 21, 2018 Real-world data (RWD) has been defined as data generated outside of traditional randomized clinical trials (RCTs). Though RWD has received increasing attention from regulatory authorities and professional societies, dividing evidence into that derived from ... Full text Link to item Cite

The future of humans as model organisms.

Journal Article Science · August 10, 2018 Full text Link to item Cite

Heart Failure With Preserved Ejection Fraction Expert Panel Report: Current Controversies and Implications for Clinical Trials.

Journal Article JACC Heart Fail · August 2018 The number of persons with heart failure has continued to rise over the last several years. Approximately one-half of those living with heart failure have heart failure with preserved ejection fraction, but critical unsolved questions remain across the spe ... Full text Open Access Link to item Cite

In Response.

Journal Article Anesth Analg · July 2018 Full text Link to item Cite

Remembering Dr Ray Lipicky.

Journal Article Circulation · March 27, 2018 Full text Link to item Cite

Biomarker definitions and their applications.

Journal Article Exp Biol Med (Maywood) · February 2018 Biomarkers are critical to the rational development of medical therapeutics, but significant confusion persists regarding fundamental definitions and concepts involved in their use in research and clinical practice, particularly in the fields of chronic di ... Full text Link to item Cite

Improving Heart Failure Therapeutics Development in the United States: The Heart Failure Collaboratory.

Journal Article J Am Coll Cardiol · January 30, 2018 The current heart failure clinical trial environment is strained by increasing complexity and cost, regulatory requirements, competing demands on stakeholders, implementation challenges, and decreasing patient and investigator participation. To begin the p ... Full text Link to item Cite

Transforming Psychiatry into Data-Driven Medicine with Digital Measurement Tools.

Journal Article NPJ Digit Med · 2018 Psychiatry has been limited by historically rooted practices centered primarily on subjective observation. Fields such as oncology have progressed toward data-driven clinical decision-making that combines subjective clinical assessment of symptoms and pref ... Full text Link to item Cite

The digital transformation of medicine can revitalize the patient-clinician relationship.

Journal Article NPJ Digit Med · 2018 Health professionals within the medical community feel that the principles of humanism in medicine have not been a point of emphasis for information and computer technology in healthcare. There is concern that the electronic health record is eroding the pa ... Full text Link to item Cite

The ubiquity of data & communication: A double-edged sword for disparities

Journal Article Behavioral Science and Policy · January 1, 2018 The fourth industrial revolution, in which most information is stored in digital form, is characterized by connectivity and communication among people and groups via, for instance, cell phones and smart watches. The amount of information now generated abou ... Full text Cite

Large Clinical Trials and Registries-Clinical Research Institutes

Chapter · January 1, 2018 The growing need for high-quality scientific evidence to inform medical practice and decision-making is placing increasing pressure on the clinical research enterprise. Although new diagnostic and therapeutic technologies offer dramatic opportunities to im ... Full text Cite

Accelerating development of scientific evidence for medical products within the existing US regulatory framework.

Journal Article Nat Rev Drug Discov · May 2017 Growing access to diverse 'real-world' data sources is enabling new approaches to close persistent evidence gaps about the optimal use of medical products in real-world practice. Here, we argue that contrary to widespread impressions, existing FDA regulati ... Full text Link to item Cite

Launching Effectiveness Research to Guide Practice in Neurosurgery: A National Institute Neurological Disorders and Stroke Workshop Report.

Journal Article Neurosurgery · April 1, 2017 This workshop addressed challenges of clinical research in neurosurgery. Randomized controlled clinical trials (RCTs) have high internal validity, but often insufficiently generalize to real-world practice. Observational studies are inclusive but often lac ... Full text Link to item Cite

Warning About Shortcuts in Drug Development.

Journal Article J Am Heart Assoc · March 21, 2017 Full text Link to item Cite

Clarifying Stem-Cell Therapy's Benefits and Risks.

Journal Article N Engl J Med · March 16, 2017 Full text Link to item Cite

Improving Medication Adherence in Cardiometabolic Disease: Practical and Regulatory Implications.

Journal Article J Am Coll Cardiol · January 31, 2017 Medication nonadherence, a major problem in cardiovascular disease (CVD), contributes yearly to approximately 125,000 preventable deaths, which is partly attributable to only about one-half of CVD patients consistently taking prescribed life-saving medicat ... Full text Link to item Cite

Transparency at the U.S. food and drug administration

Journal Article Journal of Law Medicine and Ethics · January 1, 2017 Full text Cite

The regulatory landscape

Chapter · January 1, 2017 We now have a world turned upside down. ... Full text Cite

Clinical Trials

Chapter · January 1, 2017 The chapter gives an overview of clinical trials. Medical practice has entered an era of "evidence-based medicine" characterized by an increasingly widespread societal belief that clinical practice should be based on scientific information in addition to i ... Full text Cite

The US Food and Drug Administration and the Future of Cardiovascular Medicine.

Journal Article JAMA Cardiol · November 1, 2016 Cardiovascular medicine has led the drive for creativity and innovation with a culture that has been at the forefront of evidence generation. However, we are functioning at only a fraction of our evidence generation capacity. Despite the leadership of card ... Full text Link to item Cite

Overcoming the Challenges of Conducting Early Feasibility Studies of Medical Devices in the United States.

Journal Article J Am Coll Cardiol · October 25, 2016 Initial clinical studies of new medical technologies involve a complex balance of research participant benefits versus risks and costs of uncertainty when novel concepts are tested. The Food and Drug Administration Center for Devices and Radiological Healt ... Full text Link to item Cite

Pragmatic clinical trials: Emerging challenges and new roles for statisticians.

Journal Article Clin Trials · October 2016 Patients, clinicians, and policymakers alike need access to high-quality scientific evidence in order to make informed choices about health and healthcare, but the current national clinical trials enterprise is not yet optimally configured for the efficien ... Full text Link to item Cite

Reducing Health Inequities in the U.S.: Recommendations From the NHLBI's Health Inequities Think Tank Meeting.

Journal Article J Am Coll Cardiol · August 2, 2016 The National, Heart, Lung, and Blood Institute convened a Think Tank meeting to obtain insight and recommendations regarding the objectives and design of the next generation of research aimed at reducing health inequities in the United States. The panel re ... Full text Link to item Cite

TRENDS IN THE CARE AND OUTCOMES OF MEDICARE BENEFICIARIES WITH TYPE 2 DIABETES, 2002-2011.

Journal Article Endocr Pract · August 2016 OBJECTIVE: To summarize characteristics of Medicare beneficiaries with type 2 diabetes and to describe changing trends in care and outcomes. METHODS: We conducted a retrospective cohort study of a nationally representative 5% sample of fee-for-service Medi ... Full text Link to item Cite

Native valve disease in patients with non-valvular atrial fibrillation on warfarin or rivaroxaban.

Journal Article Heart · July 1, 2016 OBJECTIVE: To compare the characteristics and outcomes of patients with atrial fibrillation (AF) and aortic stenosis (AS) with patients with AF with mitral regurgitation (MR) or aortic regurgitation (AR) and patients without significant valve disease (no S ... Full text Link to item Cite

Effect of single and dual renin-angiotensin blockade on stroke in patients with and without diabetes in VALIANT.

Journal Article Eur Stroke J · June 2016 INTRODUCTION: Concern has been raised about a possible increase in risk of stroke in patients with diabetes treated with the combination of the renin-inhibitor aliskiren and an angiotensin converting enzyme inhibitor or angiotensin receptor blocker. We com ... Full text Link to item Cite

Author Reply.

Other Urology · May 2016 Full text Link to item Cite

Emerging Research Directions in Adult Congenital Heart Disease: A Report From an NHLBI/ACHA Working Group.

Journal Article J Am Coll Cardiol · April 26, 2016 Congenital heart disease (CHD) is the most common birth defect, affecting about 0.8% of live births. Advances in recent decades have allowed >85% of children with CHD to survive to adulthood, creating a growing population of adults with CHD. Little informa ... Full text Link to item Cite

A Proactive Response to Prescription Opioid Abuse.

Journal Article N Engl J Med · April 14, 2016 Full text Link to item Cite

Arrival by ambulance in acute heart failure: insights into the mode of presentation from Acute Studies of Nesiritide in Decompensated Heart Failure (ASCEND-HF).

Journal Article BMJ Open · March 17, 2016 OBJECTIVES: Limited data exist assessing the relationship between ambulance versus self-presentation and outcomes in patients with acute heart failure (AHF). SETTING: Clinical trial sites in North America. PARTICIPANTS: 1068 patients enrolled in the Acute ... Full text Link to item Cite

Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation: Data From ROCKET AF.

Journal Article J Am Heart Assoc · March 8, 2016 BACKGROUND: Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. METHODS AND RESULTS: In the Rivaroxaban Once Daily Oral Direct Factor Xa I ... Full text Link to item Cite

Reply.

Journal Article Clin Gastroenterol Hepatol · March 2016 Full text Link to item Cite

Altered Maturation Status and Possible Immune Exhaustion of CD8 T Lymphocytes in the Peripheral Blood of Patients Presenting With Acute Coronary Syndromes.

Journal Article Arterioscler Thromb Vasc Biol · February 2016 OBJECTIVE: Inflammation in response to oxidized lipoproteins is thought to play a key role in acute coronary syndromes (ACS), but the pattern of immune activation has not been fully characterized. We sought to perform detailed phenotypic and functional ana ... Full text Link to item Cite

High-degree atrioventricular block, asystole, and electro-mechanical dissociation complicating non-ST-segment elevation myocardial infarction.

Journal Article Am Heart J · January 2016 UNLABELLED: Non-ST-segment myocardial infarction (NSTEMI) can be complicated by high-degree atrioventricular (AV) block, asystole, or electromechanical dissociation (EMD), but these events are not well characterized in the contemporary era. This analysis a ... Full text Link to item Cite

Anticipated Ethics and Regulatory Challenges in PCORnet: The National Patient-Centered Clinical Research Network.

Journal Article Account Res · 2016 PCORnet, the National Patient-Centered Clinical Research Network, seeks to establish a robust national health data network for patient-centered comparative effectiveness research. This article reports the results of a PCORnet survey designed to identify th ... Full text Link to item Cite

CTSA Consortium Consensus Scientific Review Committee (SRC) Working Group Report on the SRC Processes.

Journal Article Clin Transl Sci · December 2015 Human research projects must have a scientifically valid study design, analytic plan, and be operationally feasible in order to be successfully completed and thus to have translational impact. To ensure this, institutions that conduct clinical research sho ... Full text Link to item Cite

Acquisition, Analysis, and Sharing of Data in 2015 and Beyond: A Survey of the Landscape: A Conference Report From the American Heart Association Data Summit 2015.

Journal Article J Am Heart Assoc · November 5, 2015 BACKGROUND: A 1.5-day interactive forum was convened to discuss critical issues in the acquisition, analysis, and sharing of data in the field of cardiovascular and stroke science. The discussion will serve as the foundation for the American Heart Associat ... Full text Open Access Link to item Cite

Circulating Kidney Injury Molecule-1 Levels in Acute Heart Failure: Insights From the ASCEND-HF Trial (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure).

Journal Article JACC Heart Fail · October 2015 OBJECTIVES: This study sought to determine the relationship of KIM-1 levels with adverse clinical outcomes in acute decompensated heart failure (ADHF). BACKGROUND: Kidney injury molecule (KIM)-1 is a biomarker expressed by the nephron in acute tubular inju ... Full text Link to item Cite

Exploring the ethical and regulatory issues in pragmatic clinical trials.

Journal Article Clin Trials · October 2015 The need for high-quality evidence to support decision making about health and health care by patients, physicians, care providers, and policy-makers is well documented. However, serious shortcomings in evidence persist. Pragmatic clinical trials that use ... Full text Link to item Cite

Acute Heart Failure and Atrial Fibrillation: Insights From the Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure (ASCEND-HF) Trial.

Journal Article J Am Heart Assoc · August 24, 2015 BACKGROUND: Patients with acute heart failure (AHF) frequently have atrial fibrillation (AF), but how this affects patient-reported outcomes has not been well characterized. METHODS AND RESULTS: We examined dyspnea improvement and clinical outcomes in 7007 ... Full text Link to item Cite

Prospective relationships between body weight and physical activity: an observational analysis from the NAVIGATOR study.

Journal Article BMJ Open · August 14, 2015 OBJECTIVES: While bidirectional relationships exist between body weight and physical activity, direction of causality remains uncertain and previous studies have been limited by self-reported activity or weight and small sample size. We investigated the pr ... Full text Link to item Cite

Physical activity as a determinant of fasting and 2-h post-challenge glucose: a prospective cohort analysis of the NAVIGATOR trial.

Journal Article Diabet Med · August 2015 AIM: To investigate whether previous physical activity levels are associated with blood glucose levels in individuals with impaired glucose tolerance in the context of an international pharmaceutical trial. METHODS: Data were analysed from the NAVIGATOR tr ... Full text Link to item Cite

Worsening heart failure during hospitalization for acute heart failure: Insights from the Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure (ASCEND-HF).

Journal Article Am Heart J · August 2015 BACKGROUND: Despite initial in-hospital treatment of acute heart failure (HF), some patients experience worsening HF (WHF). There are limited data about the outcomes and characteristics of patients who experience in-hospital WHF. METHODS AND RESULTS: We as ... Full text Link to item Cite

Predictors of clinical outcomes in acute decompensated heart failure: Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure outcome models.

Journal Article Am Heart J · August 2015 BACKGROUND: Patients hospitalized for acute decompensated heart failure (ADHF) are at high risk for early mortality and rehospitalization. Risk stratification of ADHF using clinically available data on admission is increasingly important to integrate with ... Full text Link to item Cite

Diuretic response in acute heart failure-an analysis from ASCEND-HF.

Journal Article Am Heart J · August 2015 BACKGROUND: Diuretic unresponsiveness often occurs during hospital admission for acute heart failure (AHF) and is associated with adverse outcome. This study aims to investigate determinants, clinical outcome, and the effects of nesiritide on diuretic resp ... Full text Link to item Cite

Sunscreen and the FDA.

Journal Article N Engl J Med · July 9, 2015 Full text Link to item Cite

Effects of the dual peroxisome proliferator-activated receptor activator aleglitazar in patients with Type 2 Diabetes mellitus or prediabetes.

Journal Article Am Heart J · July 2015 BACKGROUND: Insulin-resistant states, including type 2 diabetes (T2D) and prediabetes, are associated with elevated cardiovascular (CV) risk. Aleglitazar is a dual peroxisome proliferator-activated receptor α/γ agonist with favorable insulin-sensitizing an ... Full text Link to item Cite

Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes.

Journal Article N Engl J Med · June 18, 2015 BACKGROUND: Statin therapy reduces low-density lipoprotein (LDL) cholesterol levels and the risk of cardiovascular events, but whether the addition of ezetimibe, a nonstatin drug that reduces intestinal cholesterol absorption, can reduce the rate of cardio ... Full text Link to item Cite

Digoxin use in patients with atrial fibrillation and adverse cardiovascular outcomes: a retrospective analysis of the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF).

Journal Article Lancet · June 13, 2015 BACKGROUND: Digoxin is a widely used drug for ventricular rate control in patients with atrial fibrillation (AF), despite a scarcity of randomised trial data. We studied the use and outcomes of digoxin in patients in the Rivaroxaban Once Daily Oral Direct ... Full text Link to item Cite

Ethical and regulatory issues of pragmatic cluster randomized trials in contemporary health systems.

Journal Article Clin Trials · June 2015 Cluster randomized trials randomly assign groups of individuals to examine research questions or test interventions and measure their effects on individuals. Recent emphasis on quality improvement, comparative effectiveness, and learning health systems has ... Full text Link to item Cite

The future of cardiovascular clinical research in North America and beyond-addressing challenges and leveraging opportunities through unique academic and grassroots collaborations.

Journal Article Am Heart J · June 2015 Recent developments have highlighted the challenges facing cardiovascular clinical research in global contemporary practice, particularly in North America, including shifting priorities for drug development targets, increasing regulatory requirements, and ... Full text Link to item Cite

Utility of socioeconomic status in predicting 30-day outcomes after heart failure hospitalization.

Journal Article Circ Heart Fail · May 2015 BACKGROUND: An individual's socioeconomic status (SES) is associated with health outcomes and mortality, yet it is unknown whether accounting for SES can improve risk-adjustment models for 30-day outcomes among Centers for Medicare & Medicaid Services bene ... Full text Link to item Cite

Cardiovascular drug development: is it dead or just hibernating?

Journal Article J Am Coll Cardiol · April 21, 2015 Despite the global burden of cardiovascular disease, investment in cardiovascular drug development has stagnated over the past 2 decades, with relative underinvestment compared with other therapeutic areas. The reasons for this trend are multifactorial, bu ... Full text Link to item Cite

Regional, age and sex differences in baseline characteristics of patients enrolled in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS).

Journal Article Diabetes Obes Metab · April 2015 AIMS: To report baseline characteristics and cardiovascular (CV) risk management by region, age, sex and CV event type for 14 724 participants in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS), a randomized, double-blind, placebo-con ... Full text Link to item Cite

Compliance with results reporting at ClinicalTrials.gov.

Journal Article N Engl J Med · March 12, 2015 BACKGROUND: The Food and Drug Administration Amendments Act (FDAAA) mandates timely reporting of results of applicable clinical trials to ClinicalTrials.gov. We characterized the proportion of applicable clinical trials with publicly available results and ... Full text Open Access Link to item Cite

Alternative calculations of individual patient time in therapeutic range while taking warfarin: results from the ROCKET AF trial.

Journal Article J Am Heart Assoc · March 3, 2015 BACKGROUND: In the ROCKET AF (Rivaroxaban-Once-daily, oral, direct Factor Xa inhibition Compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation) trial, marked regional differences in control of warfarin anticoa ... Full text Link to item Cite

Loop diuretic dose adjustments after a hospitalization for heart failure: insights from ASCEND-HF.

Conference Eur J Heart Fail · March 2015 AIMS: Loop diuretics are a cornerstone of heart failure (HF) treatment, but data regarding diuretic dose adjustments after a HF hospitalization and the association with subsequent outcomes are limited. This study was therefore conducted to determine these ... Full text Link to item Cite

Venous thromboembolism and cardiovascular risk: results from the NAVIGATOR trial.

Journal Article Am J Med · March 2015 BACKGROUND: Contemporary studies suggest an association between venous thromboembolism and a higher incidence of major cardiovascular events, mostly attributed to arterial atherothrombosis. Using data from the Nateglinide and Valsartan in Impaired Glucose ... Full text Link to item Cite

Sex differences in clinical characteristics and outcomes after myocardial infarction: insights from the Valsartan in Acute Myocardial Infarction Trial (VALIANT).

Journal Article Eur J Heart Fail · March 2015 BACKGROUND: We examined the association of sex with clinical characteristics and outcomes in patients following myocardial infarction (MI) in the Valsartan in Acute Myocardial Infarction Trial (VALIANT). METHODS AND RESULTS: A total of 4570 women and 10 13 ... Full text Link to item Cite

Methods and initial findings from the Durham Diabetes Coalition: Integrating geospatial health technology and community interventions to reduce death and disability.

Journal Article J Clin Transl Endocrinol · March 2015 OBJECTIVE: The Durham Diabetes Coalition (DDC) was established in response to escalating rates of disability and death related to type 2 diabetes mellitus, particularly among racial/ethnic minorities and persons of low socioeconomic status in Durham County ... Full text Link to item Cite

Implementation of management strategies for diabetes and hypertension: from local to global health in cardiovascular diseases.

Journal Article Glob Heart · March 2015 Diabetes and hypertension are chronic conditions that are growing in prevalence as major causal factors of cardiovascular disease (CVD). The need for chronic-illness surveillance, population-risk management, and successful treatment interventions are cruci ... Full text Link to item Cite

LCZ696: too good to be true?

Journal Article Eur Heart J · February 14, 2015 Full text Link to item Cite

Higher risk of death and stroke in patients with persistent vs. paroxysmal atrial fibrillation: results from the ROCKET-AF Trial.

Journal Article Eur Heart J · February 1, 2015 AIM: Anticoagulation prophylaxis for stroke is recommended for at-risk patients with either persistent or paroxysmal atrial fibrillation (AF). We compared outcomes in patients with persistent vs. paroxysmal AF receiving oral anticoagulation. METHODS AND RE ... Full text Link to item Cite

Simultaneous consideration of multiple candidate protein biomarkers for long-term risk for cardiovascular events.

Journal Article Circ Cardiovasc Genet · February 2015 BACKGROUND: Although individual protein biomarkers are associated with cardiovascular risk, rarely have multiple proteins been considered simultaneously to identify which set of proteins best predicts risk. METHODS AND RESULTS: In a nested case-control stu ... Full text Link to item Cite

Translation of acute coronary syndrome therapies: from evidence to routine clinical practice.

Journal Article Am Heart J · February 2015 BACKGROUND: The use of evidence-based therapies has improved the outcome of patients with acute coronary syndrome (ACS), but there is a time lag between the generation of clinical evidence and its application in routine clinical practice. We sought to quan ... Full text Link to item Cite

Comparative assessment of short-term adverse events in acute heart failure with cystatin C and other estimates of renal function: results from the ASCEND-HF trial.

Journal Article JACC Heart Fail · January 2015 OBJECTIVES: The purpose of this study was to investigate the predictive values of baseline and changes in cystatin C (CysC) and its derived equations for short-term adverse outcomes and the effect of nesiritide therapy on CysC in acute decompensated heart ... Full text Link to item Cite

Long-term clinical and angiographic outcomes in patients with diabetes undergoing coronary artery bypass graft surgery: results from the Project of Ex-vivo Vein Graft Engineering via Transfection IV trial.

Journal Article Am Heart J · January 2015 BACKGROUND: There is limited information about the association between diabetes, its treatment, and long-term angiographic and clinical outcomes in patients undergoing coronary artery bypass graft surgery (CABG). We evaluated the association of diabetes an ... Full text Link to item Cite

Acute decompensated heart failure patients admitted to critical care units: insights from ASCEND-HF.

Journal Article Int J Cardiol · December 20, 2014 BACKGROUND: Little is known about global patterns of critical care unit (CCU) care and the relationship with outcomes in patients with acute decompensated heart failure (ADHF). Whether a ward or a CCU admission is associated with better outcomes is unclear ... Full text Link to item Cite

Clinical characteristics and outcomes with rivaroxaban vs. warfarin in patients with non-valvular atrial fibrillation but underlying native mitral and aortic valve disease participating in the ROCKET AF trial.

Journal Article Eur Heart J · December 14, 2014 AIMS: We investigated clinical characteristics and outcomes of patients with significant valvular disease (SVD) in the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in ... Full text Link to item Cite

Change in levels of physical activity after diagnosis of type 2 diabetes: an observational analysis from the NAVIGATOR study.

Journal Article Diabetes Obes Metab · December 2014 Increased physical activity is known to be beneficial in people with type 2 diabetes mellitus (T2DM), but it is not known whether individuals change their activity levels after T2DM diagnosis. The present Nateglinide and Valsartan in Impaired Glucose Toler ... Full text Link to item Cite

Commentary on Vickers.

Journal Article Clin Trials · December 2014 Full text Link to item Cite

Extent, location, and clinical significance of non-infarct-related coronary artery disease among patients with ST-elevation myocardial infarction.

Journal Article JAMA · 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, ... Full text Link to item Cite

Clinical trials in peripheral vascular disease: pipeline and trial designs: an evaluation of the ClinicalTrials.gov database.

Conference Circulation · November 11, 2014 BACKGROUND: Tremendous advances have occurred in therapies for peripheral vascular disease (PVD); until recently, however, it has not been possible to examine the entire clinical trial portfolio of studies for the treatment of PVD (both arterial and venous ... Full text Link to item Cite

Hypotension during hospitalization for acute heart failure is independently associated with 30-day mortality: findings from ASCEND-HF.

Journal Article Circ Heart Fail · November 2014 BACKGROUND: Outcomes associated with episodes of hypotension while hospitalized with acute decompensated heart failure are not well understood. METHODS AND RESULTS: Using data from Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart ... Full text Link to item Cite

Check it, change it: a community-based, multifaceted intervention to improve blood pressure control.

Journal Article Circ Cardiovasc Qual Outcomes · November 2014 BACKGROUND: Although home blood pressure (BP) monitoring interventions have shown potential in selected populations, it is unclear whether such strategies can be generalized. We sought to determine whether a multifaceted BP control program that uses a web- ... Full text Link to item Cite

The Clinical Trials Transformation Initiative: innovation through collaboration.

Journal Article Nat Rev Drug Discov · November 2014 The Clinical Trials Transformation Initiative (CTTI) identifies and promotes practices to increase the quality and efficiency of clinical trials through projects that generate empirical data on how trials are currently conducted, leading to recommendations ... Full text Link to item Cite

Saphenous vein graft failure after coronary artery bypass surgery: insights from PREVENT IV.

Journal Article Circulation · October 21, 2014 BACKGROUND: Coronary artery bypass grafting success is limited by vein graft failure (VGF). Understanding the factors associated with VGF may improve patient outcomes. METHODS AND RESULTS: We examined 1828 participants in the Project of Ex Vivo Vein Graft ... Full text Link to item Cite

Nesiritide, renal function, and associated outcomes during hospitalization for acute decompensated heart failure: results from the Acute Study of Clinical Effectiveness of Nesiritide and Decompensated Heart Failure (ASCEND-HF).

Journal Article Circulation · September 16, 2014 BACKGROUND: Contradictory results have been reported on the effects of nesiritide on renal function in patients with acute decompensated heart failure. We studied the effects of nesiritide on renal function during hospitalization for acute decompensated he ... Full text Link to item Cite

Addressing barriers to optimal oral anticoagulation use and persistence among patients with atrial fibrillation: Proceedings, Washington, DC, December 3-4, 2012.

Journal Article Am Heart J · September 2014 Approximately half of patients with atrial fibrillation and with risk factors for stroke are not treated with oral anticoagulation (OAC), whether it be with vitamin K antagonists (VKAs) or novel OACs (NOACs); and of those treated, many discontinue treatmen ... Full text Open Access Link to item Cite

Population pharmacokinetics and pharmacodynamics of rivaroxaban in patients with non-valvular atrial fibrillation: results from ROCKET AF.

Journal Article J Clin Pharmacol · August 2014 Two once-daily rivaroxaban dosing regimens were compared with warfarin for stroke prevention in patients with non-valvular atrial fibrillation in ROCKET AF: 20 mg for patients with normal/mildly impaired renal function and 15 mg for patients with moderate ... Full text Link to item Cite

Independent data monitoring committees: preparing a path for the future.

Journal Article Am Heart J · August 2014 Independent data monitoring committees (IDMCs) were introduced to monitor patient safety and study conduct in randomized clinical trials (RCTs), but certain challenges regarding the utilization of IDMCs have developed. First, the roles and responsibilities ... Full text Link to item Cite

Prevalence, characteristics, and predictors of early termination of cardiovascular clinical trials due to low recruitment: insights from the ClinicalTrials.gov registry.

Journal Article Am Heart J · August 2014 BACKGROUND: Early termination of clinical trials due to low recruitment represents an understudied challenge for clinical research. We aimed to describe characteristics of cardiovascular trials terminated because of low recruitment and identify the major p ... Full text Link to item Cite

Evaluating cardiovascular event reduction with ezetimibe as an adjunct to simvastatin in 18,144 patients after acute coronary syndromes: final baseline characteristics of the IMPROVE-IT study population.

Journal Article Am Heart J · August 2014 BACKGROUND: The IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) is evaluating the potential benefit for reduction in major cardiovascular (CV) events from the addition of ezetimibe versus placebo to 40 mg/d of simvastatin ... Full text Link to item Cite

Vein graft preservation solutions, patency, and outcomes after coronary artery bypass graft surgery: follow-up from the PREVENT IV randomized clinical trial.

Journal Article JAMA Surg · August 2014 IMPORTANCE: In vitro and animal model data suggest that intraoperative preservation solutions may influence endothelial function and vein graft failure (VGF) after coronary artery bypass graft (CABG) surgery. Clinical studies to validate these findings are ... Full text Link to item Cite

Management of major bleeding events in patients treated with rivaroxaban vs. warfarin: results from the ROCKET AF trial.

Journal Article Eur Heart J · July 21, 2014 AIMS: There are no data regarding management and outcomes of major bleeding events in patients treated with oral factor Xa inhibitors. METHODS AND RESULTS: Using data from ROCKET AF, we analysed the management and outcomes of major bleeding overall and acc ... Full text Link to item Cite

Efficacy and safety of rivaroxaban compared with warfarin among elderly patients with nonvalvular atrial fibrillation in the Rivaroxaban Once Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF).

Journal Article Circulation · July 8, 2014 BACKGROUND: Nonvalvular atrial fibrillation is common in elderly patients, who face an elevated risk of stroke but difficulty sustaining warfarin treatment. The oral factor Xa inhibitor rivaroxaban was noninferior to warfarin in the Rivaroxaban Once Daily, ... Full text Link to item Cite

Cardiovascular outcome trials of glucose-lowering drugs or strategies in type 2 diabetes.

Journal Article Lancet · June 7, 2014 Few trials of glucose-lowering drugs or strategies in people with type 2 diabetes have investigated cardiovascular outcomes, even though most patients die from cardiovascular causes despite the beneficial effects of lipid-reducing and blood pressure-loweri ... Full text Link to item Cite

Proceedings from Duke resistant hypertension think tank.

Journal Article Am Heart J · June 2014 To identify patients at increased risk for cardiovascular outcomes, apparent treatment resistant hypertension (aTRH) is defined as having a blood pressure (BP) above goal despite the use of ≥3 antihypertensive therapies of different classes at maximally to ... Full text Link to item Cite

Characteristics of pediatric cardiovascular clinical trials registered on ClinicalTrials.gov.

Journal Article Am Heart J · June 2014 BACKGROUND: ClinicalTrials.gov is an National Institutes of Health-sponsored registry of federally and privately funded trials. We sought to determine fundamental characteristics of registered pediatric cardiovascular trials (PCVTs). METHODS: A data set in ... Full text Link to item Cite

Rivaroxaban for stroke prevention in East Asian patients from the ROCKET AF trial.

Journal Article Stroke · June 2014 BACKGROUND AND PURPOSE: In Rivaroxaban Once Daily Oral Direct Factor Xa Inhibitor Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) trial, rivaroxaban was noninferior to dose-adjusted warfarin ... Full text Link to item Cite

Use and outcomes of antiarrhythmic therapy in patients with atrial fibrillation receiving oral anticoagulation: results from the ROCKET AF trial.

Journal Article Heart Rhythm · June 2014 BACKGROUND: Antiarrhythmic drugs (AADs) and anticoagulation are mainstays of atrial fibrillation (AF) treatment. OBJECTIVE: To study the use and outcomes of AAD therapy in anticoagulated patients with AF. METHODS: Patients in the Rivaroxaban Once Daily Ora ... Full text Link to item Cite

Outcomes of temporary interruption of rivaroxaban compared with warfarin in patients with nonvalvular atrial fibrillation: results from the rivaroxaban once daily, oral, direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation (ROCKET AF).

Journal Article Circulation · May 6, 2014 BACKGROUND: During long-term anticoagulation in atrial fibrillation, temporary interruptions (TIs) of therapy are common, but the relationship between patient outcomes and TIs has not been well studied. We sought to determine reasons for TI, the characteri ... Full text Link to item Cite

The landscape of clinical trials in nephrology: a systematic review of Clinicaltrials.gov.

Journal Article Am J Kidney Dis · May 2014 BACKGROUND: Well-designed trials are of paramount importance in improving the delivery of care to patients with kidney disease. However, it remains unknown whether contemporary clinical trials within nephrology are of sufficient quality and quantity to mee ... Full text Link to item Cite

High-sensitivity C-reactive protein in acute heart failure: insights from the ASCEND-HF trial.

Journal Article J Card Fail · May 2014 BACKGROUND: Inflammation is associated with progression of chronic heart failure (HF). Few data exist on high-sensitivity C-reactive protein (hsCRP) levels and their importance in acute HF. METHODS AND RESULTS: In this biomarker substudy of the ASCEND-HF t ... Full text Link to item Cite

Intracranial hemorrhage among patients with atrial fibrillation anticoagulated with warfarin or rivaroxaban: the rivaroxaban once daily, oral, direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation.

Journal Article Stroke · May 2014 BACKGROUND AND PURPOSE: Intracranial hemorrhage (ICH) is a life-threatening complication of anticoagulation. METHODS: We investigated the rate, outcomes, and predictors of ICH in 14 264 patients with atrial fibrillation from Rivaroxaban Once Daily, Oral, D ... Full text Link to item Cite

Impact of baseline physical activity and diet behavior on metabolic syndrome in a pharmaceutical trial: results from NAVIGATOR.

Journal Article Metabolism · April 2014 OBJECTIVE: The cardiometabolic risk cluster metabolic syndrome (MS) includes ≥3 of elevated fasting glucose, hypertension, elevated triglycerides, reduced high-density lipoprotein cholesterol (HDL-c), and increased waist circumference. Each can be affected ... Full text Link to item Cite

Impact of cardiovascular events on change in quality of life and utilities in patients after myocardial infarction: a VALIANT study (valsartan in acute myocardial infarction).

Journal Article JACC Heart Fail · April 2014 OBJECTIVES: The objective of this study was to determine the impact of nonfatal cardiovascular (CV) events on changes in health-related quality of life (HRQL). BACKGROUND: There is limited understanding of the impact of nonfatal CV events on long-term chan ... Full text Link to item Cite

Factors associated with major bleeding events: insights from the ROCKET AF trial (rivaroxaban once-daily oral direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation).

Journal Article J Am Coll Cardiol · March 11, 2014 OBJECTIVES: This study sought to report additional safety results from the ROCKET AF (Rivaroxaban Once-daily oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation). BACKGROUND ... Full text Link to item Cite

Outcomes among non-ST-segment elevation acute coronary syndromes patients with no angiographically obstructive coronary artery disease: observations from 37,101 patients.

Journal Article Eur Heart J Acute Cardiovasc Care · March 2014 AIMS: Limited data exist concerning outcomes of patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) with no angiographically obstructive coronary artery disease (non-obstructive CAD). We assessed the frequency of clinical outcomes am ... Full text Link to item Cite

Integrated efficacy to effectiveness trials.

Journal Article Clin Pharmacol Ther · February 2014 Experts in clinical research, therapeutic development, and comparative effectiveness are continually frustrated in their attempts to fit the square peg of therapeutic development into the round hole of clinical trials. Trials can be optimized to provide si ... Full text Link to item Cite

Efficacy and safety of rivaroxaban compared with warfarin in patients with peripheral artery disease and non-valvular atrial fibrillation: insights from ROCKET AF.

Journal Article Eur Heart J · January 2014 AIMS: Vascular disease is included in a risk scoring system to predict stroke in patients with non-valvular atrial fibrillation (AF). This post hoc analysis of ROCKET AF aimed to determine the absolute rates of stroke and bleeding, and the relative effecti ... Full text Link to item Cite

Launching PCORnet, a national patient-centered clinical research network.

Journal Article J Am Med Inform Assoc · 2014 The Patient-Centered Outcomes Research Institute (PCORI) has launched PCORnet, a major initiative to support an effective, sustainable national research infrastructure that will advance the use of electronic health data in comparative effectiveness researc ... Full text Link to item Cite

The Patient-Centered Outcomes Research Network: a national infrastructure for comparative effectiveness research.

Journal Article N C Med J · 2014 The current clinical research system does not produce high-quality evidence quickly enough to support health care decision making. The Patient-Centered Outcomes Research Network (PCORnet) embodies a novel strategy for creating a national "network of networ ... Full text Link to item Cite

Launching PCORnet, a national patient-centered clinical research network

Journal Article Journal of the American Medical Informatics Association · January 1, 2014 The Patient-Centered Outcomes Research Institute (PCORI) has launched PCORnet, a major initiative to support an effective, sustainable national research infrastructure that will advance the use of electronic health data in comparative effectiveness researc ... Full text Cite

Foreword

Journal Article · 2014 Open Access Cite

Introduction

Journal Article Progress in Biomedical Optics and Imaging Proceedings of SPIE · January 1, 2014 Cite

Ischaemic cardiac outcomes in patients with atrial fibrillation treated with vitamin K antagonism or factor Xa inhibition: results from the ROCKET AF trial.

Journal Article Eur Heart J · January 2014 AIMS: We investigated the prevalence of prior myocardial infarction (MI) and incidence of ischaemic cardiovascular (CV) events among atrial fibrillation (AF) patients. METHODS AND RESULTS: In ROCKET AF, 14 264 patients with nonvalvular AF were randomized t ... Full text Link to item Cite

Relationship between time in therapeutic range and comparative treatment effect of rivaroxaban and warfarin: Results from the ROCKET AF trial

Conference Journal of the American Heart Association · January 1, 2014 Background: Time in therapeutic range (TTR) is a standard quality measure of the use of warfarin. We assessed the relative effects of rivaroxaban versus warfarin at the level of trial center TTR (cTTR) since such analysis preserves randomized comparisons. ... Full text Cite

A pharmacogenetic versus a clinical algorithm for warfarin dosing.

Journal Article N Engl J Med · December 12, 2013 BACKGROUND: The clinical utility of genotype-guided (pharmacogenetically based) dosing of warfarin has been tested only in small clinical trials or observational studies, with equivocal results. METHODS: We randomly assigned 1015 patients to receive doses ... Full text Link to item Cite

Role of diuretics, β blockers, and statins in increasing the risk of diabetes in patients with impaired glucose tolerance: reanalysis of data from the NAVIGATOR study.

Journal Article BMJ · December 9, 2013 OBJECTIVE: To examine the degree to which use of β blockers, statins, and diuretics in patients with impaired glucose tolerance and other cardiovascular risk factors is associated with new onset diabetes. DESIGN: Reanalysis of data from the Nateglinide and ... Full text Link to item Cite

Randomized clinical trials--removing obstacles.

Journal Article N Engl J Med · December 5, 2013 Full text Link to item Cite

Differences in treatment, outcomes, and quality of life among patients with heart failure in Canada and the United States.

Journal Article JACC Heart Fail · December 2013 OBJECTIVES: The aim of this study was to compare clinical outcomes, resource utilization, and health-related quality of life between Canadian and U.S. patients enrolled in ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Hear ... Full text Link to item Cite

Electronic health records based phenotyping in next-generation clinical trials: a perspective from the NIH Health Care Systems Collaboratory.

Journal Article J Am Med Inform Assoc · December 2013 Widespread sharing of data from electronic health records and patient-reported outcomes can strengthen the national capacity for conducting cost-effective clinical trials and allow research to be embedded within routine care delivery. While pragmatic clini ... Full text Link to item Cite

A comparison of phenotype definitions for diabetes mellitus.

Journal Article J Am Med Inform Assoc · December 2013 OBJECTIVE: This study compares the yield and characteristics of diabetes cohorts identified using heterogeneous phenotype definitions. MATERIALS AND METHODS: Inclusion criteria from seven diabetes phenotype definitions were translated into query algorithms ... Full text Link to item Cite

Incidence of atrial fibrillation in a population with impaired glucose tolerance: the contribution of glucose metabolism and other risk factors. A post hoc analysis of the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research trial.

Journal Article Am Heart J · November 2013 BACKGROUND: The role of dysglycemia as an additional risk factor for atrial fibrillation (AF) is controversial. Therefore, it was of interest to assess risk factors for incident AF in a large, representative population of patients with cardiovascular risk ... Full text Link to item Cite

Check it, change it: a community-based intervention to improve blood pressure control.

Journal Article Circ Cardiovasc Qual Outcomes · November 2013 BACKGROUND: Despite the widespread availability of effective and affordable therapies, hypertension remains this country's most significant modifiable cardiovascular risk factor. Approximately 30% to 50% of individuals with hypertension currently fail to r ... Full text Link to item Cite

The relationship between meteorological conditions and index acute coronary events in a global clinical trial.

Journal Article Int J Cardiol · October 3, 2013 BACKGROUND: Considerable uncertainty exists concerning the interaction between climate and human health. We explored this issue by evaluating the relationship between meteorological events and acute coronary syndrome (ACS) events. METHODS: 9406 patients in ... Full text Link to item Cite

Association between bleeding and mortality among women and men with high-risk acute coronary syndromes: insights from the Early versus Delayed, Provisional Eptifibatide in Acute Coronary Syndromes (EARLY ACS) trial.

Journal Article Am Heart J · October 2013 BACKGROUND: Female sex is an established risk factor for bleeding, which is an important safety end point in patients presenting with non-ST-segment elevation acute coronary syndromes (NSTE ACS). However, it is unknown whether the association between bleed ... Full text Link to item Cite

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

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

Effects of nesiritide and predictors of urine output in acute decompensated heart failure: results from ASCEND-HF (acute study of clinical effectiveness of nesiritide and decompensated heart failure).

Journal Article J Am Coll Cardiol · September 24, 2013 OBJECTIVES: This study sought to determine if nesiritide increases diuresis in congestive heart failure patients. BACKGROUND: In the ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide and Decompensated Heart Failure), 7,141 patients hospitalize ... Full text Link to item Cite

Global variation in quality of care among patients hospitalized with acute heart failure in an international trial: findings from the acute study clinical effectiveness of nesiritide in decompensated heart failure trial (ASCEND-HF).

Journal Article Circ Cardiovasc Qual Outcomes · September 1, 2013 BACKGROUND: Translation of evidence-based heart failure (HF) therapies to clinical practice is incomplete and may vary internationally. We examined common measures of quality of care in patients enrolled in the international Acute Study of Clinical Effecti ... Full text Link to item Cite

Predictors of stroke in patients with impaired glucose tolerance: results from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research trial.

Journal Article Stroke · September 2013 BACKGROUND AND PURPOSE: Risk factors for stroke are well-established in general populations but sparsely studied in individuals with impaired glucose tolerance. METHODS: We identified predictors of stroke among participants with impaired glucose tolerance ... Full text Link to item Cite

Forging stronger partnerships between academic health centers and patient-driven organizations.

Journal Article Acad Med · September 2013 In this article, the authors review the unique role that patient-driven organizations, such as patient advocacy groups and voluntary health organizations (PAG/VHOs), play in translational and clinical research. The importance of fostering collaborations be ... Full text Link to item Cite

Routine early eptifibatide versus delayed provisional use at percutaneous coronary intervention in high-risk non-ST-segment elevation acute coronary syndromes patients: an analysis from the Early Glycoprotein IIb/IIIa Inhibition in Non-ST-Segment Elevation Acute Coronary Syndrome trial.

Journal Article Am Heart J · September 2013 AIMS: In the EARLY ACS trial, routine early eptifibatide was not superior to delayed provisional use at percutaneous coronary intervention (PCI); however, among PCI-treated patients, numerically fewer ischemic end points occurred in the upstream eptifibati ... Full text Link to item Cite

Predictive models in heart failure: who cares?

Journal Article Circ Heart Fail · September 1, 2013 Full text Link to item Cite

Geographic health information systems: a platform to support the 'triple aim'.

Journal Article Health Aff (Millwood) · September 2013 Despite the rapid growth of electronic health data, most data systems do not connect individual patient records to data sets from outside the health care delivery system. These isolated data systems cannot support efforts to recognize or address how the ph ... Full text Link to item Cite

Medical resource use, costs, and quality of life in patients with acute decompensated heart failure: findings from ASCEND-HF.

Journal Article J Card Fail · September 2013 BACKGROUND: The Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure (ASCEND-HF) randomly assigned 7,141 participants to nesiritide or placebo. Dyspnea improvement was more often reported in the nesiritide group, but there wer ... Full text Link to item Cite

Duration of eptifibatide infusion after percutaneous coronary intervention and outcomes among high-risk patients with non-ST-segment elevation acute coronary syndrome: insights from EARLY ACS.

Journal Article Eur Heart J Acute Cardiovasc Care · September 2013 BACKGROUND AND OBJECTIVES: Eptifibatide is indicated during percutaneous coronary intervention (PCI) with continuation for 18-24 hours post procedure but is associated with bleeding. We examined the efficacy and safety of shorter post-PCI eptifibatide infu ... Full text Link to item Cite

Trends in clinical trials of non-ST-segment elevation acute coronary syndromes over 15 years.

Journal Article Int 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 ... Full text Link to item Cite

Cardiac troponin after percutaneous coronary intervention and 1-year mortality in non-ST-segment elevation acute coronary syndrome using systematic evaluation of biomarker trends.

Journal Article J Am Coll Cardiol · July 16, 2013 OBJECTIVES: This study sought to review cardiac troponin (cTn) trends during non-ST-segment elevation acute coronary syndrome (NSTE ACS) in patients undergoing percutaneous coronary intervention (PCI) in the EARLY ACS (Early Glycoprotein IIb/IIIa Inhibitio ... Full text Link to item Cite

Efficacy and safety of rivaroxaban in patients with heart failure and nonvalvular atrial fibrillation: insights from ROCKET AF.

Journal Article Circ Heart Fail · July 2013 BACKGROUND: In Rivaroxaban Once daily, oral, direct factor Xa inhibition Compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF), rivaroxaban was noninferior to warfarin for the prevention of stroke ... Full text Link to item Cite

End of study transition from study drug to open-label vitamin K antagonist therapy: the ROCKET AF experience.

Journal Article Circ Cardiovasc Qual Outcomes · July 2013 BACKGROUND: To evaluate the previously reported excess of thromboembolic events during the 30 days after the end of study (EOS) visit when participants transitioned from blinded therapy to open-label vitamin K antagonist. METHODS AND RESULTS: At the EOS vi ... Full text Link to item Cite

Do countries or hospitals with longer hospital stays for acute heart failure have lower readmission rates?: Findings from ASCEND-HF.

Journal Article Circ Heart Fail · July 2013 BACKGROUND: Hospital readmission is an important clinical outcome of patients with heart failure. Its relation to length of stay for the initial hospitalization is not clear. METHODS AND RESULTS: We used hierarchical modeling of data from a clinical trial ... Full text Link to item Cite

Clinical outcomes with rivaroxaban in patients transitioned from vitamin K antagonist therapy: a subgroup analysis of a randomized trial.

Journal Article Ann Intern Med · June 18, 2013 BACKGROUND: In ROCKET AF (Rivaroxaban Once-Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation), a large randomized, clinical trial, rivaroxaban was noninferior to w ... Full text Link to item Cite

Characteristics of oncology clinical trials: insights from a systematic analysis of ClinicalTrials.gov.

Journal Article JAMA Intern Med · June 10, 2013 IMPORTANCE: Clinical trials are essential to cancer care, and data about the current state of research in oncology are needed to develop benchmarks and set the stage for improvement. OBJECTIVE: To perform a comprehensive analysis of the national oncology c ... Full text Link to item Cite

Reply: To PMID 22921873.

Journal Article J Allergy Clin Immunol · June 2013 Full text Link to item Cite

Effects of changes in potassium with valsartan use on diabetes risk: Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial.

Journal Article Am J Hypertens · June 2013 BACKGROUND: Low and low-normal serum potassium is associated with an increased risk of diabetes. We hypothesized that the protective effect of valsartan on diabetes risk could be mediated by its effect of raising serum potassium. METHODS: We analyzed data ... Full text Link to item Cite

Rescuing clinical trials in the United States and beyond: a call for action.

Journal Article Am Heart J · June 2013 Numerous challenges-financial, regulatory, and cultural-are hindering US participation and performance in multinational clinical trials. Consequently, it is increasingly unclear how the results of these trials should be applied to American patients, practi ... Full text Link to item Cite

Outcomes after cardioversion and atrial fibrillation ablation in patients treated with rivaroxaban and warfarin in the ROCKET AF trial.

Journal Article J Am Coll Cardiol · May 14, 2013 OBJECTIVES: This study sought to investigate the outcomes following cardioversion or catheter ablation in patients with atrial fibrillation (AF) treated with warfarin or rivaroxaban. BACKGROUND: There are limited data on outcomes following cardioversion or ... Full text Link to item Cite

Predictors of early dyspnoea relief in acute heart failure and the association with 30-day outcomes: findings from ASCEND-HF.

Journal Article Eur J Heart Fail · April 2013 AIMS: To examine the characteristics associated with early dyspnoea relief during acute heart failure (HF) hospitalization, and its association with 30-day outcomes. METHODS AND RESULTS: ASCEND-HF was a randomized trial of nesiritide vs. placebo in 7141 pa ... Full text Link to item Cite

Conflicting information about conflict of interest.

Journal Article J Am Coll Cardiol · March 19, 2013 Full text Link to item Cite

Dynamic modeling of 90-day mortality in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention.

Journal Article Am Heart J · March 2013 AIMS: Dynamic risk models update the risk profile of ST-elevation myocardial infarction (STEMI) patients over the acute period following the event and have implications to clinical practice and research. METHODS AND RESULTS: Multivariable survival models w ... Full text Link to item Cite

Predictors of incident heart failure hospitalizations among patients with impaired glucose tolerance: insight from the Nateglinide And Valsartan in Impaired Glucose Tolerance Outcomes Research study.

Journal Article Circ Heart Fail · March 2013 BACKGROUND: Impaired glucose tolerance and metabolic syndrome are associated with increased risk of heart failure (HF). However, predictors associated with the increased risk of incident HF have not been well characterized. We aimed to identify independent ... Full text Link to item Cite

Cycle Time Metrics for Multisite Clinical Trials in the United States.

Journal Article Ther Innov Regul Sci · March 2013 Conducting randomized controlled trials entails a prolonged, costly study start-up (SSU) process that may create significant delays. Optimizing the operational aspects of multisite trials requires identifying benchmarks in the SSU process and the potential ... Full text Link to item Cite

Impact of global geographic region on time in therapeutic range on warfarin anticoagulant therapy: data from the ROCKET AF clinical trial.

Journal Article J Am Heart Assoc · February 19, 2013 BACKGROUND: Vitamin K antagonist (VKA) therapy remains the most common method of stroke prevention in patients with atrial fibrillation. Time in therapeutic range (TTR) is a widely cited measure of the quality of VKA therapy. We sought to identify factors ... Full text Link to item Cite

Outcomes of discontinuing rivaroxaban compared with warfarin in patients with nonvalvular atrial fibrillation: analysis from the ROCKET AF trial (Rivaroxaban Once-Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation).

Journal Article J Am Coll Cardiol · February 12, 2013 OBJECTIVES: The purpose of this study was to understand the possible risk of discontinuation in the context of clinical care. BACKGROUND: Rivaroxaban is noninferior to warfarin for preventing stroke in atrial fibrillation patients. Concerns exist regarding ... Full text Link to item Cite

Renal dysfunction as a predictor of stroke and systemic embolism in patients with nonvalvular atrial fibrillation: validation of the R(2)CHADS(2) index in the ROCKET AF (Rivaroxaban Once-daily, oral, direct factor Xa inhibition Compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation) and ATRIA (AnTicoagulation and Risk factors In Atrial fibrillation) study cohorts.

Journal Article Circulation · January 15, 2013 BACKGROUND: We sought to define the factors associated with the occurrence of stroke and systemic embolism in a large, international atrial fibrillation (AF) trial. METHODS AND RESULTS: In ROCKET AF (Rivaroxaban Once-daily, oral, direct factor Xa inhibitio ... Full text Link to item Cite

Reply: To PMID 22653543.

Journal Article Retina · 2013 Full text Link to item Cite

Biomarkers, putative surrogates, surrogates, and decision making.

Journal Article Circ Cardiovasc Imaging · January 1, 2013 Full text Link to item Cite

Cardiovascular toxicity of epoetin-alfa in patients with chronic kidney disease.

Journal Article Am J Nephrol · 2013 BACKGROUND: Recombinant erythropoietin has become a routine component of care of patients with chronic kidney disease reducing the need for blood transfusions but raising the risks for cardiovascular events. We undertook this secondary analysis of subjects ... Full text Link to item Cite

Conflicting Information About Conflict of Interest

Journal Article Journal of the American College of Cardiology · 2013 Cite

Missing signposts on the roadmap to quality: a call to improve medication adherence indicators in data collection for population research.

Journal Article Front Pharmacol · 2013 PURPOSE: Poor adherence to prescribed medicines is associated with increased rates of poor outcomes, including hospitalization, serious adverse events, and death, and is also associated with increased healthcare costs. However, current approaches to evalua ... Full text Link to item Cite

Comparison of the prognosis of spontaneous and percutaneous coronary intervention-related myocardial infarction.

Journal Article J Am Coll Cardiol · December 4, 2012 OBJECTIVES: This study compared prognoses of myocardial infarction related to percutaneous coronary intervention (PCI, procedural MI) using increasing creatine kinase-myocardial band (CK-MB) thresholds with spontaneous MI. BACKGROUND: Procedural MI usually ... Full text Link to item Cite

Troponin I in acute decompensated heart failure: insights from the ASCEND-HF study.

Journal Article Eur J Heart Fail · November 2012 AIMS: We examined the prognostic importance of cardiac troponin I (cTnI) in a cohort of patients enrolled in the ASCEND-HF study of nesiritide in acute decompensated heart failure (ADHF). Circulating troponins are a prognostic marker in patients with ADHF. ... Full text Link to item Cite

Evaluating the impact of public health notification: Duke clopidogrel experience.

Journal Article Circ Cardiovasc Qual Outcomes · November 2012 BACKGROUND: Provider and public health interventions in the late 2006 sought to change the duration of clopidogrel use after drug-eluting stent (DES) implantation. We evaluated whether public health interventions were associated with changes in patient-rep ... Full text Link to item Cite

Prediabetes and the risk of diabetes.

Journal Article Lancet · October 6, 2012 Full text Link to item Cite

An evidence-based score to detect prevalent peripheral artery disease (PAD).

Journal Article Vasc Med · October 2012 Detection of peripheral artery disease (PAD) typically entails collection of medical history, physical examination, and noninvasive imaging, but whether a risk factor-based model has clinical utility in population screening is unclear. Our objective was to ... Full text Link to item Cite

Effect of hemoglobin target on progression of kidney disease: a secondary analysis of the CHOIR (Correction of Hemoglobin and Outcomes in Renal Insufficiency) trial.

Journal Article Am J Kidney Dis · September 2012 BACKGROUND: Conflicting relationships have been described between anemia correction using erythropoiesis-stimulating agents and progression of chronic kidney disease (CKD). This study was undertaken to examine the impact of target hemoglobin level on progr ... Full text Link to item Cite

Impact of higher hemoglobin targets on blood pressure and clinical outcomes: a secondary analysis of CHOIR.

Journal Article Nephrol Dial Transplant · September 2012 BACKGROUND: Targeting a higher hemoglobin in patients with chronic kidney disease leads to adverse cardiovascular outcomes, yet the reasons remain unclear. Herein, we sought to determine whether changes in erythropoiesis-stimulating agent (ESA) dose and in ... Full text Link to item Cite

Edifoligide and long-term outcomes after coronary artery bypass grafting: PRoject of Ex-vivo Vein graft ENgineering via Transfection IV (PREVENT IV) 5-year results.

Journal Article Am Heart J · September 2012 BACKGROUND: Edifoligide, an E2F transcription factor decoy, does not prevent vein graft failure or adverse clinical outcomes at 1 year in patients undergoing coronary artery bypass grafting (CABG). We compared the 5-year clinical outcomes of patients in PR ... Full text Link to item Cite

Association between angiographic complications and clinical outcomes among patients with acute coronary syndrome undergoing percutaneous coronary intervention: an EARLY ACS (Early Glycoprotein IIb/IIIa Inhibition in Non-ST-Segment Elevation Acute Coronary Syndrome) angiographic substudy.

Journal Article JACC Cardiovasc Interv · September 2012 OBJECTIVES: The goal of this analysis was to determine the association between intraprocedural complications and clinical outcomes among patients with high-risk non-ST-segment elevation acute coronary syndrome (NSTEACS) undergoing percutaneous coronary int ... Full text Link to item Cite

The trouble with ischemia.

Journal Article Am Heart J · August 2012 Full text Link to item Cite

Sustained ventricular tachycardia and ventricular fibrillation complicating non-ST-segment-elevation acute coronary syndromes.

Journal Article Circulation · July 3, 2012 BACKGROUND: Ventricular arrhythmias remain a lethal complication of acute coronary syndromes (ACS). However, the incidence and prognosis of sustained ventricular tachycardia/ventricular fibrillation (VT/VF) in contemporary non-ST-segment-elevation (NSTE) A ... Full text Link to item Cite

Activated partial thromboplastin time measurement is not associated with clinical outcomes in patients with high-risk non-ST-segment elevation acute coronary syndromes treated with unfractionated heparin.

Journal Article J Thromb Thrombolysis · July 2012 Our objective was to determine the association of activated partial thromboplastin time (aPTT) with recurrent ischemic events and non-coronary artery bypass surgery-related thrombolysis in myocardial infarction major bleeding. We studied 4,985 patients wit ... Full text Link to item Cite

A new look at an old therapy.

Journal Article JAMA · May 9, 2012 Full text Link to item Cite

Characteristics of clinical trials registered in ClinicalTrials.gov, 2007-2010.

Journal Article JAMA · May 2, 2012 CONTEXT: Recent reports highlight gaps between guidelines-based treatment recommendations and evidence from clinical trials that supports those recommendations. Strengthened reporting requirements for studies registered with ClinicalTrials.gov enable a com ... Full text Link to item Cite

Baseline metabolomic profiles predict cardiovascular events in patients at risk for coronary artery disease.

Journal Article Am Heart J · May 2012 BACKGROUND: Cardiovascular risk models remain incomplete. Small-molecule metabolites may reflect underlying disease and, as such, serve as novel biomarkers of cardiovascular risk. METHODS: We studied 2,023 consecutive patients undergoing cardiac catheteriz ... Full text Link to item Cite

Mechanisms and predictors of mitral regurgitation after high-risk myocardial infarction.

Journal Article J Am Soc Echocardiogr · May 2012 BACKGROUND: Mitral regurgitation (MR) has been associated with adverse outcomes after myocardial infarction (MI). Without structural valve disease, functional MR has been related to left ventricular (LV) remodeling and geometric deformation of the mitral a ... Full text Link to item Cite

Assessment of dyspnea in acute decompensated heart failure: insights from ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure) on the contributions of peak expiratory flow.

Journal Article J Am Coll Cardiol · April 17, 2012 OBJECTIVES: This study hypothesized that peak expiratory flow rate (PEFR) would increase with acute heart failure (AHF) treatment over the first 24 h, related to a Dyspnea Index (DI) change and treatment effect. BACKGROUND: Dyspnea is a key symptom and cli ... Full text Link to item Cite

Rivaroxaban compared with warfarin in patients with atrial fibrillation and previous stroke or transient ischaemic attack: a subgroup analysis of ROCKET AF.

Journal Article Lancet Neurol · April 2012 BACKGROUND: In ROCKET AF, rivaroxaban was non-inferior to adjusted-dose warfarin in preventing stroke or systemic embolism among patients with atrial fibrillation (AF). We aimed to investigate whether the efficacy and safety of rivaroxaban compared with wa ... Full text Link to item Cite

Impediments to clinical research in the United States.

Journal Article Clin Pharmacol Ther · March 2012 Clinical trials are essential to the evaluation of promising scientific discoveries, but they are becoming unsustainably burdensome, threatening to deprive patients and health-care providers of new therapies and new evidence to guide the use of existing tr ... Full text Link to item Cite

An academic-health service partnership in nursing: lessons from the field.

Journal Article J Nurs Scholarsh · March 2012 PURPOSE: To describe the development of an academic-health services partnership undertaken to improve use of evidence in clinical practice. APPROACH: Academic health science schools and health service settings share common elements of their missions: to ed ... Full text Link to item Cite

Regional patterns of use of a medical management strategy for patients with non-ST-segment elevation acute coronary syndromes: insights from the EARLY ACS Trial.

Journal Article Circ 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 ... Full text Link to item Cite

Relationship between vein graft failure and subsequent clinical outcomes after coronary artery bypass surgery.

Journal Article Circulation · February 14, 2012 BACKGROUND: Vein graft failure (VGF) is common after coronary artery bypass graft surgery, but its relationship with long-term clinical outcomes is unknown. In this retrospective analysis, we examined the relationship between VGF, assessed by coronary angi ... Full text Link to item Cite

Comparison of incidence of bleeding and mortality of men versus women with ST-elevation myocardial infarction treated with fibrinolysis.

Journal Article Am J Cardiol · February 1, 2012 Gender-related differences in the incidence of bleeding and its relation to subsequent mortality in patients with ST-segment elevation myocardial infarction (STEMI) treated with fibrinolysis are not well understood. We studied patients with STEMI receiving ... Full text Link to item Cite

Association of depression and survival in patients with chronic heart failure over 12 Years.

Journal Article Psychosomatics · 2012 OBJECTIVE: To examine the relationship between depression and survival in patients with chronic heart failure (HF) over a 12-year follow-up period. BACKGROUND: The survival associated with depression has been demonstrated in HF patients for up to 7 years. ... Full text Link to item Cite

Predictors of cardiovascular events in a contemporary population with impaired glucose tolerance: an observational analysis of the Nateglinide and Valsartan in impaired glucose tolerance outcomes research (NAVIGATOR) trial.

Journal Article BMJ Open · 2012 OBJECTIVES: Risk factors for cardiovascular events are well established in general populations and those with diabetes but have been sparsely studied in impaired glucose tolerance (IGT). We sought to identify predictors of (1) a composite cardiovascular ou ... Full text Link to item Cite

The MURDOCK Study: a long-term initiative for disease reclassification through advanced biomarker discovery and integration with electronic health records.

Journal Article Am J Transl Res · 2012 BACKGROUND: Facing critically low return per dollar invested on clinical research and clinical care, the American biomedical enterprise is in need of a significant transformation. A confluence of high-throughput "omic" technologies and increasing adoption ... Link to item Cite

The Measurement to Understand Reclassification of Disease of Cabarrus/Kannapolis (MURDOCK) Study Community Registry and Biorepository.

Journal Article Am J Transl Res · 2012 Current understanding of chronic diseases is based on crude clinical characterization, imaging studies, and laboratory testing that has evolved over decades. The Measurement to Understand Reclassification of Disease of Cabarrus/Kannapolis (MURDOCK) Study i ... Link to item Cite

Commentary on Anand et al.

Journal Article Clin Trials · December 2011 Full text Link to item Cite

Safety and efficacy of adjusted-dose eptifibatide in patients with acute coronary syndromes and reduced renal function.

Journal Article Am Heart J · November 2011 BACKGROUND: Dose adjustment of renally excreted antithrombotic drugs is recommended for patients with reduced renal function. We examined the influence of dose modification on bleeding and efficacy. METHODS: Based on initial study drug infusion rate, Early ... Full text Link to item Cite

Nesiritide in acute decompensated heart failure.

Journal Article N Engl J Med · October 20, 2011 Full text Link to item Cite

Prevention of stroke and systemic embolism with rivaroxaban compared with warfarin in patients with non-valvular atrial fibrillation and moderate renal impairment.

Journal Article Eur Heart J · October 2011 AIMS: Patients with non-valvular atrial fibrillation (AF) and renal insufficiency are at increased risk for ischaemic stroke and bleeding during anticoagulation. Rivaroxaban, an oral, direct factor Xa inhibitor metabolized predominantly by the liver, prese ... Full text Link to item Cite

Conduct of clinical trials in acute heart failure: regional differences in heart failure clinical trials.

Journal Article Heart Fail Clin · October 2011 Clinical trials are often conducted globally. Differences in standard of care, patient populations including genetic and phenotypic differences, disease etiologies, rates of comorbidities, ascertainment of endpoints, and differences in concomitant therapie ... Full text Link to item Cite

Relationship of the time interval between cardiac catheterization and elective coronary artery bypass surgery with postprocedural acute kidney injury.

Journal Article Circulation · September 13, 2011 BACKGROUND: Some prior studies have suggested that the time to cardiac surgery after cardiac catheterization is inversely related to postoperative acute kidney injury (AKI). However, these studies, because of the small number of patients, were unable to ad ... Full text Link to item Cite

Rivaroxaban versus warfarin in nonvalvular atrial fibrillation.

Journal Article N Engl J Med · September 8, 2011 BACKGROUND: The use of warfarin reduces the rate of ischemic stroke in patients with atrial fibrillation but requires frequent monitoring and dose adjustment. Rivaroxaban, an oral factor Xa inhibitor, may provide more consistent and predictable anticoagula ... Full text Link to item Cite

Highlights from the III International Symposium of Thrombosis and Anticoagulation (ISTA), October 14-16, 2010, São Paulo, Brazil.

Journal Article J Thromb Thrombolysis · August 2011 To discuss and share knowledge around advances in the care of patients with thrombotic disorders, the Third International Symposium of Thrombosis and Anticoagulation was held in São Paulo, Brazil, from October 14-16, 2010. This scientific program was devel ... Full text Link to item Cite

The STARBRITE trial: a randomized, pilot study of B-type natriuretic peptide-guided therapy in patients with advanced heart failure.

Journal Article J Card Fail · August 2011 BACKGROUND: STARBRITE, a multicenter randomized pilot trial, tested whether outpatient diuretic management guided by B-type natriuretic peptide (BNP) and clinical assessment resulted in more days alive and not hospitalized over 90 days compared with clinic ... Full text Link to item Cite

Saphenous vein grafts with multiple versus single distal targets in patients undergoing coronary artery bypass surgery: one-year graft failure and five-year outcomes from the Project of Ex-Vivo Vein Graft Engineering via Transfection (PREVENT) IV trial.

Journal Article Circulation · July 19, 2011 BACKGROUND: Limited information exists on the intermediate-term graft patency and 5-year clinical outcomes of patients receiving saphenous vein grafts with multiple (m-SVG) versus single distal targets (s-SVG) during coronary artery bypass graft (CABG) sur ... Full text Link to item Cite

Effect of nesiritide in patients with acute decompensated heart failure.

Journal Article N Engl J Med · July 7, 2011 BACKGROUND: Nesiritide is approved in the United States for early relief of dyspnea in patients with acute heart failure. Previous meta-analyses have raised questions regarding renal toxicity and the mortality associated with this agent. METHODS: We random ... Full text Link to item Cite

Upstream use of small-molecule glycoprotein iib/iiia inhibitors in patients with non-ST-segment elevation acute coronary syndromes: a systematic overview of randomized clinical trials.

Journal Article Circ Cardiovasc Qual Outcomes · July 2011 BACKGROUND: The use of upstream small-molecule glycoprotein (GP) IIb/IIIa inhibitors in non-ST-segment elevation acute coronary syndromes (NSTE ACS) has been studied in multiple randomized clinical trials. We systematically reviewed the effect of upstream ... Full text Link to item Cite

Circumstances and outcomes of sudden unexpected death in patients with high-risk myocardial infarction: implications for prevention.

Journal Article Circulation · June 14, 2011 BACKGROUND: Sudden death (SD) is a frequent catastrophic complication in patients after myocardial infarction. Circumstances of SD may affect strategies for prevention. METHODS AND RESULTS: We reviewed source documentation for 1067 patients who had SD in t ... Full text Link to item Cite

Incremental value of echocardiographic assessment beyond clinical evaluation for prediction of death and development of heart failure after high-risk myocardial infarction.

Journal Article Am Heart J · June 2011 BACKGROUND: Echocardiographic measurements of left ventricular (LV) function, predominantly LV ejection fraction (LVEF), have been used to define risk in patients after myocardial infarction. However, the extent to which measures of LV structure and functi ... Full text Link to item Cite

High predictive accuracy of an unbiased proteomic profile for sustained virologic response in chronic hepatitis C patients.

Journal Article Hepatology · June 2011 UNLABELLED: Chronic hepatitis C (CHC) infection is a leading cause of endstage liver disease. Current standard-of-care (SOC) interferon-based therapy results in sustained virological response (SVR) in only one-half of patients, and is associated with signi ... Full text Link to item Cite

Refining clinical trial composite outcomes: an application to the Assessment of the Safety and Efficacy of a New Thrombolytic-3 (ASSENT-3) trial.

Journal Article Am Heart J · May 2011 BACKGROUND: Traditional time-to-event analysis assigns equal weight to the first event in the composite end point. This is counterintuitive to many stakeholders. METHODS: We constructed weights for components of a composite efficacy end point and a net cli ... Full text Link to item Cite

The ClinicalTrials.gov results database--update and key issues.

Journal Article N Engl J Med · March 3, 2011 Featured Publication BACKGROUND: The ClinicalTrials.gov trial registry was expanded in 2008 to include a database for reporting summary results. We summarize the structure and contents of the results database, provide an update of relevant policies, and show how the data can b ... Full text Link to item Cite

Cardiovascular research in India: a perspective.

Journal Article Am Heart J · March 2011 Featured Publication With cardiovascular disease (CVD) emerging as a major cause of mortality in India, clinical research in CVD is becoming increasingly important. There are several favorable factors that offer robust growth of clinical research infrastructure in India: well- ... Full text Link to item Cite

The impact of postrandomization crossover of therapy in acute coronary syndromes care.

Journal Article Circ Cardiovasc Qual Outcomes · March 2011 BACKGROUND: In the Superior Yield of the New Strategy of Enoxaparin, Revascularization, and Glycoprotein IIb/IIIa Inhibitors (SYNERGY) study, patients assigned enoxaparin or unfractionated heparin (UFH) were treated with alternative anticoagulant therapy a ... Full text Link to item Cite

Upstream clopidogrel use and the efficacy and safety of early eptifibatide treatment in patients with acute coronary syndrome: an analysis from the Early Glycoprotein IIb/IIIa Inhibition in Patients with Non-ST-Segment Elevation Acute Coronary Syndrome (EARLY ACS) trial.

Journal Article Circulation · February 22, 2011 BACKGROUND: In the Early Glycoprotein IIb/IIIa Inhibition in Patients with Non-ST-Segment Elevation Acute Coronary Syndrome (EARLY ACS) trial, routine preangiography eptifibatide use was not superior to delayed provisional use but led to more bleeding. Thi ... Full text Link to item Cite

Predictors and prognostic impact of recurrent myocardial infarction in patients with left ventricular dysfunction, heart failure, or both following a first myocardial infarction.

Journal Article Eur J Heart Fail · February 2011 UNLABELLED: IMS: Recurrent myocardial infarction (MI) is common after a first MI and is associated with increased morbidity and mortality. Predictors and prognosis of a recurrent MI with contemporary management are not well known. METHODS AND RESULTS: We a ... Full text Link to item Cite

Association of mortality with years of education in patients with ST-segment elevation myocardial infarction treated with fibrinolysis.

Journal Article J 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 ... Full text Link to item Cite

Race, Bleeding, and Outcomes in STEMI Patients Treated with Fibrinolytic Therapy.

Journal Article Am J Med · January 2011 BACKGROUND: studies have shown higher bleeding and mortality rates among African Americans who receive fibrinolytic therapy for ST-segment elevation myocardial infarction (STEMI) compared with whites; however, the relationship of bleeding risk to mortality ... Full text Link to item Cite

Antiarrhythmic drug therapy for sustained ventricular arrhythmias complicating acute myocardial infarction.

Journal Article Crit Care Med · January 2011 OBJECTIVE: Few 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 ventricu ... Full text Link to item Cite

The authors reply

Journal Article New England Journal of Medicine · 2011 Cite

Impact of recovery of renal function on long-term mortality after coronary artery bypass grafting.

Journal Article Am J Cardiol · December 15, 2010 Whether prognosis differs in acute renal failure (ARF) after coronary artery bypass grafting (CABG) in patients with and without recovery of renal function is not known. We studied patients who had CABG at Duke University Medical Center (1995 to 2008). ARF ... Full text Link to item Cite

The inter-relationship of diabetes and left ventricular systolic function on outcome after high-risk myocardial infarction.

Journal Article Eur J Heart Fail · November 2010 AIMS: Diabetes is a potent risk factor for death and heart failure (HF) hospitalization following myocardial infarction (MI). Whether diabetes modifies the relationship between left ventricular ejection fraction (LVEF) and outcomes in the post-MI populatio ... Full text Link to item Cite

Departures from the protocol during conduct of a clinical trial: a pattern from the data record consistent with a learning curve.

Journal Article Qual Saf Health Care · October 2010 OBJECTIVE: Recognition of learning curves in medical skill acquisition has enhanced patient safety through improved training techniques. Clinical trials research has not been similarly scrutinised. The VALsartan In Acute myocardial iNfarcTion, a large mult ... Full text Link to item Cite

Hormone replacement therapy among postmenopausal women presenting with acute myocardial infarction: insights from the GUSTO-III trial.

Journal Article Am 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 ... Full text Link to item Cite

Relationship between renal function and outcomes in high-risk patients with non-ST-segment elevation acute coronary syndromes: results from SYNERGY.

Journal Article Int J Cardiol · September 24, 2010 BACKGROUND: Chronic kidney disease (CKD) is a risk factor for coronary heart disease and bleeding with antithrombotic therapy in patients with acute coronary syndromes (ACS). We evaluated the effect of renal function on efficacy and outcomes in high-risk p ... Full text Link to item Cite

Attained educational level and incident atherothrombotic events in low- and middle-income compared with high-income countries.

Journal Article Circulation · 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 ... Full text Link to item Cite

Reclassification of cardiovascular risk using integrated clinical and molecular biosignatures: Design of and rationale for the Measurement to Understand the Reclassification of Disease of Cabarrus and Kannapolis (MURDOCK) Horizon 1 Cardiovascular Disease Study.

Journal Article Am Heart J · September 2010 BACKGROUND: Clinical predictive models leave gaps in our ability to stratify cardiovascular risk. High-throughput molecular profiling promises to improve risk classification. METHODS: Horizon 1 of the Measurement to Understand the Reclassification of Disea ... Full text Link to item Cite

Prior cardiovascular interventions are not associated with worsened clinical outcomes in patients with symptomatic atherothrombosis.

Journal Article Crit Pathw Cardiol · September 2010 To assess the effect of prior cardiovascular interventions on long-term clinical outcomes in patients with symptomatic atherothrombosis, the risk factor profiles, treatment patterns, and 24-month outcomes of patients in the United States with and without p ... Full text Link to item Cite

Pathogenesis of sudden unexpected death in a clinical trial of patients with myocardial infarction and left ventricular dysfunction, heart failure, or both.

Journal Article Circulation · August 10, 2010 BACKGROUND: The frequency of sudden unexpected death is highest in the early post-myocardial infarction (MI) period; nevertheless, 2 recent trials showed no improvement in mortality with early placement of an implantable cardioverter-defibrillator after MI ... Full text Link to item Cite

A review of dyspnea in acute heart failure syndromes.

Journal Article Am Heart J · August 2010 In acute heart failure syndrome (AHFS), dyspnea is one of the most common but least understood presenting symptoms for hospitalization. For this reason, dyspnea relief is increasingly becoming a focus in the development of therapies for the treatment of AH ... Full text Link to item Cite

Is rhythm-control superior to rate-control in patients with atrial fibrillation and diastolic heart failure?

Journal Article Ann Noninvasive Electrocardiol · July 2010 BACKGROUND: Although no clinical trial data exist on the optimal management of atrial fibrillation (AF) in patients with diastolic heart failure, it has been hypothesized that rhythm-control is more advantageous than rate-control due to the dependence of t ... Full text Link to item Cite

Fatal myocardial rupture after acute myocardial infarction complicated by heart failure, left ventricular dysfunction, or both: the VALsartan In Acute myocardial iNfarcTion Trial (VALIANT).

Journal Article Am Heart J · July 2010 BACKGROUND: Myocardial rupture is a relatively rare and usually fatal complication of myocardial infarction (MI). Early recognition of patients at greatest risk of myocardial rupture provides an opportunity for early intervention. METHODS: VALIANT was a do ... Full text Link to item Cite

Cough in pediatric patients receiving angiotensin-converting enzyme inhibitor therapy or angiotensin receptor blocker therapy in randomized controlled trials.

Journal Article Clin Pharmacol Ther · June 2010 The incidence of cough in children receiving antihypertension therapy with angiotensin-converting enzyme inhibitors (ACEis) or angiotensin receptor blockers (ARBs) is unknown. We analyzed patient-level data from eight randomized trials for the treatment of ... Full text Link to item Cite

Atrial fibrillation management strategies and early mortality after myocardial infarction: results from the Valsartan in Acute Myocardial Infarction (VALIANT) Trial.

Journal Article Heart · June 2010 OBJECTIVE: The management of patients with atrial fibrillation (AF) following a myocardial infarction (MI) remains uncertain. This study compared a rate control strategy to an anti-arrhythmic-based rhythm control strategy for the treatment of AF following ... Full text Link to item Cite

Unexplained international differences in clinical outcomes after acute myocardial infarction and fibrinolytic therapy: lessons from the Hirulog and Early Reperfusion or Occlusion (HERO)-2 trial.

Journal Article Am Heart J · June 2010 BACKGROUND: Despite advances in therapy, global mortality due to acute myocardial infarction remains high. The international Hirulog and Early Reperfusion or Occlusion (HERO-2) trial of 17,073 patients with ST-segment elevation myocardial infarction provid ... Full text Link to item Cite

There is a role for industry-sponsored education in cardiology.

Journal Article Circulation · May 25, 2010 Featured Publication Full text Link to item Cite

Response to avorn and choudhry

Journal Article Circulation · May 25, 2010 Full text Cite

Enoxaparin 0.3 mg/kg IV supplement for patients transitioning to PCI after subcutaneous enoxaparin therapy for NSTE ACS: a subgroup analysis from the SYNERGY trial.

Journal Article Catheter Cardiovasc Interv · May 1, 2010 OBJECTIVE: To explore clinical and bleeding outcomes in patients enrolled in the SYNERGY trial who had percutaneous coronary intervention (PCI) based on adherence to the dosing regimens of enoxaparin mandated by the protocol. BACKGROUND: In SYNERGY, 4,687 ... Full text Link to item Cite

ST2 and mortality in non-ST-segment elevation acute coronary syndrome.

Journal Article Am Heart J · May 2010 BACKGROUND: ST2 is a member of the interleukin-1 receptor family that is up-regulated in conditions associated with increased myocardial strain. ST2 has been shown to be independently predictive of adverse outcome in heart failure and ST-segment elevation ... Full text Link to item Cite

Is old blood bad blood?

Journal Article Am Heart J · May 2010 Full text Link to item Cite

Effect of valsartan on the incidence of diabetes and cardiovascular events.

Journal Article N Engl J Med · April 22, 2010 Featured Publication BACKGROUND: It is not known whether drugs that block the renin-angiotensin system reduce the risk of diabetes and cardiovascular events in patients with impaired glucose tolerance. METHODS: In this double-blind, randomized clinical trial with a 2-by-2 fact ... Full text Link to item Cite

Effect of nateglinide on the incidence of diabetes and cardiovascular events.

Journal Article N Engl J Med · April 22, 2010 Featured Publication BACKGROUND: The ability of short-acting insulin secretagogues to reduce the risk of diabetes or cardiovascular events in people with impaired glucose tolerance is unknown. METHODS: In a double-blind, randomized clinical trial, we assigned 9306 participants ... Full text Link to item Cite

Baseline characteristics of the Nateglinide and Valsartan Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial population: comparison with other diabetes prevention trials.

Journal Article Cardiovasc Ther · April 2010 The Nateglinide and Valsartan Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial is exploring two pharmacological strategies (nateglinide and valsartan, both alone and in combination) in the prevention of overt diabetes mellitus (DM) and the re ... Full text Link to item Cite

Biomarker bonanza?

Journal Article J Am Coll Cardiol · March 23, 2010 Full text Link to item Cite

Mechanical dyssynchrony after myocardial infarction in patients with left ventricular dysfunction, heart failure, or both.

Journal Article Circulation · March 9, 2010 BACKGROUND: Mechanical dyssynchrony is considered an independent predictor for adverse cardiovascular outcomes in patients with heart failure. However, its importance as a risk factor after myocardial infarction is not well defined. METHODS AND RESULTS: We ... Full text Link to item Cite

Obesity in patients with non-ST-segment elevation acute coronary syndromes: results from the SYNERGY trial.

Journal Article Int J Cardiol · March 4, 2010 BACKGROUND: Obese patients are at increased risk of acute coronary syndromes (ACS). We evaluated the prevalence of obesity in a large ACS population, as well as the relationship between body mass index (BMI) and the use of cardiac medications and procedure ... Full text Link to item Cite

Triage after hospitalization with advanced heart failure: the ESCAPE (Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness) risk model and discharge score.

Journal Article J Am Coll Cardiol · March 2, 2010 OBJECTIVES: Identifying high-risk heart failure (HF) patients at hospital discharge may allow more effective triage to management strategies. BACKGROUND: Heart failure severity at presentation predicts outcomes, but the prognostic importance of clinical st ... Full text Link to item Cite

Linking scientific discovery and better health for the nation: the first three years of the NIH's Clinical and Translational Science Awards.

Journal Article Acad Med · March 2010 Featured Publication A comprehensive system for translating basic biomedical research into useful and effectively implemented clinical diagnostic, preventive, and therapeutic practices is essential to the nation's health. The state of clinical and translational research (CTR) ... Full text Link to item Cite

Clopidogrel use and clinical events after drug-eluting stent implantation: findings from the HealthCore Integrated Research Database.

Journal Article Am Heart J · March 2010 BACKGROUND: Relationships between long-term use and level of dual antiplatelet therapy and outcomes after drug-eluting stent implantation are not well established. METHODS: This is a retrospective cohort study of 9,256 patients receiving drug-eluting stent ... Full text Link to item Cite

Reengineering the national clinical and translational research enterprise: the strategic plan of the National Clinical and Translational Science Awards Consortium.

Journal Article Acad Med · March 2010 Advances in human health require the efficient and rapid translation of scientific discoveries into effective clinical treatments; this process, in turn, depends on observational data gathered from patients, communities, and public health research that can ... Full text Link to item Cite

Current use of aspirin and antithrombotic agents in the United States among outpatients with atherothrombotic disease (from the REduction of Atherothrombosis for Continued Health [REACH] Registry).

Journal Article Am 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 ... Full text Link to item Cite

A secondary analysis of the CHOIR trial shows that comorbid conditions differentially affect outcomes during anemia treatment.

Journal Article Kidney Int · February 2010 The CHOIR trial in anemic patients with chronic kidney disease compared epoetin-alfa treatment with low (11.3 g/l) and high (13.5 g/l) hemoglobin targets on the composite end point of death, hospitalization for heart failure, stroke, and myocardial infarct ... Full text Link to item Cite

Evolution of the coronary care unit: clinical characteristics and temporal trends in healthcare delivery and outcomes.

Journal Article Crit Care Med · February 2010 OBJECTIVE: To describe long-term temporal trends in patient characteristics, processes of care, and in-hospital outcomes among unselected admissions within the contemporary coronary care unit. DESIGN: Hospital administrative database that records both paym ... Full text Link to item Cite

Predictors of sudden cardiac death change with time after myocardial infarction: results from the VALIANT trial.

Journal Article Eur Heart J · January 2010 AIMS: To determine whether predictors of sudden cardiac death (SCD) vary with time after myocardial infarction (MI). METHODS AND RESULTS: We analysed 11 256 patients enrolled in VALIANT. Landmark analysis and Cox proportional hazards modelling were used to ... Full text Link to item Cite

Usefulness of the Duke Sudden Cardiac Death risk score for predicting sudden cardiac death in patients with angiographic (>75% narrowing) coronary artery disease.

Journal Article Am J Cardiol · December 15, 2009 The currently available sudden cardiac death (SCD) risk prediction tools fail to identify most at-risk patients and cannot delineate a specific patient's SCD risk. We sought to develop a tool to improve the risk stratification of patients with coronary art ... Full text Link to item Cite

Traversing the valley of death: a guide to assessing prospects for translational success.

Journal Article Sci Transl Med · December 9, 2009 Featured Publication On the basis of our experience in drug and device development, we have identified six broad categories of issues that profoundly affect the probability for successful translation of basic scientific discoveries into effective therapies. Within each categor ... Full text Link to item Cite

Perspective: Autonomic care systems for hospitalized patients.

Journal Article Acad Med · December 2009 With advancements of medical technology and improved diagnostic and treatment options, children with severe birth defects who would otherwise have no chance of surviving post birth survive to go home every day. The average lifespan in the United States has ... Full text Link to item Cite

Safety and transparency of pediatric drug trials.

Journal Article Arch Pediatr Adolesc Med · December 2009 OBJECTIVES: To quantify the frequency and type of new safety information arising from studies performed under the auspices of the Pediatric Exclusivity Program, to describe the dissemination of these findings in the peer-reviewed literature and compare thi ... Full text Link to item Cite

Metabolic syndrome and alanine aminotransferase: a global perspective from the NAVIGATOR screening population.

Journal Article Diabet Med · December 2009 AIMS: Non-alcoholic fatty liver disease (NAFLD) is associated with features of the metabolic syndrome (MetS) and may be an expression of the syndrome within the liver. Using screening data from the Nateglinide And Valsartan in Impaired Glucose Tolerance Ou ... Full text Link to item Cite

Ethnic differences in the prevalence and treatment of cardiovascular risk factors in US outpatients with peripheral arterial disease: insights from the reduction of atherothrombosis for continued health (REACH) registry.

Journal Article Am 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 ... Full text Link to item Cite

Clinical Trials

Journal Article · December 1, 2009 The chapter gives an overview of clinical trials. Medical practice has entered an era of "evidence-based medicine" characterized by an increasingly widespread societal belief that clinical practice should be based on scientific information in addition to i ... Full text Cite

Comparison of site-reported and core laboratory-reported creatine kinase-MB values in non-ST-segment elevation acute coronary syndrome (from the international trial SYNERGY).

Journal Article Am J Cardiol · November 15, 2009 The effect of nonstandardized creatine kinase (CK)-MB assays on the assessment of myocardial infarction (MI) end points in multicenter international trials has not been evaluated. We compared the site-reported and corresponding core laboratory CK-MB measur ... Full text Link to item Cite

Patterns of management of atrial fibrillation complicating coronary artery bypass grafting: Results from the PRoject of Ex-vivo Vein graft ENgineering via Transfection IV (PREVENT-IV) Trial.

Journal Article Am Heart J · November 2009 BACKGROUND: Current practice related to the management of atrial fibrillation (AF) complicating coronary artery bypass grafting (CABG) is uncertain. METHODS: We examined management of post-CABG AF in the PREVENT-IV trial, and we explored patterns of use of ... Full text Link to item Cite

Acute decline in renal function, inflammation, and cardiovascular risk after an acute coronary syndrome.

Journal Article Clin J Am Soc Nephrol · November 2009 BACKGROUND AND OBJECTIVES: Chronic kidney disease is associated with a higher risk of cardiovascular outcomes. The prognostic significance of worsening renal function has also been shown in various cohorts of cardiac disease; however, the predictors of wor ... Full text Link to item Cite

Comparative efficacy of dronedarone and amiodarone for the maintenance of sinus rhythm in patients with atrial fibrillation.

Journal Article J Am Coll Cardiol · September 15, 2009 OBJECTIVES: We sought to compare the efficacy and safety of dronedarone versus amiodarone for the prevention of recurrent atrial fibrillation (AF). BACKGROUND: Dronedarone is a noniodinated amiodarone congener developed to maintain sinus rhythm. Few data a ... Full text Link to item Cite

Antithrombotics in acute coronary syndromes.

Journal Article J Am Coll Cardiol · September 8, 2009 Antithrombotic agents are an integral component of the medical regimens and interventional strategies currently recommended to reduce thrombotic complications in patients with acute coronary syndromes (ACS). Despite great advances with these therapies, ass ... Full text Link to item Cite

Gastrointestinal bleeding in high risk survivors of myocardial infarction: the VALIANT Trial.

Journal Article Eur Heart J · September 2009 AIMS: The risk of gastrointestinal (GI) bleeding limits the use of antiplatelet and anticoagulant drugs. Risk factors for GI bleeding in post- myocardial infarction (MI) patients have not been well defined. We sought to identify risk factors for GI bleedin ... Full text Link to item Cite

Regional and practice variation in adherence to guideline recommendations for secondary and primary prevention among outpatients with atherothrombosis or risk factors in the United States: a report from the REACH Registry.

Journal Article Crit Pathw Cardiol · September 2009 BACKGROUND: To reduce atherothrombosis-related morbidity and mortality, implementation of guideline-recommended therapies for primary and secondary prevention is necessary. Few data are available for outpatients in actual clinical practice, especially thos ... Full text Link to item Cite

Sex differences in mortality following acute coronary syndromes.

Journal Article JAMA · August 26, 2009 CONTEXT: Conflicting information exists about whether sex differences modulate short-term mortality following acute coronary syndromes (ACS). OBJECTIVES: To investigate the relationship between sex and 30-day mortality in ACS, and to determine whether this ... Full text Link to item Cite

Key issues for global cardiovascular medicine.

Journal Article Lancet · August 15, 2009 Featured Publication Full text Link to item Cite

Premature release of data from clinical trials of ezetimibe.

Journal Article N Engl J Med · August 13, 2009 Featured Publication Full text Link to item Cite

Endoscopic versus open vein-graft harvesting in coronary-artery bypass surgery.

Journal Article N Engl J Med · July 16, 2009 BACKGROUND: Vein-graft harvesting with the use of endoscopy (endoscopic harvesting) is a technique that is widely used to reduce postoperative wound complications after coronary-artery bypass grafting (CABG), but the long-term effects on the rate of vein-g ... Full text Link to item Cite

Usefulness of beta blockers in high-risk patients after myocardial infarction in conjunction with captopril and/or valsartan (from the VALsartan In Acute Myocardial Infarction [VALIANT] trial).

Journal Article Am J Cardiol · July 15, 2009 Concern has been raised about combining beta blockers with angiotensin-receptor blockers in patients with heart failure. The VALsartan In Acute myocardial infarction (VALIANT) trial enrolled 14,703 patients with myocardial infarction complicated by heart f ... Full text Link to item Cite

Rational use of medications: if Canada can't do it ..

Journal Article CMAJ · July 7, 2009 Featured Publication Full text Link to item Cite

Angiographic profiles in courage.

Journal Article Circ Cardiovasc Qual Outcomes · July 2009 Full text Link to item Cite

Long-term mortality of patients undergoing cardiac catheterization for ST-elevation and non-ST-elevation myocardial infarction.

Journal Article Circulation · June 23, 2009 BACKGROUND: There are limited contemporary data comparing long-term outcomes after cardiac catheterization for ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). METHODS AND RESULTS: We studied patients undergoing cardiac catheteriz ... Full text Link to item Cite

Careers for clinician investigators.

Journal Article Circulation · June 9, 2009 Full text Link to item Cite

Influence of body mass index on the efficacy of revascularization in patients with coronary artery disease.

Journal Article J Thorac Cardiovasc Surg · June 2009 OBJECTIVE: We examined the effect of body mass index on the association between revascularization strategy and survival in patients with coronary artery disease. METHODS: Using the Duke Database for Cardiovascular Disease, we selected 22,877 patients who u ... Full text Link to item Cite

Cardiovascular ischemic event rates in outpatients with symptomatic atherothrombosis or risk factors in the united states: insights from the REACH Registry.

Journal Article Crit Pathw Cardiol · June 2009 BACKGROUND: Atherothrombosis, defined as coronary artery, cerebrovascular, and peripheral arterial disease, is the leading cause of death in the United States. Limited data are available from outpatient populations to describe contemporary cardiovascular i ... Full text Link to item Cite

Patients with prior coronary artery bypass grafting have a poor outcome after myocardial infarction: an analysis of the VALsartan in acute myocardial iNfarcTion trial (VALIANT).

Journal Article Eur Heart J · June 2009 AIMS: The number of patients presenting with an acute myocardial infarction (MI) and prior coronary artery bypass grafting (CABG) is increasing. We compared the baseline characteristics, treatment, and clinical outcomes of patients with and without prior C ... Full text Link to item Cite

Early versus delayed, provisional eptifibatide in acute coronary syndromes.

Journal Article N Engl J Med · May 21, 2009 BACKGROUND: Glycoprotein IIb/IIIa inhibitors are indicated in patients with acute coronary syndromes who are undergoing an invasive procedure. The optimal timing of the initiation of such therapy is unknown. METHODS: We compared a strategy of early, routin ... Full text Link to item Cite

Early versus delayed, provisional eptifibatide in acute coronary syndromes

Journal Article Revista Portuguesa De Cardiologia · April 1, 2009 Cite

Scientific evidence underlying the ACC/AHA clinical practice guidelines.

Journal Article JAMA · February 25, 2009 CONTEXT: The joint cardiovascular practice guidelines of the American College of Cardiology (ACC) and the American Heart Association (AHA) have become important documents for guiding cardiology practice and establishing benchmarks for quality of care. OBJE ... Full text Link to item Cite

Rationale and design of the Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure Trial (ASCEND-HF).

Journal Article Am Heart J · February 2009 BACKGROUND: Acute decompensated heart failure (ADHF) is a major public health burden with significant mortality and morbidity. Nesiritide is a recombinantly produced intravenous formulation of human B-type natriuretic peptide that promotes vasodilation and ... Full text Link to item Cite

Standardizing care for acute decompensated heart failure in a large megatrial: the approach for the Acute Studies of Clinical Effectiveness of Nesiritide in Subjects with Decompensated Heart Failure (ASCEND-HF).

Journal Article Am Heart J · February 2009 Acute decompensated heart failure (ADHF) is a major public health issue and remains a heterogeneous, complex, and difficult condition to manage. Although novel acute therapies are being tested in large randomized clinical trials, opportunities exist to imp ... Full text Link to item Cite

Association of weight change with subsequent outcomes in patients hospitalized with acute decompensated heart failure.

Journal Article Am J Cardiol · January 1, 2009 The association of weight loss achieved through various decongestive strategies with clinical outcomes in patients with acute decompensated heart failure (HF) is not well described. The aim of this study was to determine the relation between weight change ... Full text Link to item Cite

Clinical Trials

Chapter · December 15, 2008 The chapter gives an overview of clinical trials. Medical practice has entered an era of "evidence-based medicine" characterized by an increasingly widespread societal belief that clinical practice should be based on scientific information in addition to i ... Full text Cite

Relation of mortality to failure to prescribe beta blockers acutely in patients with sustained ventricular tachycardia and ventricular fibrillation following acute myocardial infarction (from the VALsartan In Acute myocardial iNfarcTion trial [VALIANT] Registry).

Journal Article Am J Cardiol · December 1, 2008 Sustained ventricular arrhythmias and heart failure are well-recognized complications after acute myocardial infarction (AMI) and have been associated with worse outcomes and increased mortality. The use of and outcomes associated with acute beta-blocker t ... Full text Link to item Cite

Changing preferences for survival after hospitalization with advanced heart failure.

Journal Article J Am Coll Cardiol · November 18, 2008 OBJECTIVES: This study was designed to analyze how patient preferences for survival versus quality-of-life change after hospitalization with advanced heart failure (HF). BACKGROUND: Although patient-centered care is a priority, little is known about prefer ... Full text Link to item Cite

Relation between aspirin dose, all-cause mortality, and bleeding in patients with recent cerebrovascular or coronary ischemic events (from the BRAVO Trial).

Journal Article Am J Cardiol · November 15, 2008 Despite aspirin's established role in the treatment of atherosclerotic vascular disease, considerable controversy exists regarding its most effective dosing strategy. In a retrospective observational study, we examined the relation between prescribed aspir ... Full text Link to item Cite

Antidepressant use, depression, and survival in patients with heart failure.

Journal Article Arch Intern Med · November 10, 2008 BACKGROUND: Recent studies suggest that the use of antidepressants may be associated with increased mortality in patients with cardiac disease. Because depression has also been shown to be associated with increased mortality in these patients, it remains u ... Full text Link to item Cite

Negative trials in nephrology: what can we learn?

Journal Article Kidney Int · November 2008 Chronic kidney disease is assuming epidemic proportions, and an increasing number of clinical trials are testing treatments developed to improve morbidity and mortality. Surprisingly, however, a large proportion of these trials have had negative or neutral ... Full text Link to item Cite

Considerations of net present value in policy making regarding diagnostic and therapeutic technologies.

Journal Article Am Heart J · November 2008 BACKGROUND: The pharmaceutical and medical device industries function in a business environment in which shareholders expect companies to optimize profit within legal and ethical standards. A fundamental tool used to optimize decision making is the net pre ... Full text Link to item Cite

Influence of preoperative renal dysfunction on one-year bypass graft patency and two-year outcomes in patients undergoing coronary artery bypass surgery.

Journal Article J Thorac Cardiovasc Surg · November 2008 OBJECTIVE: Limited information exists on the impact of preoperative renal dysfunction on internal thoracic artery and saphenous vein graft failure and 2-year clinical outcomes in patients undergoing coronary artery bypass surgery. METHODS: We studied the i ... Full text Link to item Cite

Rationale and design of IMPROVE-IT (IMProved Reduction of Outcomes: Vytorin Efficacy International Trial): comparison of ezetimbe/simvastatin versus simvastatin monotherapy on cardiovascular outcomes in patients with acute coronary syndromes.

Journal Article Am Heart J · November 2008 BACKGROUND: Reduction in low-density lipoprotein cholesterol (LDL-C) improves clinical outcomes in patients with chronic coronary artery disease and acute coronary syndromes (ACSs). The combination of ezetimibe/simvastatin produces greater reductions in LD ... Full text Link to item Cite

The economic returns of pediatric clinical trials of antihypertensive drugs.

Journal Article Am Heart J · October 2008 BACKGROUND: Congress has authorized the United States Food and Drug Administration (FDA) to provide industry sponsors with a 6-month extension of drug marketing rights under the Pediatric Exclusivity Provision if FDA-requested pediatric drug trials are con ... Full text Link to item Cite

High mortality without ESCAPE: the registry of heart failure patients receiving pulmonary artery catheters without randomization.

Journal Article J Card Fail · October 2008 BACKGROUND: In the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE), there was no difference in days alive and out of the hospital for patients with decompensated heart failure randomly assigned to th ... Full text Link to item Cite

Prevention of diabetes and cardiovascular disease in patients with impaired glucose tolerance: rationale and design of the Nateglinide And Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) Trial.

Journal Article Am Heart J · October 2008 Patients with impaired glucose tolerance (IGT) have increased risk for developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Lifestyle modification and medication can prevent or delay progression to diabetes (PD), but whether such in ... Full text Link to item Cite

Determining the most appropriate components for a composite clinical trial outcome.

Journal Article Am Heart J · October 2008 BACKGROUND: Because composite end points augment event rates, they are often thought to increase statistical power. This may not be true if the intervention has a lesser effect on some components of the composite. Consequently, treatment effect size may de ... Full text Link to item Cite

Analyses of cancer data from three ezetimibe trials.

Journal Article N Engl J Med · September 25, 2008 BACKGROUND: Five years of statin therapy lowers low-density lipoprotein (LDL) cholesterol substantially and, over a 5-year period, results in reductions in the incidence of cardiovascular events. The Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) tria ... Full text Link to item Cite

Safety monitoring of drugs receiving pediatric marketing exclusivity.

Journal Article Pediatrics · September 2008 OBJECTIVES: The Food and Drug Administration Modernization Act provided for an additional 6-month period of marketing exclusivity to companies that perform pediatric drug trials in response to a Food and Drug Administration-issued written request. Because ... Full text Link to item Cite

Secondary analysis of the CHOIR trial epoetin-alpha dose and achieved hemoglobin outcomes.

Journal Article Kidney Int · September 2008 Trials of anemia correction in chronic kidney disease have found either no benefit or detrimental outcomes of higher targets. We did a secondary analysis of patients with chronic kidney disease enrolled in the Correction of Hemoglobin in the Outcomes in Re ... Full text Link to item Cite

Impact of perioperative myocardial infarction on angiographic and clinical outcomes following coronary artery bypass grafting (from PRoject of Ex-vivo Vein graft ENgineering via Transfection [PREVENT] IV).

Journal Article Am J Cardiol · September 1, 2008 Myocardial infarction (MI) after coronary artery bypass grafting (CABG) is associated with significant morbidity and mortality. Frequency, management, mechanisms, and angiographic and clinical outcomes associated with perioperative MI remain poorly underst ... Full text Link to item Cite

Racial differences in blood pressure response to angiotensin-converting enzyme inhibitors in children: a meta-analysis.

Journal Article Clin Pharmacol Ther · September 2008 Angiotensin-converting enzyme (ACE) inhibitors are frequently used to treat hypertension in children.(1) ACE inhibitors alter the balance between the vasoconstrictive, salt-retentive, and cardiac hypertrophic properties of angiotensin II and the vasodilato ... Full text Link to item Cite

Outcomes of patients with acute coronary syndrome and previous coronary artery bypass grafting (from the Pravastatin or Atorvastatin Evaluation and Infection Therapy [PROVE IT-TIMI 22] and the Aggrastat to Zocor [A to Z] trials).

Journal Article Am J Cardiol · September 1, 2008 We examined the effects of intensive statin therapy in patients with acute coronary syndromes (ACSs) and previous coronary artery bypass graft surgery (CABG) participating in the Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis In ... Full text Link to item Cite

Value of clinician assessment of hemodynamics in advanced heart failure: the ESCAPE trial.

Journal Article Circ Heart Fail · September 2008 BACKGROUND: We determined whether estimated hemodynamics from history and physical examination (H&P) reflect invasive measurements and predict outcomes in advanced heart failure (HF). The role of the H&P in medical decision making has declined in favor of ... Full text Link to item Cite

Prognostic implications of left ventricular mass and geometry following myocardial infarction: the VALIANT (VALsartan In Acute myocardial iNfarcTion) Echocardiographic Study.

Journal Article JACC Cardiovasc Imaging · September 2008 OBJECTIVES: This study sought to understand prognostic implications of increased baseline left ventricular (LV) mass and geometric patterns in a high risk acute myocardial infarction. BACKGROUND: The LV hypertrophy and alterations in LV geometry are associ ... Full text Link to item Cite

The design of an observational study of hypertension management, adherence and pressure control in Blood Pressure Success Zone Program participants.

Journal Article Int J Clin Pract · September 2008 AIMS: The Blood Pressure Success Zone (BPSZ) Program, a nationwide initiative, provides education in addition to a complimentary trial of one of three antihypertensive medications. The BPSZ Longitudinal Observational Study of Success (BPSZ-BLISS) aims to e ... Full text Open Access Link to item Cite

Long-term clinical outcomes following coronary stenting.

Journal Article Arch Intern Med · August 11, 2008 BACKGROUND: Clinical trials of drug-eluting stents (DES) vs bare metal stents (BMS) report a reduced need for target lesion revascularization with no difference in death or myocardial infarction. However, these trials selectively enrolled patients with low ... Full text Link to item Cite

Postmarket evaluation of breakthrough technologies.

Journal Article Am Heart J · August 2008 Cardiovascular procedures performed in the United States have more than tripled in the last decade, a trend that is expected to continue with the aging of the population, coupled with epidemics of obesity and diabetes mellitus. Helping to drive this increa ... Full text Link to item Cite

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

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

Prevalence, predictors, and impact of conservative medical management for patients with non-ST-segment elevation acute coronary syndromes who have angiographically documented significant coronary disease.

Journal Article JACC Cardiovasc Interv · August 2008 OBJECTIVES: We sought to characterize the utilization and impact of a conservative medical management strategy for patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) and significant coronary artery disease on early angiography. BACK ... Full text Link to item Cite

Patterns of transfer for patients with non-ST-segment elevation acute coronary syndrome from community to tertiary care hospitals.

Journal Article Am 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 ... Full text Link to item Cite

Smoking status and antithrombin therapy in patients with non-ST-segment elevation acute coronary syndrome.

Journal Article Am Heart J · July 2008 BACKGROUND: Smoking remains a major public health issue. We investigated the incidence of smoking and outcomes in high-risk patients with acute coronary syndromes. Differences in treatment effect of antithrombin therapies were also investigated. METHODS: U ... Full text Link to item Cite

Rivaroxaban, an oral direct factor Xa inhibitor.

Journal Article Expert Opin Investig Drugs · June 2008 Rivaroxaban is a small molecule, direct Factor Xa inhibitor and may be a potentially attractive alternative to vitamin K antagonists. Rivaroxaban is being investigated for the prevention and treatment of venous and arterial thrombosis. A broad search of Me ... Full text Link to item Cite

Racial analysis of patients with myocardial infarction complicated by heart failure and/or left ventricular dysfunction treated with valsartan, captopril, or both.

Journal Article J Am Coll Cardiol · May 13, 2008 OBJECTIVES: African Americans have a high incidence of heart failure (HF). Limited retrospective observational subgroup analyses of patients with left ventricular systolic dysfunction (LVSD) suggest marginal benefit of angiotensin-converting enzyme inhibit ... Full text Link to item Cite

Consistency of financial interest disclosures in the biomedical literature: the case of coronary stents.

Journal Article PLoS One · May 7, 2008 BACKGROUND: Disclosure of authors' financial interests has been proposed as a strategy for protecting the integrity of the biomedical literature. We examined whether authors' financial interests were disclosed consistently in articles on coronary stents pu ... Full text Open Access Link to item Cite

Admission or changes in renal function during hospitalization for worsening heart failure predict postdischarge survival: results from the Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (OPTIME-CHF).

Journal Article Circ Heart Fail · May 2008 BACKGROUND: Admission measures of renal function (blood urea nitrogen [BUN], estimated glomerular filtration rate [eGFR]) in patients hospitalized for worsening heart failure are predictors of in-hospital outcomes. Less is known about the changes and relat ... Full text Link to item Cite

Coronary artery bypass surgery in patients with acute coronary syndromes is difficult to predict.

Journal Article Am Heart J · May 2008 BACKGROUND: Although the use of clopidogrel in patients "unlikely" to require coronary artery bypass grafting (CABG) is recommended in current guidelines of acute coronary syndrome (ACS) management, an important minority of patients require CABG. We assess ... Full text Link to item Cite

Antithrombotic drug development for atrial fibrillation: proceedings, Washington, DC, July 25-27, 2005.

Journal Article Am Heart J · May 2008 In July 2005, leaders from academia, government, and industry convened in Washington, DC, to discuss key issues in the development of antithrombotic treatments for atrial fibrillation (AF). In addition to summarizing available data on the relative benefits ... Full text Link to item Cite

Response to The J-point revisited

Journal Article Hypertension · May 1, 2008 Full text Cite

Safety of placebo controls in pediatric hypertension trials.

Journal Article Hypertension · April 2008 Many clinical trials, including those in pediatric populations, use a placebo arm for medical conditions for which there are readily available therapeutic interventions. Several short-term efficacy trials of antihypertensive medications performed in respon ... Full text Link to item Cite

Outcomes of second revascularization procedures after stent implantation.

Journal Article J Med Syst · April 2008 Drug-eluting stents (DES) reduce subsequent revascularization procedures. Although randomized trials have compared DES to brachytherapy and balloon angioplasty (PTCA) for in-stent restenosis, few long-term comparisons have been made to bare metal stents (B ... Full text Link to item Cite

Improving the health of the community: Duke's experience with community engagement.

Journal Article Acad Med · April 2008 Evidence is accumulating that the United States is falling behind in its potential to translate biomedical advances into practical applications for the population. Societal forces, increased awareness of health disparities, and the direction of clinical an ... Full text Link to item Cite

Pediatric antihypertensive trial failures: analysis of end points and dose range.

Journal Article Hypertension · April 2008 Historically, drugs prescribed for children have not been studied in pediatric populations. Since 1997, however, a 6-month extension of marketing rights is granted if manufacturers conduct Food and Drug Administration-defined pediatric trials. In nearly ha ... Full text Link to item Cite

Cardiorenal interactions: insights from the ESCAPE trial.

Journal Article J Am Coll Cardiol · April 1, 2008 OBJECTIVES: We examined the ESCAPE (Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness) database to understand the impact and pathophysiology of renal dysfunction in patients hospitalized with advanced decompens ... Full text Link to item Cite

Delivering heart failure disease management in 3 tertiary care centers: key clinical components and venues of care.

Journal Article Am Heart J · April 2008 BACKGROUND: Little data exist to assist to help those organizing and managing heart failure (HF) disease management (DM) programs. We aimed to describe the intensity of outpatient HF care (clinic visits and telephone calls) and medical and nonpharmacologic ... Full text Link to item Cite

Estimated glomerular filtration rate, inflammation, and cardiovascular events after an acute coronary syndrome.

Journal Article Am Heart J · April 2008 UNLABELLED: Both renal dysfunction and elevated levels of high-sensitivity C-reactive protein (CRP) are associated with a higher risk of cardiovascular (CV) outcomes. However, it remains to be established whether the prognostic value of impaired estimated ... Full text Link to item Cite

Variation in the use of stress testing and outcomes in patients with non-ST-elevation acute coronary syndromes: insights from GUSTO IIb.

Journal Article Eur 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 ... Full text Link to item Cite

Comparison of renal function and cardiovascular risk following acute myocardial infarction in patients with and without diabetes mellitus.

Journal Article Am J Cardiol · April 1, 2008 Renal dysfunction is an independent risk factor for cardiovascular (cv) disease and its associated complications. Diabetes mellitus (dm) is a common cause of renal dysfunction. Whether the presence or absence of dm modifies the relation between renal dysfu ... Full text Link to item Cite

High-risk myocardial infarction in the young: the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial.

Journal Article Am Heart J · April 2008 BACKGROUND: Advanced age is a well-established prognostic risk factor after acute myocardial infarction (AMI), yet approximately 10% of MIs occur in patients <45 years. We examined characteristics, cardiovascular outcomes, and the influence of risk factors ... Full text Link to item Cite

The efficacy and safety of short- and long-term dual antiplatelet therapy in patients with mild or moderate chronic kidney disease: results from the Clopidogrel for the Reduction of Events During Observation (CREDO) trial.

Journal Article Am Heart J · April 2008 BACKGROUND: Mild and moderate chronic kidney disease (CKD) is associated with decreased survival and increased adverse events after a percutaneous coronary intervention (PCI). Therapy with clopidogrel decreases adverse events in large patient populations. ... Full text Link to item Cite

Usefulness of right ventricular fractional area change to predict death, heart failure, and stroke following myocardial infarction (from the VALIANT ECHO Study).

Journal Article Am J Cardiol · March 1, 2008 Severe right ventricular dysfunction independent of left ventricular ejection fraction increased the risk of heart failure (HF) and death after myocardial infarction (MI). The association between right ventricular function and other clinical outcomes after ... Full text Link to item Cite

Predictors of the first heart failure hospitalization in patients who are stable survivors of myocardial infarction complicated by pulmonary congestion and/or left ventricular dysfunction: a VALIANT study.

Journal Article Eur Heart J · March 2008 AIMS: We sought to assess the incidence of and prognostic factors for heart failure (HF) hospitalization among survivors of high-risk acute myocardial infarction (MI). METHODS AND RESULTS: We assessed the risk of an initial hospitalization for HF in 11 040 ... Full text Link to item Cite

Prediction of one-year survival in high-risk patients with acute coronary syndromes: results from the SYNERGY trial.

Journal Article J Gen Intern Med · March 2008 BACKGROUND: Despite advances in pharmacologic therapy and invasive management strategies for patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS), these patients still suffer substantial morbidity and mortality. OBJECTIVE: The objecti ... Full text Link to item Cite

Clinical and research issues regarding chronic advanced coronary artery disease part II: Trial design, outcomes, and regulatory issues.

Journal Article Am 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 ... Full text Link to item Cite

Coronary artery bypass graft failure after on-pump and off-pump coronary artery bypass: findings from PREVENT IV.

Journal Article Ann Thorac Surg · February 2008 BACKGROUND: This analysis compares 1-year vein graft patency and major adverse cardiac and cerebral events (MACCE [death, myocardial infarction, or stroke]) in on-pump and off-pump patients enrolled in PREVENT IV (the PRoject of Ex-vivo Vein graft ENgineer ... Full text Link to item Cite

Association between bleeding, blood transfusion, and costs among patients with non-ST-segment elevation acute coronary syndromes.

Journal Article Am 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 ... Full text Link to item Cite

Impact of saphenous vein graft radiographic markers on clinical events and angiographic parameters.

Journal Article Ann Thorac Surg · February 2008 BACKGROUND: Use of saphenous vein graft (SVG) radiographic markers has been associated with shorter cardiac catheterization procedure times and reduced contrast agent volume for postoperative coronary artery bypass graft (CABG) catheterizations. Use of suc ... Full text Link to item Cite

Patients with non-ST-elevation acute coronary syndromes undergoing coronary artery bypass grafting in the modern era of antithrombotic therapy.

Journal Article Am Heart J · February 2008 BACKGROUND: Many high-risk patients with non-ST-elevation acute coronary syndromes within the SYNERGY trial required coronary artery bypass grafting (CABG) for optimal revascularization. We explored the clinical outcomes among high-risk patients undergoing ... Full text Link to item Cite

Initial aspirin dose and outcome among ST-elevation myocardial infarction patients treated with fibrinolytic therapy.

Journal Article Circulation · 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 ... Full text Link to item Cite

Effect of antecedent hypertension and follow-up blood pressure on outcomes after high-risk myocardial infarction.

Journal Article Hypertension · January 2008 The influence of blood pressure on outcomes after high-risk myocardial infarction is not well characterized. We studied the relationship between blood pressure and the risk of cardiovascular events in 14 703 patients with heart failure, left ventricular sy ... Full text Link to item Cite

Amiodarone use after acute myocardial infarction complicated by heart failure and/or left ventricular dysfunction may be associated with excess mortality.

Journal Article Am Heart J · January 2008 BACKGROUND: We sought to assess the association of amiodarone use with mortality during consecutive periods in patients with post-acute myocardial infarction with left ventricular systolic dysfunction and/or HF treated with a contemporary medical regimen. ... Full text Link to item Cite

Sensible approaches for reducing clinical trial costs.

Journal Article Clin Trials · 2008 BACKGROUND: Over the past decade, annual funding for biomedical research has more than doubled while new molecular entity approvals have declined by one third. OBJECTIVE: To assess the value of practices commonly employed in the conduct of large-scale clin ... Full text Link to item Cite

International variation in the use of blood transfusion in patients with non-ST-segment elevation acute coronary syndromes.

Journal Article Am J Cardiol · January 1, 2008 The purpose of this study was to determine international patterns of blood transfusion in patients with acute coronary syndrome (ACS). Previous studies showed geographic heterogeneity in some aspects of ACS care. Data for variability in the use of blood tr ... Full text Link to item Cite

Use of larger versus smaller drug-safety databases before regulatory approval: the trade-offs.

Journal Article Health Aff (Millwood) · 2008 Although efforts to revamp the drug-safety system have been directed at strengthening postmarketing surveillance, strategies for the preapproval stage may be useful. One strategy would be to require larger sample sizes in preapproval safety databases. To e ... Full text Link to item Cite

Time to coronary angiography and outcomes among patients with high-risk non ST-segment elevation acute coronary syndromes: results from the SYNERGY trial.

Journal Article Circulation · December 4, 2007 BACKGROUND: Optimal timing for an early invasive strategy in patients with non-ST-segment-elevation acute coronary syndrome remains unclear. We evaluated the relationship between time from hospital admission to coronary angiography and outcomes in high-ris ... Full text Link to item Cite

Incidence and predictors of sudden cardiac death in patients with diastolic heart failure.

Journal Article J Cardiovasc Electrophysiol · December 2007 Featured Publication INTRODUCTION: Although it is known that patients with diastolic heart failure are at an increased risk of death, their mode of death has not been clearly defined. We conducted this study to examine the incidence and predictors of sudden cardiac death (SCD) ... Full text Link to item Cite

The cycle of quality as a model for improving health outcomes in the treatment of hypertension

Journal Article European Heart Journal Supplement · December 1, 2007 Considerable progress has been made in diagnosing and treating chronic diseases such as hypertension. However, ongoing improvements in methods for characterizing the impact of long-term diseases provide strong evidence that a substantial gap still exists b ... Full text Cite

Large clinical trials and registries-clinical research institutes

Journal Article · December 1, 2007 This chapter highlights the purpose of clinical trial, registry, or outcome study-to estimate what is likely to happen to the next patient if one treatment strategy or the other is chosen. To assess the degree to which the proposed study enhances the abili ... Full text Cite

Serial measurement of monocyte chemoattractant protein-1 after acute coronary syndromes: results from the A to Z trial.

Journal Article J Am Coll Cardiol · November 27, 2007 OBJECTIVES: This study sought to determine whether the novel biomarker monocyte chemoattractant protein (MCP)-1 adds prognostic value to standard risk assessment tools and biomarkers after acute coronary syndromes (ACS). BACKGROUND: Monocyte chemoattractan ... Full text Link to item Cite

Clinical quality in non-ST-elevation acute coronary syndromes.

Journal Article Am J Med · November 2007 Featured Publication We have entered a new era of medicine in which both the interest of scientific rigor and pressure from health care purchasers demand increased adoption of empirically based standards of care. Certain therapeutic areas have seen rapid transformation from a ... Full text Link to item Cite

Cardiovascular disease on a global scale: defining the path forward for research and practice.

Journal Article Eur Heart J · November 2007 Featured Publication During the 2006 World Congress of Cardiology meeting in Barcelona, the Virtual Coordinating Centre for Global Collaborative Cardiovascular Research (VIGOUR) group held a symposium examining potential approaches to understanding and controlling the explosiv ... Full text Link to item Cite

Rapid assay brain natriuretic peptide and troponin I in patients hospitalized with decompensated heart failure (from the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness Trial).

Journal Article Am 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 ... Full text Link to item Cite

Long-term outcome and its predictors among patients with ST-segment elevation myocardial infarction complicated by shock: insights from the GUSTO-I trial.

Journal Article J Am Coll Cardiol · October 30, 2007 OBJECTIVES: This study sought to assess long-term outcome and determine its predictors among 30-day survivors of cardiogenic shock. BACKGROUND: Patients with cardiogenic shock have high in-hospital and 30-day mortality, but there are little data about thos ... Full text Link to item Cite

Evolution of adverse changes in stored RBCs.

Journal Article Proc Natl Acad Sci U S A · October 23, 2007 Featured Publication Recent studies have underscored questions about the balance of risk and benefit of RBC transfusion. A better understanding of the nature and timing of molecular and functional changes in stored RBCs may provide strategies to improve the balance of benefit ... Full text Link to item Cite

Effect of intensive lipid-lowering therapy on mortality after acute coronary syndrome (a patient-level analysis of the Aggrastat to Zocor and Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 trials).

Journal Article Am J Cardiol · October 1, 2007 Compared with moderate lipid lowering with standard-dose statin therapy, intensive lipid lowering with high-dose statin therapy after acute coronary syndromes (ACS) significantly reduces cardiovascular events. However, the 2 trials of high-dose versus stan ... Full text Link to item Cite

Timing of death and myocardial infarction in patients with non-ST elevation acute coronary syndromes: insights from randomized clinical trials.

Journal Article J Interv Cardiol · October 2007 BACKGROUND: Adverse events occur following non-ST elevation acute coronary syndromes (NSTE ACS). However, the timing of these events in relation to index event is less clear. METHODS: Accordingly, we evaluated 26,466 NSTE ACS patients from the Global Use o ... Full text Link to item Cite

Relation between dose of loop diuretics and outcomes in a heart failure population: results of the ESCAPE trial.

Journal Article Eur J Heart Fail · October 2007 Featured Publication BACKGROUND: We examined the relation of maximal in-hospital diuretic dose to weight loss, changes in renal function, and mortality in hospitalised heart failure (HF) patients. METHODS: In ESCAPE, 395 patients received diuretics in-hospital. Weight was meas ... Full text Link to item Cite

No prognostic significance of chronic infection with Chlamydia pneumoniae in acute coronary syndromes: insights from the Global Utilization of Strategies to Open Occluded Arteries IV Acute Coronary Syndromes trial.

Journal Article Am Heart J · August 2007 BACKGROUND: Although relationships between chronic Chlamydia pneumoniae (Cpn) infection and the risk of coronary events in stable coronary artery disease patients have been reported, a similar link in acute coronary syndrome (ACS) patients has not been con ... Full text Link to item Cite

Role of the centers for education and research on therapeutics (CERTs) in pharmacovigilance and proper use of therapeutics.

Journal Article Clin Pharmacol Ther · August 2007 According to the Institute of Medicine (IOM) Committee on the Assessment of the U.S. Drug Safety System, "The recent highly publicized controversies surrounding the safety of some drugs have contributed to a public perception that the drug safety system is ... Full text Link to item Cite

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

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

Clinical outcomes of palliative surgery including a systemic-to-pulmonary artery shunt in infants with cyanotic congenital heart disease: does aspirin make a difference?

Journal Article Circulation · July 17, 2007 Featured Publication BACKGROUND: Aspirin (ASA) often is used to prevent thrombosis in infants with congenital heart disease after placement of a systemic-to-pulmonary artery shunt, but its effect on outcomes is unknown. METHODS AND RESULTS: The present multicenter study prospe ... Full text Link to item Cite

Time to reperfusion in acute myocardial infarction. It is time to reduce it!

Journal Article J Electrocardiol · July 2007 Featured Publication BACKGROUND AND OBJECTIVES: Mortality from ST-segment elevation myocardial infarction remains high, with most deaths occurring before hospital admission. Despite effective pre- and in-hospital reperfusion strategies becoming standard over the past 2 decades ... Full text Link to item Cite

Relationship between depressive symptoms and long-term mortality in patients with heart failure.

Journal Article Am Heart J · July 2007 Featured Publication BACKGROUND: Depression is prevalent in patients with heart failure (HF) and is associated with short-term poor prognosis. However, the long-term effect of depression and the use of self-administered depression evaluation on HF prognosis remained unknown. T ... Full text Link to item Cite

What we publish in the American Heart Journal and why

Journal Article American Heart Journal · July 1, 2007 Full text Cite

Preventing tomorrow's sudden cardiac death today: part I: Current data on risk stratification for sudden cardiac death.

Journal Article Am Heart J · June 2007 Featured Publication Accurate and timely prediction of sudden cardiac death (SCD) is a necessary prerequisite for effective prevention and therapy. Although the largest number of SCD events occurs in patients without overt heart disease, there are currently no tests that are o ... Full text Link to item Cite

Preventing tomorrow's sudden cardiac death today: part II: Translating sudden cardiac death risk assessment strategies into practice and policy.

Journal Article Am Heart J · June 2007 Although current evidence supporting a more precise strategy for identifying patients at highest risk for sudden cardiac death (SCD) is sparse, strategies for translating existing and future evidence into clinical practice and policy are needed today. A gr ... Full text Link to item Cite

Treatment and outcomes of patients with evolving myocardial infarction: experiences from the SYNERGY trial.

Journal Article Eur Heart J · May 2007 AIMS: Patients with myocardial infarction (MI) presenting immediately after symptom onset may be treated less aggressively due to their non-elevated troponin status. We compared the initial treatment and clinical outcomes of patients presenting with evolvi ... Full text Link to item Cite

Performance measures have a major effect on cardiovascular outcomes: a review.

Journal Article Am J Med · May 2007 Improved application of existing therapies, directed by evidence-based guidelines, may offer immediate savings of life and function to patients with cardiovascular disease. We sought to evaluate the evidence that use of performance measures derived from cl ... Full text Link to item Cite

Bleeding and blood transfusion issues in patients with non-ST-segment elevation acute coronary syndromes.

Journal Article Eur Heart J · May 2007 Antithrombotic therapy and invasive risk stratification in selected high-risk patients have improved outcomes from non-ST-segment elevation acute coronary syndromes (NSTE-ACS), but carry a risk of bleeding and blood transfusion. Although the true incidence ... Full text Link to item Cite

Effects of platelet glycoprotein IIb/IIIa receptor blockers in non-ST segment elevation acute coronary syndromes: benefit and harm in different age subgroups.

Journal Article Heart · April 2007 Featured Publication OBJECTIVE: To investigate whether the beneficial and harmful effects of platelet glycoprotein IIb/IIIa receptor blockers in non-ST elevation acute coronary syndromes (NSTE-ACS) depend on age. METHODS: A meta-analysis of six trials of platelet glycoprotein ... Full text Link to item Cite

Publication or presentation of results from multicenter clinical trials: evidence from an academic medical center.

Journal Article Am Heart J · April 2007 BACKGROUND: Nonpublication of research results threatens the integrity of clinical research, but the extent of nonpublication and factors associated with publication remain poorly documented. We sought to examine rates of publication or presentation of res ... Full text Link to item Cite

Impact of initial heart rate and systolic blood pressure on relation of age and mortality among fibrinolytic-treated patients with acute ST-elevation myocardial infarction presenting with cardiogenic shock.

Journal Article Am 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 ... Full text Link to item Cite

A View from Academia

Journal Article · March 14, 2007 Full text Cite

Role of lifestyle and oral anti-diabetic agents to prevent type 2 diabetes mellitus and cardiovascular disease.

Journal Article Am J Cardiol · March 1, 2007 Patients with type 2 diabetes mellitus (DM) and those with impaired glucose tolerance are at increased risk for the development of cardiovascular disease. With an increasing global incidence and prevalence of type 2 DM, and with the 2003 lowering of the gl ... Full text Link to item Cite

Long-term outcomes of left bundle branch block in high-risk survivors of acute myocardial infarction: the VALIANT experience.

Journal Article Heart Rhythm · March 2007 BACKGROUND: In survivors of myocardial infarction (MI), new left bundle branch block (LBBB) is associated with adverse outcomes, but its impact is not well described in post-MI patients with left ventricular (LV) systolic dysfunction and/or heart failure ( ... Full text Link to item Cite

Outcomes associated with the use of secondary prevention medications after coronary artery bypass graft surgery.

Journal Article Ann Thorac Surg · March 2007 Featured Publication BACKGROUND: Secondary prevention medications are beneficial after acute coronary syndromes, but these benefits are less clear after coronary artery bypass graft surgery. We investigated whether greater use of secondary prevention medications after coronary ... Full text Link to item Cite

Techniques and benefits of multiple internal mammary artery bypass at 20 years of follow-up.

Journal Article Ann Thorac Surg · March 2007 BACKGROUND: In patients with multivessel coronary artery disease, performing multiple internal mammary artery (MIMA) grafts to two coronary systems during coronary artery bypass grafting (CABG) improves clinical outcome. Few databases have decades of follo ... Full text Link to item Cite

Prognostic value of growth-differentiation factor-15 in patients with non-ST-elevation acute coronary syndrome.

Journal Article Circulation · February 27, 2007 BACKGROUND: Growth-differentiation factor-15 (GDF-15) is a member of the transforming growth factor-beta cytokine superfamily that is induced in the heart after ischemia-and-reperfusion injury. Circulating levels of GDF-15 may provide prognostic informatio ... Full text Link to item Cite

Economic return of clinical trials performed under the pediatric exclusivity program.

Journal Article JAMA · February 7, 2007 Featured Publication CONTEXT: In 1997, Congress authorized the US Food and Drug Administration (FDA) to grant 6-month extensions of marketing rights through the Pediatric Exclusivity Program if industry sponsors complete FDA-requested pediatric trials. The program has been pra ... Full text Open Access Link to item Cite

Racial differences among high-risk patients presenting with non-ST-segment elevation acute coronary syndromes (results from the SYNERGY trial).

Journal Article Am J Cardiol · February 1, 2007 Featured Publication Management and outcomes of patients with acute coronary syndromes (ACSs) may vary according to patient race and ethnicity. To assess racial differences in presentation and outcome in high-risk North American patients with non-ST-segment elevation (NSTE) AC ... Full text Link to item Cite

The impact of anthropomorphic indices on clinical outcomes in patients with acute ST-elevation myocardial infarction.

Journal Article Eur Heart J · February 2007 AIMS: Multiple studies have focused on the relationship of body anthropometric measures with clinical events in ST-elevation myocardial infarction (STEMI) patients, highlighting the 'obesity paradox'. However, the relative prognostic importance of these me ... Full text Link to item Cite

Creatine kinase-MB elevation after coronary artery bypass grafting surgery in patients with non-ST-segment elevation acute coronary syndromes predict worse outcomes: results from four large clinical trials.

Journal Article Eur Heart J · February 2007 Featured Publication AIMS: To assess the significance of creatine kinase (CK)-MB elevations in outcomes of patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) who have undergone coronary artery bypass grafting (CABG) surgery. METHODS AND RESULTS: This an ... Full text Link to item Cite

Clopidogrel use and long-term clinical outcomes after drug-eluting stent implantation.

Journal Article JAMA · January 10, 2007 Featured Publication CONTEXT: Recent studies of drug-eluting intracoronary stents suggest that current antiplatelet regimens may not be sufficient to prevent late stent thrombosis. OBJECTIVE: To assess the association between clopidogrel use and long-term clinical outcomes of ... Full text Link to item Cite

Bleeding complications in patients with acute coronary syndrome undergoing early invasive management can be reduced with radial access, smaller sheath sizes, and timely sheath removal.

Journal Article Catheter Cardiovasc Interv · January 2007 OBJECTIVES: Our objective was to analyze the impact of arterial access site, sheath size, timing of sheath removal, and use of access site closure devices on high-risk patients with acute coronary syndromes (ACS). BACKGROUND: In the SYNERGY trial, 9,978 pa ... Full text Link to item Cite

Benefit assessment of therapeutic products: the Centers for Education and Research on Therapeutics.

Journal Article Pharmacoepidemiol Drug Saf · January 2007 Featured Publication The ability to manage risk depends critically on an understanding of the degree to which a known risk is balanced by the probability of a clinical benefit. Despite the massive emphasis on risk and risk management in the past few years and the long-term foc ... Full text Link to item Cite

Curbing the cardiovascular disease epidemic: aligning industry, government, payers, and academics.

Journal Article Health Aff (Millwood) · 2007 Featured Publication Despite decades of progress in the diagnosis, treatment, and prevention of cardiovascular disease, its prevalence continues to grow in both developed and developing countries. We have constructed a model, the "cycle of quality," which connects the innovati ... Full text Link to item Cite

Is there a price to pay for short-term savings in the clinical development of new pharmaceutical products?

Journal Article Drug Information Journal · January 1, 2007 Clinical development of new pharmaceutical compounds has historically been geared toward meeting the information demands of regulatory agencies while minimizing the cost and duration of the drug development process. One strategy for meeting these objective ... Full text Cite

Predictors of stroke within 30 days in patients with non-ST-segment elevation acute coronary syndromes.

Journal Article Eur Heart J · December 2006 AIMS: Stroke is an uncommon but serious complication after non-ST-segment elevation acute coronary syndrome (NSTE-ACS). We aimed to identify predictors of stroke within 30 days in patients who suffered NSTE-ACS. METHODS AND RESULTS: We pooled data from six ... Full text Link to item Cite

Efficacy and safety of enoxaparin compared with unfractionated heparin in high-risk patients with non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention in the Superior Yield of the New Strategy of Enoxaparin, Revascularization and Glycoprotein IIb/IIIa Inhibitors (SYNERGY) trial.

Journal Article Am Heart J · December 2006 BACKGROUND: Enoxaparin reduces ischemic events more effectively than unfractionated heparin (UFH) in patients treated conservatively for non-ST-segment elevation acute coronary syndrome. The SYNERGY trial compared these agents in high-risk patients undergo ... Full text Link to item Cite

Racial differences in the characteristics of patients admitted for acute decompensated heart failure and their relation to outcomes: results from the OPTIME-CHF trial.

Journal Article J Card Fail · December 2006 BACKGROUND: Recent data suggest that differences in response to therapy and survival exist between African Americans and Caucasians with heart failure. Whether these differences exist in acute decompensated heart failure (ADHF) is uncertain. METHODS AND RE ... Full text Link to item Cite

Recent trends in the care of patients with non-ST-segment elevation acute coronary syndromes: insights from the CRUSADE initiative.

Journal Article Arch 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 ... Full text Link to item Cite

A subgroup analysis of the impact of prerandomization antithrombin therapy on outcomes in the SYNERGY trial: enoxaparin versus unfractionated heparin in non-ST-segment elevation acute coronary syndromes.

Journal Article J Am Coll Cardiol · October 3, 2006 OBJECTIVES: The purpose of this study was to compare the effect of receiving pretreatment with antithrombin before randomization as well as overall efficacy and safety of enoxaparin versus unfractionated heparin (UFH) in the SYNERGY (Superior Yield of the ... Full text Link to item Cite

Previously known and newly diagnosed atrial fibrillation: a major risk indicator after a myocardial infarction complicated by heart failure or left ventricular dysfunction.

Journal Article Eur J Heart Fail · October 2006 AIMS: To characterize the relationship between known and newly diagnosed atrial fibrillation (AF) and the risk of death and major cardiovascular (CV) events in patients with acute myocardial infarction (MI) complicated by heart failure (HF) and/or left ven ... Full text Link to item Cite

Selection of surgical or percutaneous coronary intervention provides differential longevity benefit.

Journal Article Ann Thorac Surg · October 2006 BACKGROUND: Treatment of coronary artery disease (CAD) is evolving with better medications, improvements in percutaneous coronary intervention (PCI), and enhanced techniques for coronary artery bypass grafting (CABG). METHODS: In this study, 18,481 patient ... Full text Link to item Cite

Troponin-T and N-terminal pro-B-type natriuretic peptide predict mortality benefit from coronary revascularization in acute coronary syndromes: a GUSTO-IV substudy.

Journal Article J Am Coll Cardiol · September 19, 2006 OBJECTIVES: This study was designed to evaluate biomarkers for selection of patients with non-ST-segment elevation acute coronary syndromes (ACS) that derive mortality benefit from revascularization. BACKGROUND: Biomarkers are essential for identification ... Full text Link to item Cite

Evaluation of the National Cholesterol Education Program Adult Treatment Panel III algorithm for selecting candidates for statin therapy: insights from the A to Z trial.

Journal Article Am J Cardiol · September 15, 2006 The National Cholesterol Education Program Adult Treatment Panel III recommends an algorithm to integrate iterative risk-stratification information with low-density lipoprotein (LDL) cholesterol levels to identify candidates for statin therapy. We used the ... Full text Link to item Cite

Peer-reviewed publication of clinical trials completed for pediatric exclusivity.

Journal Article JAMA · September 13, 2006 CONTEXT: Much of pediatric drug use is off-label because appropriate pediatric studies have not been conducted and the drugs have not been labeled by the US Food and Drug Administration (FDA) for use in children. In 1997, Congress authorized the FDA to gra ... Full text Link to item Cite

Short- and long-term risk stratification in acute coronary syndromes: the added value of quantitative ST-segment depression and multiple biomarkers.

Journal Article J Am Coll Cardiol · September 5, 2006 OBJECTIVES: The purpose of this study was to develop 30-day and 1-year risk stratification models for non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients that incorporate quantitative ST-segment depression and novel biomarkers. BACKGROUND: ... Full text Link to item Cite

Keynote: Translating clinical trials into practice

Journal Article Texas Heart Institute Journal · September 4, 2006 Cite

Geographic variation in the treatment of acute myocardial infarction in the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial.

Journal Article Am Heart J · September 2006 BACKGROUND: The VALIANT trial compared the efficacy and safety of captopril, valsartan, and their combination in patients with left ventricular systolic dysfunction, heart failure, or both after acute myocardial infarction (MI). By examining this internati ... Full text Link to item Cite

The prognostic value of the admission and predischarge electrocardiogram in acute coronary syndromes: the GUSTO-IIb ECG Core Laboratory experience.

Journal Article Am Heart J · August 2006 BACKGROUND: Prior research suggests that patients may be entered into clinical trials with different electrocardiographic (ECG) findings than specified by study protocol criteria; the extent and impact of this variability in a large-scale trial have not be ... Full text Link to item Cite

Racial differences are seen in blood pressure response to fosinopril in hypertensive children.

Journal Article Am Heart J · August 2006 BACKGROUND: Few antihypertensive therapies have been systematically studied in children and dosages for many agents are either extrapolated from adult studies or obtained from small homogenous pediatric populations. It is well established that adult patien ... Full text Link to item Cite

Predicting significant coronary artery disease in patients with left ventricular dysfunction.

Journal Article Am Heart J · August 2006 BACKGROUND: Because coronary artery disease (CAD) is a prevalent comorbidity in patients with low ejection function (EF), a number of patients with heart failure undergo diagnostic cardiac catheterization. The objective of this study was to develop a model ... Full text Link to item Cite

Clinical relevance of C-reactive protein during follow-up of patients with acute coronary syndromes in the Aggrastat-to-Zocor Trial.

Journal Article Circulation · July 25, 2006 BACKGROUND: Elevated levels of high-sensitivity C-reactive protein (hsCRP) are associated with higher risk of adverse outcomes in patients at risk for or with established coronary artery disease. Retrospective analyses suggest that this risk may be modifie ... Full text Link to item Cite

Impact of internal mammary artery conduit on long-term outcomes after percutaneous intervention of saphenous vein graft.

Journal Article Circulation · July 4, 2006 BACKGROUND: The influence of an internal mammary artery (IMA) graft on long-term outcomes after percutaneous saphenous vein graft (SVG) intervention is currently unknown. METHODS AND RESULTS: To examine the impact of IMA on outcomes in patients undergoing ... Full text Link to item Cite

Evaluation of diagnostic imaging technologies and therapeutics devices: better information for better decisions: proceedings of a multidisciplinary workshop.

Journal Article Am Heart J · July 2006 We are entering an era in which the success of biomedical science and the increasing understanding of the value of evidence for practice are in a state of tension. This tension is especially notable in the device arena, in which the short life cycles and i ... Full text Link to item Cite

Extent of coronary artery disease as a predictor of outcomes in acute myocardial infarction complicated by heart failure, left ventricular dysfunction, or both.

Journal Article Am Heart J · July 2006 BACKGROUND: Left ventricular systolic dysfunction (LVSD) and heart failure (HF) are powerful predictors of poor outcome after acute myocardial infarction (MI). It is not known, however, whether the extent of coronary artery disease (CAD) independently infl ... Full text Link to item Cite

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

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

Statin use and sex-specific stroke outcomes in patients with vascular disease.

Journal Article Stroke · June 2006 BACKGROUND AND PURPOSE: Although statins reduce the risk of stroke in patients with coronary heart disease, possible differing effects of statins on stroke outcomes based on sex remain uncertain. We investigated the relationships between statin use and sex ... Full text Link to item Cite

The influence of risk status on guideline adherence for patients with non-ST-segment elevation acute coronary syndromes.

Journal Article Am 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 ... Full text Link to item Cite

Optimizing use of revascularization and clinical outcomes in ST-elevation myocardial infarction: insights from the GUSTO-V trial.

Journal Article Eur 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 ... Full text Link to item Cite

Multifaceted intervention to promote beta-blocker use in heart failure.

Journal Article Am Heart J · May 2006 BACKGROUND: Despite a survival benefit and guideline recommendation for beta-blockers in left ventricular systolic dysfunction, beta-blockers are underused in clinical practice. METHODS: Medical practices with > or = 15 patients with heart failure (HF) in ... Full text Link to item Cite

How obesity affects the cut-points for B-type natriuretic peptide in the diagnosis of acute heart failure. Results from the Breathing Not Properly Multinational Study.

Journal Article Am Heart J · May 2006 BACKGROUND: B-type natriuretic peptide (BNP) is valuable in diagnosing heart failure (HF), but its utility in obese patients is unknown. Studies have suggested a cut-point of BNP > or = 100 pg/mL for the diagnosis of HF; however, there is an inverse relati ... Full text Link to item Cite

Marketing drugs too early in testing.

Journal Article Science · April 14, 2006 Full text Link to item Cite

A tale of two trials: a comparison of the post-acute coronary syndrome lipid-lowering trials A to Z and PROVE IT-TIMI 22.

Journal Article Circulation · March 21, 2006 BACKGROUND: The Aggrastat to Zocor (A to Z) and Pravastatin or Atorvastatin Evaluation and Infection Therapy (PROVE IT) trials compared intensive and moderate statin therapy after acute coronary syndromes, with seemingly disparate results. We analyzed the ... Full text Link to item Cite

In reply [2]

Journal Article JAMA · March 8, 2006 Full text Cite

Outcomes of patients in clinical trials with ST-segment elevation myocardial infarction among countries with different gross national incomes.

Journal Article Eur Heart J · March 2006 AIMS: To evaluate whether there is an association between 30-day mortality in patients with ST-segment elevation myocardial infarction (STEMI) included in clinical trials and country gross national income (GNI). METHODS AND RESULTS: A retrospective analysi ... Full text Link to item Cite

Clinical trial issues in weight-loss therapy.

Journal Article Am Heart J · March 2006 BACKGROUND: Overweight and obesity rates continue to increase nationally, generating significant interest in weight-loss therapies to address both the burden of obesity-associated chronic disease and individual concerns about appearance. Effective obesity ... Full text Link to item Cite

A comparison of the clinical impact of bleeding measured by two different classifications among patients with acute coronary syndromes.

Journal Article J Am Coll Cardiol · February 21, 2006 OBJECTIVES: The goal of this study was to determine the association between Thrombolysis In Myocardial Infarction (TIMI) and Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) bleeding and clinical outcomes. BACKGROUND: There are limited d ... Full text Link to item Cite

The effect of valsartan, captopril, or both on atherosclerotic events after acute myocardial infarction: an analysis of the Valsartan in Acute Myocardial Infarction Trial (VALIANT).

Journal Article J Am Coll Cardiol · February 21, 2006 OBJECTIVES: We attempted to compare the effect of an angiotensin-converting enzyme (ACE) inhibitor and angiotensin receptor blocker (ARB) on atherosclerotic events. BACKGROUND: Angiotensin-converting enzyme inhibitors and ARBs interrupt the renin-angiotens ... Full text Link to item Cite

Cardiac tamponade in the fibrinolytic era: analysis of >100,000 patients with ST-segment elevation myocardial infarction.

Journal Article Am Heart J · February 2006 BACKGROUND: Cardiac tamponade is a life-threatening complication of acute myocardial infarction (MI). Data on the incidence, risk factors, and outcome of tamponade in patients with acute MI in the fibrinolytic era are limited. METHODS: Data from a combined ... Full text Link to item Cite

Long-term adherence to evidence-based secondary prevention therapies in coronary artery disease.

Journal Article Circulation · January 17, 2006 BACKGROUND: Studies have examined the use of evidence-based therapies for coronary artery disease (CAD) in the short term and at hospital discharge, but few have evaluated long-term use. METHODS AND RESULTS: Using the Duke Databank for Cardiovascular Disea ... Full text Link to item Cite

Usefulness of biomarkers for predicting long-term mortality in patients with diabetes mellitus and non-ST-elevation acute coronary syndromes (a GUSTO IV substudy).

Journal Article Am J Cardiol · January 15, 2006 The present study evaluated whether biomarkers of ischemia, inflammation, myocardial damage, and dysfunction are equally useful in patients who have diabetes mellitus (DM) for prediction of cardiac events in non-ST-elevation acute coronary syndrome (ACS). ... Full text Link to item Cite

Where's the flap?

Journal Article J Cardiovasc Magn Reson · 2006 We present a case of aortic intramural hematoma (IMH) in an elderly woman who presented with sudden onset of mid-scapular pain. The patient underwent a series of multimodality imaging studies before the diagnosis of IMH was evident by cardiovascular magnet ... Full text Link to item Cite

Assessment and treatment of depression in patients with cardiovascular disease: National Heart, Lung, and Blood Institute Working Group Report.

Journal Article Psychosom Med · 2006 OBJECTIVE: The National Heart, Lung, and Blood Institute convened an interdisciplinary working group of experts to develop recommendations for the assessment and treatment of depression in patients with coronary heart disease (CHD). METHOD: Consensus of ex ... Full text Link to item Cite

Translating clinical trials into practice.

Journal Article Tex Heart Inst J · 2006 Link to item Cite

Clinical trials bureaucracy: unintended consequences of well-intentioned policy.

Journal Article Clin Trials · 2006 BACKGROUND: As randomized controlled trials have become the 'gold standard' for medical research, a complex regulatory structure for the conduct of clinical trials has emerged. However, this structure has not been adequately assessed to ensure that regulat ... Full text Link to item Cite

Elevated creatine kinase-MB with normal creatine kinase predicts worse outcomes in patients with acute coronary syndromes: results from 4 large clinical trials.

Journal Article Am Heart J · January 2006 BACKGROUND: The 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 patients ... Full text Link to item Cite

How changes in drug-safety regulations affect the way drug and biotech companies invest in innovation.

Journal Article Health Aff (Millwood) · 2006 Changes in the economics of product development resulting from heightened safety regulations could have a sizable negative impact on drug and biotechnology companies' decisions about investing in innovation. We developed a model to compare the potential ec ... Full text Link to item Cite

The cost of acute myocardial infarction in the new millennium: evidence from a multinational registry.

Journal Article Am Heart J · January 2006 BACKGROUND: Although geographic variation in the treatment of acute myocardial infarction (AMI) has been recognized, the impact of evidence-based international treatment guidelines on such variation is unclear. We sought to characterize resource use and co ... Full text Link to item Cite

Differences in the clinical features and outcomes in African Americans and whites with myocardial infarction.

Journal Article Am 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 ... Full text Link to item Cite

Reply

Journal Article Journal of the American College of Cardiology · 2006 Full text Cite

Prognostic value of serial B-type natriuretic peptide testing during follow-up of patients with unstable coronary artery disease.

Journal Article JAMA · December 14, 2005 CONTEXT: Elevated concentrations of B-type natriuretic peptide (BNP) at presentation in patients with acute coronary syndrome (ACS) are associated with long-term mortality. Few data exist regarding serial assessment of BNP levels during follow-up. OBJECTIV ... Full text Link to item Cite

Mortality and morbidity remain high despite captopril and/or Valsartan therapy in elderly patients with left ventricular systolic dysfunction, heart failure, or both after acute myocardial infarction: results from the Valsartan in Acute Myocardial Infarction Trial (VALIANT).

Journal Article Circulation · November 29, 2005 BACKGROUND: The elderly constitute an increasing proportion of acute myocardial infarction patients and have disproportionately high mortality and morbidity. Those with heart failure or impaired left ventricular left ventricular function after acute myocar ... Full text Link to item Cite

High-risk patients with acute coronary syndromes treated with low-molecular-weight or unfractionated heparin: outcomes at 6 months and 1 year in the SYNERGY trial.

Journal Article JAMA · November 23, 2005 CONTEXT: The SYNERGY trial comparing enoxaparin and unfractionated heparin in high-risk patients with acute coronary syndromes (ACS) showed that enoxaparin was not inferior to unfractionated heparin in reducing death or nonfatal myocardial infarction (MI) ... Full text Link to item Cite

Efficacy and safety of edifoligide, an E2F transcription factor decoy, for prevention of vein graft failure following coronary artery bypass graft surgery: PREVENT IV: a randomized controlled trial.

Journal Article JAMA · November 16, 2005 CONTEXT: Coronary artery bypass graft (CABG) surgery with autologous vein grafting is commonly performed. Progressive neointimal hyperplasia, however, contributes to considerable vein graft failure. Edifoligide is an oligonucleotide decoy that binds to and ... Full text Link to item Cite

Impact of bleeding severity on clinical outcomes among patients with acute coronary syndromes.

Journal Article Am J Cardiol · November 1, 2005 Bleeding is a complication of current therapies for acute coronary syndrome (ACS). No studies have examined the effect of bleeding events on clinical outcomes. We analyzed pooled data from 4 multicenter, randomized clinical trials of patients who had ACS ( ... Full text Link to item Cite

A nitric oxide processing defect of red blood cells created by hypoxia: deficiency of S-nitrosohemoglobin in pulmonary hypertension.

Journal Article Proc Natl Acad Sci U S A · October 11, 2005 The mechanism by which hypoxia [low partial pressure of O(2) (pO(2))] elicits signaling to regulate pulmonary arterial pressure is incompletely understood. We considered the possibility that, in addition to its effects on smooth muscle, hypoxia may influen ... Full text Link to item Cite

Left ventricular assessment in myocardial infarction: the VALIANT registry.

Journal Article Arch Intern Med · October 10, 2005 BACKGROUND: How often echocardiography and cardiac catheterization are used to evaluate left ventricular (LV) function in patients with myocardial infarction (MI) and how they are associated with quality of care is unknown. METHODS: Patients with MI in the ... Full text Link to item Cite

Impact of the pulmonary artery catheter in critically ill patients: meta-analysis of randomized clinical trials.

Journal Article JAMA · October 5, 2005 CONTEXT: Randomized clinical trials (RCTs) evaluating the pulmonary artery catheter (PAC) have been limited by small sample size. Some nonrandomized studies suggest that PAC use is associated with increased morbidity and mortality. OBJECTIVE: To estimate t ... Full text Link to item Cite

Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial.

Journal Article JAMA · October 5, 2005 CONTEXT: Pulmonary artery catheters (PACs) have been used to guide therapy in multiple settings, but recent studies have raised concerns that PACs may lead to increased mortality in hospitalized patients. OBJECTIVE: To determine whether PAC use is safe and ... Full text Link to item Cite

Heart failure on admission and the risk of stroke following acute myocardial infarction: the VALIANT registry.

Journal Article Eur Heart J · October 2005 AIMS: We sought to assess the relative contribution of heart failure (HF) on admission for an acute myocardial infarction (MI) to the subsequent in-hospital stroke risk. METHODS AND RESULTS: The VALsartan In Acute myocardial iNfarcTion (VALIANT) registry e ... Full text Link to item Cite

Renal function, concomitant medication use and outcomes following acute coronary syndromes.

Journal Article Nephrol 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 ... Full text Link to item Cite

Electrocardiographic infarct size assessment after thrombolysis: insights from the Acute Myocardial Infarction STudy ADenosine (AMISTAD) trial.

Journal Article Am Heart J · October 2005 BACKGROUND: Noninvasive methods are needed to evaluate reperfusion success in patients with acute myocardial infarction (MI). The AMISTAD trial was analyzed to compare MI size and myocardial salvage determined by electrocardiogram (ECG) with technetium Tc ... Full text Link to item Cite

Extent of ST-segment depression and cardiac events in non-ST-segment elevation acute coronary syndromes.

Journal Article Eur Heart J · October 2005 AIMS: We sought to determine whether the extent of myocardial ischaemia on the admission electrocardiogram (ECG) has independent predictive value for short-term risk stratification of patients with non-ST-segment elevation acute coronary syndromes (NSTE AC ... Full text Link to item Cite

The PRoject of Ex-vivo Vein graft ENgineering via Transfection IV (PREVENT IV) trial: study rationale, design, and baseline patient characteristics.

Journal Article Am Heart J · October 2005 BACKGROUND: Coronary artery bypass graft (CABG) surgery with autologous vein graft (VG) conduit is one of the most frequently performed operations in the United States. Unfortunately, many VGs become occluded during long-term follow-up largely because of n ... Full text Link to item Cite

Sudden death in patients with myocardial infarction.

Journal Article N Engl J Med · September 22, 2005 Link to item Cite

Elevated body mass index and intermediate-term clinical outcomes after acute coronary syndromes.

Journal Article Am J Med · September 2005 PURPOSE: Obesity is a coronary disease risk factor, but its independent effect on clinical outcomes following acute coronary syndromes has not been quantified. We evaluated the relationship between elevated body mass index (BMI) and 30-day, 90-day, and 1-y ... Full text Link to item Cite

Prognostic/Clinical Prediction Models: Using Observational Data to Estimate Prognosis: An Example Using a Coronary Artery Disease Registry

Chapter · August 24, 2005 With the proliferation of clinical data registries and the rising expense of clinical trials, observational data sources are increasingly providing evidence for clinical decision making. These data are viewed as complementary to randomized clinical trials ... Full text Cite

Stenting or surgery: an opportunity to do it right.

Journal Article J Am Coll Cardiol · August 16, 2005 Full text Link to item Cite

Resource use, costs, and quality of life among patients in the multinational Valsartan in Acute Myocardial Infarction Trial (VALIANT).

Journal Article Am Heart J · August 2005 BACKGROUND: In a multinational clinical trial, valsartan was statistically not inferior to captopril in reducing mortality and cardiovascular morbidity after myocardial infarction (MI) in patients with signs of heart failure and/or left ventricular dysfunc ... Full text Link to item Cite

Patients with prolonged ischemic chest pain and presumed-new left bundle branch block have heterogeneous outcomes depending on the presence of ST-segment changes.

Journal Article J Am Coll Cardiol · July 5, 2005 OBJECTIVES: The purpose of this research was to examine the prognostic value of ST-segment changes (concordant ST-segment elevation and/or precordial V1 to V3 ST-segment depression) during presumed-new left bundle branch block (LBBB) in patients receiving ... Full text Link to item Cite

Tenecteplase and tirofiban in ST-segment elevation acute myocardial infarction: results of a randomized trial.

Journal Article Am 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 ... Full text Link to item Cite

Intradialytic blood volume monitoring in ambulatory hemodialysis patients: a randomized trial.

Journal Article J Am Soc Nephrol · July 2005 Complications related to inadequate volume management are common during hemodialysis. This trial tested the hypothesis that availability of an intradialytic blood volume monitoring (IBVM) device improves fluid removal, reducing morbidity. A six-center, ran ... Full text Link to item Cite

Major clinical trials of hypertension: what should be done next?

Journal Article Hypertension · July 2005 The National Heart, Lung, and Blood Institute assembled an ad hoc working group to evaluate opportunities for new major clinical trials in the field of hypertension. The mandate of this working group was to consider the possible designs of major randomized ... Full text Link to item Cite

Changes in ventricular size and function in patients treated with valsartan, captopril, or both after myocardial infarction.

Journal Article Circulation · June 28, 2005 BACKGROUND: Angiotensin-converting enzyme (ACE) inhibitors have been shown to attenuate left ventricular (LV) enlargement in association with reducing mortality after myocardial infarction (MI). Preclinical data suggest that angiotensin receptor blockers ( ... Full text Link to item Cite

Sudden death in patients with myocardial infarction and left ventricular dysfunction, heart failure, or both.

Journal Article N Engl J Med · June 23, 2005 BACKGROUND: The risk of sudden death from cardiac causes is increased among survivors of acute myocardial infarction with reduced left ventricular systolic function. We assessed the risk and time course of sudden death in high-risk patients after myocardia ... Full text Link to item Cite

The early glycoprotein IIb/IIIa inhibition in non-ST-segment elevation acute coronary syndrome (EARLY ACS) trial: a randomized placebo-controlled trial evaluating the clinical benefits of early front-loaded eptifibatide in the treatment of patients with non-ST-segment elevation acute coronary syndrome--study design and rationale.

Journal Article Am Heart J · June 2005 BACKGROUND: The recent North American and European practice guidelines in patients with non-ST-segment elevation acute coronary syndrome (nSTE ACS) recommend glycoprotein IIb/IIIa (GpIIb-IIIa) inhibition in patients undergoing an early invasive treatment s ... Full text Link to item Cite

Association of height with outcomes in patients with acute myocardial infarction receiving reperfusion therapy.

Journal Article Am J Cardiol · June 1, 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 ... Full text Link to item Cite

Implantable cardioverter defibrillators and cardiac resynchronization therapy in patients with left ventricular dysfunction: randomized trial evidence through 2004.

Journal Article Am Heart J · June 2005 Although many studies have shown that implantable cardioverter defibrillator (ICD) therapy improves the survival of patients with significant left ventricular dysfunction, the magnitude of effectiveness of ICD therapy in clinically defined subgroups remain ... Full text Link to item Cite

Lower serum sodium is associated with increased short-term mortality in hospitalized patients with worsening heart failure: results from the Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (OPTIME-CHF) study.

Journal Article Circulation · May 17, 2005 BACKGROUND: The prognostic value of serum sodium in patients hospitalized for worsening heart failure has not been well defined. METHODS AND RESULTS: The Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (O ... Full text Link to item Cite

Pulmonary artery catheterization in acute coronary syndromes: insights from the GUSTO IIb and GUSTO III trials.

Journal Article Am 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 ... Full text Link to item Cite

A survey of health care practitioners' knowledge of the QT interval.

Journal Article J Gen Intern Med · May 2005 OBJECTIVE: To assess health care practitioners' ability to correctly measure the QT interval, and to identify factors and medications that may increase the risk of QT-interval prolongation and torsades de pointes. DESIGN: A cross-sectional analysis of a su ... Full text Link to item Cite

The case for practical clinical trials in psychiatry.

Journal Article Am J Psychiatry · May 2005 OBJECTIVE: Clinical trials in psychiatry frequently fail to maximize clinical utility for practicing clinicians, or, stated differently, available evidence is not perceived by clinicians (and other decision makers) as sufficiently relevant to clinical prac ... Full text Link to item Cite

Clinical and economic implications of the Multicenter Automatic Defibrillator Implantation Trial-II.

Journal Article Ann Intern Med · April 19, 2005 BACKGROUND: The Multicenter Automatic Defibrillator Implantation Trial (MADIT)-II demonstrated that implantable cardioverter defibrillators (ICDs) save lives when used in patients with a history of myocardial infarction (MI) and an ejection fraction of 0.3 ... Full text Link to item Cite

Relationship of incorrect dosing of fibrinolytic therapy and clinical outcomes.

Journal Article JAMA · April 13, 2005 CONTEXT: Incorrect dosing of alteplase has been associated with worse clinical outcomes in patients. However, patients at high risk of adverse events are more prone to dosing errors, thus confounding this relationship. OBJECTIVE: To determine if the associ ... Full text Link to item Cite

Incidence, predictors, and outcomes of high-degree atrioventricular block complicating acute myocardial infarction treated with thrombolytic therapy.

Journal Article Am Heart J · April 2005 BACKGROUND: In 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 delineate predi ... Full text Link to item Cite

A perspective on trials comparing enoxaparin and unfractionated heparin in the treatment of non-ST-elevation acute coronary syndromes.

Journal Article Am Heart J · April 2005 BACKGROUND: Non-ST-elevation (NSTE) acute coronary syndrome (ACS) is a serious, acute illness characterized by a high rate of death and morbid events, and antithrombin therapy is integral to its management. Contemporary guidelines from the American College ... Full text Link to item Cite

Reducing the costs of phase III cardiovascular clinical trials.

Journal Article Am Heart J · March 2005 BACKGROUND: The pharmaceutical industry spends approximately 26.4 billion dollars annually for research and development (4.1 billion dollars in cardiovascular products). We compared pharmaceutical companies' planned resource use and costs in Phase III card ... Full text Link to item Cite

Comparison of ST-segment resolution with combined fibrinolytic and glycoprotein IIb/IIIa inhibitor therapy versus fibrinolytic alone (data from four clinical trials).

Journal Article Am J Cardiol · March 1, 2005 We compared combination fibrinolytic plus glycoprotein IIb/IIIa inhibitor therapy with stand-alone fibrinolysis with respect to speed and stability of reperfusion in patients who had acute ST-segment elevation myocardial infarction; data were obtained from ... Full text Link to item Cite

Conducting economic evaluations alongside multinational clinical trials: toward a research consensus.

Journal Article Am Heart J · March 2005 Demand for economic evaluations in multinational clinical trials is increasing, but there is little consensus about how such studies should be conducted and reported. At a workshop in Durham, North Carolina, we sought to identify areas of agreement about h ... Full text Link to item Cite

Creating a new structure for research on health care effectiveness.

Journal Article J Investig Med · March 2005 Effectiveness research (a term we use in preference to the more confining and difficult health services or outcomes research) evaluates the clinical setting and the health care system on which it depends. It uses a variety of health care assessment techniq ... Full text Link to item Cite

Incremental prognostic power of single-photon emission computed tomographic myocardial perfusion imaging in patients with known or suspected coronary artery disease.

Journal Article Am J Cardiol · January 15, 2005 Noninvasive stress testing provides prognostic information in patients who have suspected coronary artery disease, but limited data are available on the incremental value of myocardial perfusion testing in high-risk patients. We studied 3,275 patients who ... Full text Link to item Cite

Foreword

Journal Article Management of Acute Decompensated Heart Failure · January 1, 2005 Cite

AHA scientific statement: practice standards for electrocardiographic monitoring in hospital settings: an American Heart Association Scientific Statement from the Councils on Cardiovascular Nursing, Clinical Cardiology, and Cardiovascular Disease in the Young: endorsed by the International Society of Computerized electrocardiology and the American Association of Critical-Care Nurses.

Journal Article J Cardiovasc Nurs · 2005 The goals of electrocardiographic (ECG) monitoring in hospital settings have expanded from simple heart rate and basic rhythm determination to the diagnosis of complex arrhythmias, myocardial ischemia, and prolonged QT interval. Whereas Computerized arrhyt ... Full text Link to item Cite

Outcomes of patients with acute coronary syndromes and prior percutaneous coronary intervention: a pooled analysis of three randomized clinical trials.

Journal Article Eur Heart J · January 2005 AIMS: We sought to characterize the outcomes of patients with a prior percutaneous coronary intervention (PCI) who presented with a non-ST-segment elevation acute coronary syndrome (ACS). METHODS AND RESULTS: We analysed the 30 and 180 day outcomes of 3012 ... Full text Link to item Cite

Lessons learned from a clinical trial.

Journal Article Circulation · December 7, 2004 Full text Link to item Cite

Antibodies to platelet factor 4/heparin are associated with elevated endothelial cell activation markers in patients with acute coronary ischemic syndromes.

Journal Article J Thromb Thrombolysis · December 2004 BACKGROUND: We postulated that antibodies to platelet factor 4/heparin complex lead to a heightened inflammatory state, contributing to an increased risk of recurrent thrombotic events. METHODS: We analyzed serum from a subset of patients in the placebo/un ... Full text Link to item Cite

Risk stratification after hospitalization for decompensated heart failure.

Journal Article J Card Fail · December 2004 BACKGROUND: Decompensated heart failure (HF) is among the most common indications for hospitalization in the United States, but little is known about features on admission that predict adverse events. We used data from the Outcomes of a Prospective Trial o ... Full text Link to item Cite

Prognostic value of anxiety and depression in patients with chronic heart failure.

Journal Article Circulation · November 30, 2004 BACKGROUND: Anxiety is often present with depression and may be one of its manifestations. Although the adverse effects of depression in patients with chronic heart failure (CHF) have been well studied, the relation between anxiety and CHF prognosis has no ... Full text Link to item Cite

A time of accelerated change in academic cardiovascular medicine: implications for academic divisions of cardiology and their training programs.

Journal Article J Am Coll Cardiol · November 16, 2004 With the vast epidemic of vascular disease predicted to be the leading cause of death and disability by a growing margin over the next 30 years, academic medical centers with cardiology training programs have a special responsibility. Given the dramatic ad ... Full text Link to item Cite

Introduction. Quality of health care.

Journal Article Am Heart J · November 2004 Full text Link to item Cite

A comparison of clinical outcomes between Canadian and American patients after nonurgent coronary stenting.

Journal Article Can J Cardiol · November 2004 BACKGROUND: Practice patterns for percutaneous coronary interventions (PCIs) may differ between Canada and the United States. Few data are available comparing PCI outcomes between the two countries in the era of coronary stenting and adjunctive glycoprotei ... Link to item Cite

Prognostic value of predischarge electrocardiographic measurement of infarct size after thrombolysis: insights from GUSTO I Economics and Quality of Life substudy.

Journal Article Am 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 ... Full text Link to item Cite

An international perspective on heart failure and left ventricular systolic dysfunction complicating myocardial infarction: the VALIANT registry.

Journal Article Eur Heart J · November 2004 AIMS: We analysed the contemporary incidence, outcomes, and predictors of heart failure (HF) and/or left ventricular systolic dysfunction (LVSD) before discharge in patients with acute myocardial infarction (MI). The baseline presence of HF or LVSD, or its ... Full text Link to item Cite

Practice standards for electrocardiographic monitoring in hospital settings: an American Heart Association scientific statement from the Councils on Cardiovascular Nursing, Clinical Cardiology, and Cardiovascular Disease in the Young: endorsed by the International Society of Computerized Electrocardiology and the American Association of Critical-Care Nurses.

Journal Article Circulation · October 26, 2004 The goals of electrocardiographic (ECG) monitoring in hospital settings have expanded from simple heart rate and basic rhythm determination to the diagnosis of complex arrhythmias, myocardial ischemia, and prolonged QT interval. Whereas computerized arrhyt ... Full text Link to item Cite

Relationship of blood transfusion and clinical outcomes in patients with acute coronary syndromes.

Journal Article JAMA · October 6, 2004 CONTEXT: It is unclear if blood transfusion in anemic patients with acute coronary syndromes is associated with improved survival. OBJECTIVE: To determine the association between blood transfusion and mortality among patients with acute coronary syndromes ... Full text Link to item Cite

Postmenopausal hormone use in women with acute coronary syndromes.

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

Enoxaparin versus unfractionated heparin in patients treated with tirofiban, aspirin and an early conservative initial management strategy: results from the A phase of the A-to-Z trial.

Journal Article Eur Heart J · October 2004 AIMS: In high risk patients with non-ST elevation acute coronary syndromes (ACS), enoxaparin is generally preferred to unfractionated heparin (UFH). However, less is known about the relative merits of these two forms of heparin in patients receiving concom ... Full text Link to item Cite

Long-term mortality of patients with acute myocardial infarction in the United States and Canada: comparison of patients enrolled in Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO)-I.

Journal Article Circulation · September 28, 2004 BACKGROUND: In a previous substudy of the GUSTO-I trial, we observed better functional and quality-of-life outcomes among patients in the United States (US patients) compared with patients in Canada. Rates of invasive therapy were significantly higher in t ... Full text Link to item Cite

Relation between renal dysfunction and cardiovascular outcomes after myocardial infarction.

Journal Article N Engl J Med · September 23, 2004 BACKGROUND: The presence of coexisting conditions has a substantial effect on the outcome of acute myocardial infarction. Renal failure is associated with one of the highest risks, but the influence of milder degrees of renal impairment is less well define ... Full text Link to item Cite

Newly diagnosed and previously known diabetes mellitus and 1-year outcomes of acute myocardial infarction: the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial.

Journal Article Circulation · September 21, 2004 BACKGROUND: A prior diagnosis of diabetes mellitus is associated with adverse outcomes after acute myocardial infarction (MI), but the risk associated with a new diagnosis of diabetes in this setting has not been well defined. METHODS AND RESULTS: We asses ... Full text Link to item Cite

Early intensive vs a delayed conservative simvastatin strategy in patients with acute coronary syndromes: phase Z of the A to Z trial.

Journal Article JAMA · September 15, 2004 CONTEXT: Limited data are available evaluating how the timing and intensity of statin therapy following an acute coronary syndrome (ACS) event affect clinical outcome. OBJECTIVE: To compare early initiation of an intensive statin regimen with delayed initi ... Full text Link to item Cite

Is rhythm control superior to rate control in patients with atrial fibrillation and congestive heart failure?

Journal Article Am J Cardiol · September 15, 2004 In 1,009 patients with atrial fibrillation and congestive heart failure, the 2-year mortality rate was 31% in patients treated with rate control (n = 505) versus 29% in patients treated with rhythm control (n = 504). After adjusting for differences in base ... Full text Link to item Cite

Incidence and characteristics of stroke during 90-day follow-up in patients stabilized after an acute coronary syndrome.

Journal Article Am Heart J · September 2004 BACKGROUND: Stroke is a rare but serious event that complicates the course of patients with acute coronary syndromes (ACS). The type, outcome, and risk factors of stroke occurring in stabilized patients with ACS have not been previously reported. METHODS: ... Full text Link to item Cite

Is the extrapolated adult dose of fosinopril safe and effective in treating hypertensive children?

Journal Article Hypertension · September 2004 We evaluated the efficacy, safety, and dose-response relationship of fosinopril in children aged 6 to 16 years with hypertension or high-normal blood pressure with an associated medical condition requiring treatment. The study was a prospective, double-bli ... Full text Link to item Cite

Association between platelet receptor occupancy after eptifibatide (integrilin) therapy and patency, myocardial perfusion, and ST-segment resolution among patients with ST-segment-elevation myocardial infarction: an INTEGRITI (Integrilin and Tenecteplase in Acute Myocardial Infarction) substudy.

Journal Article Circulation · August 10, 2004 BACKGROUND: Paradoxically, fibrinolytic agents may systemically activate platelets, which in turn secrete plasminogen activator inhibitor (PAI-1), an antagonist of the fibrinolytic process in proportion to total body platelet mass. We hypothesized that imp ... Full text Link to item Cite

Slowing the progression of diabetic nephropathy and its cardiovascular consequences.

Journal Article Am Heart J · August 2004 This paper incorporates the findings from a multidisciplinary meeting on diabetic nephropathy and its renal and cardiovascular complications into a review article. The epidemic of obesity and the growing elderly population in the United States are primary ... Full text Link to item Cite

Cardiovascular disease and chronic kidney disease: insights and an update.

Journal Article Am Heart J · August 2004 Despite the high prevalence and significant morbidity and mortality rates of chronic kidney disease (CKD) related to cardiovascular disease, it remains vastly understudied. Most of the current practice recommendations come from small under-powered prospect ... Full text Link to item Cite

Coordinated series of studies to evaluate characteristics and mechanisms of acute coronary syndromes in high-risk patients randomly assigned to enoxaparin or unfractionated heparin: design and rationale of the SYNERGY Library.

Journal Article Am Heart J · August 2004 Clinical trials and accompanying substudies in patients with acute coronary syndromes (ACS) have over the last several years yielded a wealth of knowledge about the pathophysiology and management of this high-risk condition. The Superior Yield of the New s ... Full text Link to item Cite

Enoxaparin vs unfractionated heparin in high-risk patients with non-ST-segment elevation acute coronary syndromes managed with an intended early invasive strategy: primary results of the SYNERGY randomized trial.

Journal Article JAMA · July 7, 2004 CONTEXT: Enoxaparin has demonstrated advantages over unfractionated heparin in low- to moderate-risk patients with non-ST-segment elevation acute coronary syndromes (ACS) treated with a conservative strategy. OBJECTIVES: To compare the outcomes of patients ... Full text Link to item Cite

Safety and efficacy of enoxaparin vs unfractionated heparin in patients with non-ST-segment elevation acute coronary syndromes who receive tirofiban and aspirin: a randomized controlled trial.

Journal Article JAMA · July 7, 2004 CONTEXT: Enoxaparin or the combination of glycoprotein IIb/IIIa inhibitor tirofiban with unfractionated heparin independently have shown superior efficacy over unfractionated heparin alone in patients with non-ST-elevation acute coronary syndromes (ACS). I ... Full text Link to item Cite

Efficacy and bleeding complications among patients randomized to enoxaparin or unfractionated heparin for antithrombin therapy in non-ST-Segment elevation acute coronary syndromes: a systematic overview.

Journal Article JAMA · July 7, 2004 CONTEXT: Antithrombin therapy has become a guidelines-recommended standard of care in the treatment of acute coronary syndromes (ACS), but recent trials comparing use of enoxaparin and unfractionated heparin in ACS have yielded less robust efficacy and saf ... Full text Link to item Cite

Dynamic prognostication in non-ST-elevation acute coronary syndromes: insights from GUSTO-IIb and PURSUIT.

Journal Article Am Heart J · July 2004 BACKGROUND: Risk assessment in patients with non-ST-elevation acute coronary syndromes (NSTE-ACS) traditionally focuses on and is limited to admission findings. The objective of the current study was to develop an approach to predicting outcome in NSTE-ACS ... Full text Link to item Cite

Multinational economic evaluation of valsartan in patients with chronic heart failure: results from the Valsartan Heart Failure Trial (Val-HeFT).

Journal Article Am Heart J · July 2004 BACKGROUND: The Valsartan Heart Failure Trial (Val-HeFT) compared valsartan versus placebo in 5010 patients taking prescribed background therapy for New York Heart Association class II to IV heart failure. Valsartan reduced the risk of heart failure hospit ... Full text Link to item Cite

Rationale and strategies for implementing community-based transfer protocols for primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction.

Journal Article J Am Coll Cardiol · June 16, 2004 The focus for the initial approach to the treatment of acute ST-segment elevation myocardial infarction (STEMI) has shifted toward extending the benefits of mechanical reperfusion with primary percutaneous coronary intervention (PCI) to patients who presen ... Full text Link to item Cite

Six-month outcomes of percutaneous coronary balloon angioplasty in acute coronary syndromes: Results from the PURSUIT trial.

Journal Article Can J Cardiol · June 2004 BACKGROUND: Potent inhibition of the platelet glycoprotein IIb/IIIa receptor has improved the acute outcome of patients presenting with acute coronary syndromes (ACS). For patients with ACS undergoing percutaneous balloon angioplasty without coronary stent ... Link to item Cite

Benefit the patient, manage the risk: a system goal.

Journal Article Pharmacoepidemiol Drug Saf · May 2004 Full text Link to item Cite

The Child and Adolescent Psychiatry Trials Network (CAPTN).

Journal Article J Am Acad Child Adolesc Psychiatry · May 2004 OBJECTIVE: The current generation of clinical trials in pediatric psychiatry often fails to maximize clinical utility for practicing clinicians, thereby diluting its impact. METHOD: To attain maximum clinical relevance and acceptability, the Child and Adol ... Full text Link to item Cite

Association of a pulsatile blood flow pattern on coronary arteriography and short-term clinical outcomes in acute myocardial infarction.

Journal Article J Am Coll Cardiol · April 7, 2004 OBJECTIVES: We hypothesized that recognition of systolic flow reversal (pulsatile flow) after thrombolytic administration on coronary angiography is associated with angiographic and electrocardiogram findings reflecting impaired myocardial perfusion, as we ... Full text Link to item Cite

Combining baseline clinical descriptors and real-time response to therapy: the incremental prognostic value of continuous ST-segment monitoring in acute myocardial infarction.

Journal Article Am Heart J · April 2004 BACKGROUND: Clinical descriptors and ST-segment recovery variables hold prognostic information for clinical outcome after thrombolysis for acute myocardial infarction (MI). We sought to define the incremental prognostic value of continuous 12-lead ST-segme ... Full text Link to item Cite

Novel approaches to clinical trials: device-related infections.

Journal Article Am Heart J · April 2004 The explosive growth in the use of cardiac devices and the continued large number of thoracic operations produce a significant number of costly infectious complications. These infections represent a leading cause of death and disability after device implan ... Full text Link to item Cite

Aspirin dose and six-month outcome after an acute coronary syndrome.

Journal Article J Am Coll Cardiol · March 17, 2004 OBJECTIVES: This study was designed to compare the efficacy of low and intermediate aspirin doses in acute coronary syndromes. BACKGROUND: Little is known of the comparative efficacy of low and intermediate aspirin doses in this setting. METHODS: We compar ... Full text Link to item Cite

Meta-analysis of randomized trials of percutaneous transluminal coronary angioplasty versus atherectomy, cutting balloon atherotomy, or laser angioplasty.

Journal Article J Am Coll Cardiol · March 17, 2004 OBJECTIVES: We conducted a systematic overview (meta-analysis) of randomized trials of balloon angioplasty versus coronary atherectomy, laser angioplasty, or cutting balloon atherotomy to evaluate the effects of plaque modification during percutaneous coro ... Full text Link to item Cite

Economic impact of drug-eluting stents on hospital systems: a disease-state model.

Journal Article Am Heart J · March 2004 BACKGROUND: Drug-eluting intracoronary stents decrease restenosis and later revascularization. The US Department of Health and Human Services (HHS), recognizing the financial and clinical impact of this technology, recently proposed accelerated reimburseme ... Full text Link to item Cite

Improved clinical outcomes with abciximab therapy in acute myocardial infarction: a systematic overview of randomized clinical trials.

Journal Article Am Heart J · March 2004 BACKGROUND: Investigations of glycoprotein (GP) IIb/IIIa inhibition in primary percutaneous coronary intervention (PCI) have suggested the efficacy of abciximab in improving clinical and angiographic outcomes, but sample-size limitations and variability in ... Full text Link to item Cite

Feasibility of endovascular cooling as an adjunct to primary percutaneous coronary intervention (results of the LOWTEMP pilot study).

Journal Article Am J Cardiol · March 1, 2004 In a nonrandomized feasibility study of therapeutic hypothermia in acute myocardial infarction, 18 patients were treated with endovascular cooling (Alsius, Irvine, California) as adjunctive therapy to primary percutaneous coronary intervention to assess me ... Full text Link to item Cite

Valsartan, captopril, or both in myocardial infarction.

Journal Article N Engl J Med · February 26, 2004 Full text Link to item Cite

Outcome of acute ST-segment elevation myocardial infarction in diabetics treated with fibrinolytic or combination reduced fibrinolytic therapy and platelet glycoprotein IIb/IIIa inhibition: lessons from the GUSTO V trial.

Journal Article J 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 ... Full text Link to item Cite

Risk factors for intracranial hemorrhage and nonhemorrhagic stroke after fibrinolytic therapy (from the GUSTO-i trial).

Journal Article Am J Cardiol · February 15, 2004 Of 592 patients in the Global Utilization of Streptokinase and tPA for Occluded Arteries-I trial who had a stroke during initial hospitalization, the risk for intracranial hemorrhage was significantly greater in those with recent facial or head trauma (odd ... Full text Link to item Cite

International differences in evolution of early discharge after acute myocardial infarction.

Journal Article Lancet · February 14, 2004 BACKGROUND: Early discharge of low-risk patients with acute myocardial infarction is feasible and can be achieved at no additional risk of adverse events. We aimed to identify the extent to which countries have taken advantage of the opportunity for early ... Full text Link to item Cite

Differential treatment benefit of platelet glycoprotein IIb/IIIa inhibition with percutaneous coronary intervention versus medical therapy for acute coronary syndromes: exploration of methods.

Journal Article Circulation · February 10, 2004 BACKGROUND: Although many believe that platelet glycoprotein IIb/IIIa inhibitors should be used only in acute coronary syndrome patients undergoing percutaneous coronary intervention, supporting data from randomized clinical trials are tenuous. The assumpt ... Full text Link to item Cite

Association of diabetes mellitus and glycemic control strategies with clinical outcomes after acute coronary syndromes.

Journal Article Am Heart J · February 2004 BACKGROUND: Diabetes is associated with an increased risk for coronary artery disease (CAD) and its complications. The relative effect of glucose-lowering strategies of "insulin provision" versus "insulin sensitization" among patients with CAD remains uncl ... Full text Link to item Cite

Creatine kinase-MB elevation after percutaneous coronary intervention predicts adverse outcomes in patients with acute coronary syndromes.

Journal Article Eur Heart J · February 2004 AIM: To 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 RESULTS: Peak CK-MB ratios (pe ... Full text Link to item Cite

A rapid troponin I assay is not optimal for determination of troponin status and prediction of subsequent cardiac events at suspicion of unstable coronary syndromes.

Journal Article Int J Cardiol · February 2004 BACKGROUND: Troponin is a specific marker of myocardial damage. For early prediction of coronary events in patients with suspicion of acute coronary syndromes the assay also needs to be highly sensitive. METHODS AND RESULTS: A rapid troponin I assay was pe ... Full text Link to item Cite

Activation of the inflammation, coagulation, and fibrinolysis systems, without influence of abciximab infusion in patients with non-ST-elevation acute coronary syndromes treated with dalteparin: a GUSTO IV substudy.

Journal Article Am Heart J · February 2004 BACKGROUND: In acute coronary syndromes, the inflammation and the coagulation systems are activated, implying an impaired outcome. In addition to platelet inhibition, recent evidence suggests that the glycoprotein IIb/IIIa receptor inhibitor abciximab atte ... Full text Link to item Cite

Integrating antithrombin and antiplatelet therapies with early invasive management for non-ST-segment elevation acute coronary syndromes.

Journal Article Am J Med · January 15, 2004 Non-ST-segment elevation acute coronary syndromes are a dramatic manifestation of coronary artery disease. Multiple clinical trials have shown that early cardiac catheterization improves clinical outcomes in patients with non-ST-segment elevation acute cor ... Full text Link to item Cite

Economic effects of beta-blocker therapy in patients with heart failure.

Journal Article Am J Med · January 15, 2004 PURPOSE: Studies suggest that beta-blockers improve outcomes in heart failure patients and may be cost saving to society. However, many heart failure patients are not treated with beta-blockers. Economic incentives facing hospitals, physicians, payers, and ... Full text Link to item Cite

Comment

Journal Article Clinical Trials · January 1, 2004 Full text Cite

Defining the balance of risk and benefit in the era of genomics and proteomics.

Journal Article Health Aff (Millwood) · 2004 The ability to measure the function of genes and proteins has spawned the construct of personalized medicine, in which patients' own risks and preferences are used to choose diagnostic and therapeutic strategies. The complexity of clinical data required to ... Full text Link to item Cite

Liability issues for data monitoring committee members.

Journal Article Clin Trials · 2004 In randomized clinical trials, a data monitoring committee (DMC) is often appointed to review interim data to determine whether there is early convincing evidence of intervention benefit, lack of benefit or harm to study participants. Because DMCs bear ser ... Full text Open Access Link to item Cite

Issues in regulatory guidelines for data monitoring committees.

Journal Article Clin Trials · 2004 As clinical trials have emerged as the major research method for evaluating new interventions, the process for monitoring intervention safety and benefit has also evolved. The Data Monitoring Committee (DMC) has become the standard approach to implement th ... Full text Open Access Link to item Cite

International variation in the use of evidence-based medicines for acute coronary syndromes.

Journal Article Eur Heart J · December 2003 AIMS: We sought to evaluate international patterns of use and factors influencing use of evidence-based medications early after ACS. METHODS AND RESULTS: Using a database of 15904 ACS patients enrolled in the SYMPHONY and 2nd SYMPHONY trials in 37 countrie ... Full text Link to item Cite

Aspirin use post-acute coronary syndromes: intolerance, bleeding and discontinuation.

Journal Article J Thromb Thrombolysis · December 2003 BACKGROUND: While aspirin's secondary prevention benefit is clear, prior reports indicate that 19-83% of eligible patients may not use aspirin chronically. METHODS: We investigated intolerance and bleeding while on aspirin and aspirin discontinuation using ... Full text Link to item Cite

Prognostic importance of new small Q waves following non-ST-elevation acute coronary syndromes.

Journal Article Am J Med · December 1, 2003 PURPOSE: To investigate the prognostic importance of new small Q waves following an acute coronary syndrome. METHODS: We assessed 6-month mortality in 10501 patients with non-ST-elevation acute coronary syndromes who had survived 30 days and had both admis ... Full text Link to item Cite

Valsartan, captopril, or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both.

Journal Article N Engl J Med · November 13, 2003 BACKGROUND: Angiotensin-converting-enzyme (ACE) inhibitors such as captopril reduce mortality and cardiovascular morbidity among patients with myocardial infarction complicated by left ventricular systolic dysfunction, heart failure, or both. In a double-b ... Full text Link to item Cite

Issues facing clinical trials of the future.

Journal Article J Intern Med · November 2003 Diagnostic and therapeutic technology continues to advance rapidly, as does our knowledge of therapeutics and of clinical research methods. Unfortunately, these advances have been only poorly coupled with our knowledge of therapeutic principles, leading to ... Full text Link to item Cite

The anticoagulant therapy with bivalirudin to assist in the performance of percutaneous coronary intervention in patients with heparin-induced thrombocytopenia (ATBAT) study: main results.

Journal Article J 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. ... Link to item Cite

Evaluation of the dofetilide risk-management program.

Journal Article Am Heart J · November 2003 BACKGROUND: Dose-dependent torsades de pointes has been shown to occur with dofetilide (Tikosyn) and sotalol HCl (Betapace AF); thus, detailed dosing and monitoring recommendations to minimize this risk are included in the product labeling for both drugs. ... Full text Link to item Cite

Risk of intracranial haemorrhage with combined fibrinolytic and glycoprotein IIb/IIIa inhibitor therapy in acute myocardial infarction. Dichotomous response as a function of age in the GUSTO V trial.

Journal Article Eur Heart J · October 2003 BACKGROUND: Intracranial haemorrhage is an important limitation to pharmacologic reperfusion therapy for acute myocardial infarction. The combination of a glycoprotein IIb/IIIa inhibitor, half-dose plasminogen activator and reduced-dose heparin has been ev ... Full text Link to item Cite

Changing the model of care for patients with acute coronary syndromes.

Journal Article Am 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 ... Full text Link to item Cite

Meta-analysis of survival with platelet glycoprotein IIb/IIIa antagonists for percutaneous coronary interventions.

Journal Article Am J Cardiol · September 15, 2003 We performed a cumulative meta-analysis of available studies to evaluate the effect of intravenous platelet glycoprotein (GP) IIb/IIIa antagonists on survival at 30 days and 6 months after percutaneous coronary intervention (PCI). Compounds that block the ... Full text Link to item Cite

Significance of atrial fibrillation during acute myocardial infarction, and its current management: insights from the GUSTO-3 trial.

Journal Article Card 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 ... Full text Link to item Cite

Chronic kidney disease, mortality, and treatment strategies among patients with clinically significant coronary artery disease.

Journal Article J Am Soc Nephrol · September 2003 Cardiovascular disease is an important cause of mortality among patients with chronic kidney disease (CKD). This study describes associations between CKD, cardiac revascularization strategies, and mortality among patients with CKD and cardiovascular diseas ... Full text Link to item Cite

Platelet/endothelial biomarkers in depressed patients treated with the selective serotonin reuptake inhibitor sertraline after acute coronary events: the Sertraline AntiDepressant Heart Attack Randomized Trial (SADHART) Platelet Substudy.

Journal Article Circulation · August 26, 2003 BACKGROUND: Depression after acute coronary syndromes (ACSs) has been identified as an independent risk factor for subsequent cardiac death. Enhanced platelet activation has been hypothesized to represent 1 of the mechanisms underlying this association. Se ... Full text Link to item Cite

Troponin T levels and risk of 30-day outcomes in patients with the acute coronary syndrome: prospective verification in the GUSTO-IV trial.

Journal Article Am J Med · August 15, 2003 BACKGROUND: A third-generation troponin T assay with improved precision and a lower detection limit has been developed. However, the appropriate cutoff for identifying patients with the acute coronary syndrome who are at low risk of subsequent mortality ha ... Full text Link to item Cite

Frequency of stent thrombosis after acute coronary syndromes (from the SYMPHONY and 2nd SYMPHONY trials).

Journal Article Am 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 ... Full text Link to item Cite

VALsartan In Acute myocardial iNfarcTion (VALIANT) trial: baseline characteristics in context.

Journal Article Eur J Heart Fail · August 2003 BACKGROUND: The VALsartan In Acute myocardial iNfarcTion (VALIANT) trial compared outcomes with: (1) angiotensin-converting enzyme inhibition (ACEI) with the reference agent captopril; (2) angiotensin-receptor blockade (ARB) with valsartan; or (3) both in ... Full text Link to item Cite

Randomized, double-blind, placebo-controlled, international trial of the oral IIb/IIIa antagonist lotrafiban in coronary and cerebrovascular disease.

Journal Article Circulation · July 29, 2003 BACKGROUND: This is the primary report of the large-scale evaluation of lotrafiban, an orally administered IIb/IIIa receptor antagonist, a unique trial with respect to the platelet antagonist, protocol design, and inclusion of cerebrovascular disease in a ... Full text Link to item Cite

N-terminal pro-brain natriuretic peptide and other risk markers for the separate prediction of mortality and subsequent myocardial infarction in patients with unstable coronary artery disease: a Global Utilization of Strategies To Open occluded arteries (GUSTO)-IV substudy.

Journal Article Circulation · July 22, 2003 BACKGROUND: Biochemical markers are useful for prediction of cardiac events in patients with non-ST-segment-elevation acute coronary syndrome (ACS). The associations between N-terminal pro-brain natriuretic peptide (NT-proBNP) and other biochemical and cli ... Full text Link to item Cite

Toward protecting the safety of participants in clinical trials.

Journal Article Control Clin Trials · June 2003 It is a widely held belief that the current system of oversight of clinical research, particularly the means of assessing risks and minimizing harms to participants in clinical trials, could be improved. In particular, the system is inefficient with overem ... Full text Link to item Cite

Anti-platelet factor 4/heparin antibodies: an independent predictor of 30-day myocardial infarction after acute coronary ischemic syndromes.

Journal Article Circulation · May 13, 2003 BACKGROUND: We postulated that antibodies to platelet factor 4/heparin complex might contribute to recurrent ischemic events in patients with acute coronary syndrome. METHODS AND RESULTS: We analyzed serum from patients enrolled in the placebo/unfractionat ... Full text Link to item Cite

What clinicians should know about the QT interval.

Journal Article JAMA · April 23, 2003 CONTEXT: Of the several factors implicated in causing QT interval prolongation and torsades de pointes, errors in the use of medications that may prolong this interval deserve special attention. OBJECTIVE: To systematically summarize the available clinical ... Full text Link to item Cite

Combination reperfusion therapy with eptifibatide and reduced-dose tenecteplase for ST-elevation myocardial infarction: results of the integrilin and tenecteplase in acute myocardial infarction (INTEGRITI) Phase II Angiographic Trial.

Journal Article J Am Coll Cardiol · April 16, 2003 OBJECTIVES: The goal of this study was to evaluate combinations of eptifibatide with reduced-dose tenecteplase (TNK) in ST-elevation myocardial infarction (STEMI). BACKGROUND: Glycoprotein IIb/IIIa inhibitors enhance thrombolysis. The role of combination t ... Full text Link to item Cite

Knowledge deficits related to the QT interval could affect patient safety.

Journal Article Ann Noninvasive Electrocardiol · April 2003 BACKGROUND: Recently, some QT-prolonging, noncardiac medications were withdrawn from the U.S. drug market because of continued inappropriate use by health care practitioners despite warnings and label changes from both the drug manufacturers and the U.S. F ... Full text Link to item Cite

Anticoagulation in acute cardiac care in patients with chronic kidney disease.

Journal Article Am Heart J · April 2003 The number of patients with coexisting chronic kidney disease (CKD) and cardiovascular disease is growing rapidly. Treatment of these patients is challenging, primarily because of a lack of pharmacokinetic and clinical trial data associated with these comb ... Full text Link to item Cite

Ethics and equipoise: rationale for a placebo-controlled study design of platelet glycoprotein IIb/IIIa inhibition in coronary intervention.

Journal Article J Interv Cardiol · April 2003 Rarely is it straightforward to specify the design and parameters of a clinical trial investigating an alternative therapy where effective therapies already exist. If existing therapeutic interventions are highly efficacious, safe, inexpensive, and firmly ... Full text Link to item Cite

Insulin resistance: A global epidemic in need of effective therapies

Journal Article European Heart Journal Supplement · April 1, 2003 There is a worldwide rapid increase in the prevalence of type 2 diabetes, due to factors such as improved affluence, longevity, and obesity. To prevent the development of diabetes, individuals must be identified at an early stage of risk and targeted with ... Full text Cite

Heart failure etiology and response to milrinone in decompensated heart failure: results from the OPTIME-CHF study.

Journal Article J Am Coll Cardiol · March 19, 2003 OBJECTIVES: The goal of this study was to assess the interaction between heart failure (HF) etiology and response to milrinone in decompensated HF. BACKGROUND: Etiology has prognostic and therapeutic implications in HF, but its relationship to response to ... Full text Link to item Cite

Troponin and C-reactive protein have different relations to subsequent mortality and myocardial infarction after acute coronary syndrome: a GUSTO-IV substudy.

Journal Article J Am Coll Cardiol · March 19, 2003 OBJECTIVES: We sought to evaluate C-reactive protein (CRP) and troponin T (TnT) as predictors of risk of the individual end points of mortality and myocardial infarction (MI) in a large cohort of patients with acute coronary syndrome (ACS). BACKGROUND: Bot ... Full text Link to item Cite

Impact of on-site cardiac interventional facilities on management and outcome of patients with acute coronary syndromes.

Journal Article Can J Cardiol · March 15, 2003 OBJECTIVES: To investigate the impact of on-site cardiac interventional facilities on the management and outcome of patients with versus those without ST elevation acute coronary syndromes (ACS) in the Canadian-American Global Use of Strategies to Open Occ ... Link to item Cite

Does the discharge ECG provide additional prognostic insight(s) in non-ST elevation ACS patients from that acquired on admission?

Journal Article Eur Heart J · March 2003 BACKGROUND: Although the prognostic value of admission ST changes in patients with non-ST elevation acute coronary syndrome (ACS) is established, the utility of the discharge ECG is unknown. Accordingly, using the PARAGON-B Troponin substudy, we assessed t ... Full text Link to item Cite

Sustained ventricular arrhythmias and mortality among patients with acute myocardial infarction: results from the GUSTO-III trial.

Journal Article Am 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 ... Full text Link to item Cite

Troponin T and quantitative ST-segment depression offer complementary prognostic information in the risk stratification of acute coronary syndrome patients.

Journal Article J Am Coll Cardiol · February 5, 2003 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 ... Full text Link to item Cite

Time-dependent predictors of primary cardiac arrest in patients with acute myocardial infarction.

Journal Article Am J Cardiol · February 1, 2003 To understand predictors of cardiac arrest early in acute myocardial infarction (AMI), for the Thrombolytic Predictive Instrument, we developed a multivariable regression model predicting primary cardiac arrest using time-dependent variables based on a cas ... Full text Link to item Cite

An invasive strategy is associated with decreased mortality in patients with unstable angina and non-ST-elevation myocardial infarction: GUSTO IIb trial.

Journal Article Am J Med · February 1, 2003 There has been much debate concerning an invasive versus a conservative strategy for patients with acute coronary syndromes. The purpose of this study was to determine whether early in-hospital catheterization reduced mortality in patients with unstable an ... Full text Link to item Cite

Prescription of QT-prolonging drugs in a cohort of about 5 million outpatients.

Journal Article Am J Med · February 1, 2003 Many drugs prolong the QT interval and increase the risk of torsade de pointes. Concurrent use of two or more of these drugs can further increase the risk, but the prevalence of concurrent prescription of QT-prolonging drugs is not known. Using the adminis ... Full text Link to item Cite

Development and validation of a simple model to predict severe coronary artery disease after myocardial infarction: potential impact on cardiac catheterization use in the United States and Canada.

Journal Article Am Heart J · February 2003 BACKGROUND: Improved patient selection may optimize the efficiency of cardiac catheterization in both high- and low-rate regions. The purpose of this study was to develop and validate a clinical model for predicting high-risk coronary artery disease (CAD) ... Full text Link to item Cite

Predictors of 90-day outcome in patients stabilized after acute coronary syndromes.

Journal Article Eur Heart J · January 2003 AIMS: We investigated predictors of 90-day risk among patients surviving the early period after an acute coronary syndrome (ACS). METHODS AND RESULTS: The study population included 15 904 stabilized ST-segment elevation or non-ST-segment elevation ACS pati ... Full text Link to item Cite

Improving communication of drug risks to prevent patient injury: proceedings of a workshop.

Journal Article Pharmacoepidemiol Drug Saf · 2003 PURPOSE: The Centers for Education & Research on Therapeutics (CERTs) is conducting a series of workshops on managing the risks of therapeutics, with the ultimate goal to develop an agenda for research and education about risk and its management. This pape ... Full text Link to item Cite

Time-based risk assessment after myocardial infarction. Implications for timing of discharge and applications to medical decision-making.

Journal Article Eur Heart J · January 2003 AIMS: We evaluated timing of adverse cardiac events after thrombolysis to guide length of stay after ST-segment elevation myocardial infarction. METHODS AND RESULTS: Kaplan-Meier survival curves described timing of major postinfarction complications in 410 ... Full text Link to item Cite

Integrating quality into the cycle of therapeutic development.

Journal Article J Am Coll Cardiol · December 4, 2002 The quality of healthcare, particularly as reflected in current practice versus the available evidence, has become a major focus of national health policy discussions. Key components needed to provide quality care include: 1) development of quality indicat ... Full text Link to item Cite

Promise of combined low-molecular-weight heparin and platelet glycoprotein IIb/IIIa inhibition: results from Platelet IIb/IIIa Antagonist for the Reduction of Acute coronary syndrome events in a Global Organization Network B (PARAGON B).

Journal Article Am Heart J · December 2002 BACKGROUND: Low-molecular-weight heparin (LMWH) has a more predictable anticoagulant effect than unfractionated heparin (UFH), is easier to administer, and does not require monitoring. Minimal data are available on LMWH combined with platelet glycoprotein ... Full text Link to item Cite

Reduction in vascular access site bleeding in sequential abciximab coronary intervention trials.

Journal Article Catheter Cardiovasc Interv · December 2002 We analyzed vascular access site bleeding from the EPIC, EPILOG, and EPISTENT trials to quantify the decrease in vascular bleeding complications in these three trials, especially those attributable to abciximab. The incidence of combined major and minor va ... Full text Link to item Cite

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

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

Mortality at 1 year with combination platelet glycoprotein IIb/IIIa inhibition and reduced-dose fibrinolytic therapy vs conventional fibrinolytic therapy for acute myocardial infarction: GUSTO V randomized trial.

Journal Article JAMA · November 6, 2002 CONTEXT: Among patients with acute myocardial infarction, combination reperfusion therapy with a platelet glycoprotein IIb/IIIa receptor inhibitor (abciximab) and a half dose of a plasminogen activator (reteplase) did not significantly reduce mortality at ... Full text Link to item Cite

Matching resources to treatment decisions for patients with acute coronary syndromes.

Journal Article Clin Cardiol · November 2002 Multiple dynamic forces are having an impact on the way cardiovascular disease is treated today and will be in the future. These forces include extended life expectancy, decreased disability, and accelerated improvement in the effectiveness of medical tech ... Full text Link to item Cite

Effect of abciximab on angiographic complications during percutaneous coronary stenting in the Evaluation of Platelet IIb/IIIa Inhibition in Stenting Trial (EPISTENT).

Journal Article Am J Cardiol · November 1, 2002 In the Evaluation of Platelet IIb/IIIa Inhibition in Stenting Trial (EPISTENT), abciximab reduced ischemic complications of stent implantation at 30 days and 6 months. The responsible mechanisms remain unclear. We sought to determine if abciximab decreases ... Full text Link to item Cite

Conclusion

Journal Article Clinical Cardiology · November 1, 2002 Full text Cite

A national survey of provisions in clinical-trial agreements between medical schools and industry sponsors.

Journal Article N Engl J Med · October 24, 2002 BACKGROUND: Concerned about threats to the integrity of clinical trials in a research environment increasingly controlled by private interests, the International Committee of Medical Journal Editors (ICMJE) has issued revised guidelines for investigators' ... Full text Link to item Cite

Evaluating the costs and effectiveness of cardiovascular therapies: who cares about economic analyses?

Journal Article Stat Med · October 15, 2002 The field of cardiovascular medicine is providing important insights about how the costs and effectiveness of diagnostic and therapeutic technologies are managed. As health-care budgets have taken up more of the economy and as employers and patients have b ... Full text Link to item Cite

The determinants of activated partial thromboplastin time, relation of activated partial thromboplastin time to clinical outcomes, and optimal dosing regimens for heparin treated patients with acute coronary syndromes: a review of GUSTO-IIb.

Journal Article J Thromb Thrombolysis · October 2002 CONTEXT: Unfractionated heparin remains widely utilized in the treatment of acute coronary syndromes (ACS). However, limited data exist on optimal dosing and range of activated partial thromboplastin time (aPTT) in this setting. A large trial of thrombolys ... Full text Link to item Cite

Management and outcome of patients with atrial fibrillation during acute myocardial infarction: the GUSTO-III experience. Global use of strategies to open occluded coronary arteries.

Journal Article Heart · October 2002 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 ... Full text Link to item Cite

Safety and efficacy of abciximab combined with dalteparin in treatment of acute coronary syndromes.

Journal Article Eur Heart J · October 2002 AIMS: The safety and efficacy of abciximab in addition to low-molecular-weight-heparin as the primary medical treatment of acute coronary syndromes has not previously been investigated. METHODS AND RESULTS: The GUSTO IV-ACS trial included 7800 patients wit ... Full text Link to item Cite

Patient outcomes after fibrinolytic therapy for acute myocardial infarction at hospitals with and without coronary revascularization capability.

Journal Article J Am Coll Cardiol · September 18, 2002 OBJECTIVES: This study evaluated clinical outcomes in patients with acute myocardial infarction (MI) treated with fibrinolytic therapy in hospitals with and without coronary revascularization capability. BACKGROUND: Patients with MI may have better outcome ... Full text Link to item Cite

Randomized COMparison of platelet inhibition with abciximab, tiRofiban and eptifibatide during percutaneous coronary intervention in acute coronary syndromes: the COMPARE trial. Comparison Of Measurements of Platelet aggregation with Aggrastat, Reopro, and Eptifibatide.

Journal Article Circulation · September 17, 2002 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 ... Full text Link to item Cite

Comparison of one-year outcomes following coronary artery stenting in diabetic versus nondiabetic patients (from the Enhanced Suppression of the Platelet IIb/IIIa Receptor With Integrilin Therapy [ESPRIT] Trial).

Journal Article Am J Cardiol · September 15, 2002 For patients undergoing nonurgent coronary stent implantation, blockade of the glycoprotein IIb/IIIa receptor with eptifibatide reduces the incidence of ischemic complications. We evaluated the interaction of eptifibatide with diabetes in patients who unde ... Full text Link to item Cite

Relationship between activated clotting time during percutaneous intervention and subsequent bleeding complications.

Journal Article Am Heart J · September 2002 BACKGROUND: Approximately 50% of percutaneous coronary interventions in the United States are performed with unfractionated heparin and no IIb/IIIa agent. The operator must weigh the risks and benefits of more intensive anticoagulation during these percuta ... Full text Link to item Cite

Comparison of omapatrilat and enalapril in patients with chronic heart failure: the Omapatrilat Versus Enalapril Randomized Trial of Utility in Reducing Events (OVERTURE).

Journal Article Circulation · August 20, 2002 BACKGROUND: Combined inhibition of the angiotensin-converting enzyme (ACE) and neutral endopeptidase (NEP) may produce greater benefits in heart failure than ACE inhibition alone. METHODS AND RESULTS: We randomly assigned 5770 patients with New York Heart ... Full text Link to item Cite

Prognostic implications of abnormalities in renal function in patients with acute coronary syndromes.

Journal Article Circulation · August 20, 2002 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 ... Full text Link to item Cite

Sertraline treatment of major depression in patients with acute MI or unstable angina.

Journal Article JAMA · August 14, 2002 CONTEXT: Major depressive disorder (MDD) occurs in 15% to 23% of patients with acute coronary syndromes and constitutes an independent risk factor for morbidity and mortality. However, no published evidence exists that antidepressant drugs are safe or effi ... Full text Link to item Cite

An independently derived and validated predictive model for selecting patients with myocardial infarction who are likely to benefit from tissue plasminogen activator compared with streptokinase.

Journal Article Am J Med · August 1, 2002 BACKGROUND: In the Global Utilization of Streptokinase and tPA for Occluded coronary arteries (GUSTO) trial, patients with myocardial infarction who were treated with tissue plasminogen activator (tPA) had a 6.3% 30-day mortality, compared with a mortality ... Full text Link to item Cite

Effect of hirudin vs heparin on haemostatic activity in patients with acute coronary syndromes; the GUSTO-IIb haemostasis substudy.

Journal Article Eur Heart J · August 2002 AIMS: We compared the effects of hirudin and heparin on thrombin generation and activity among 350 patients with acute coronary syndromes enrolled in the GUSTO-IIb trial. METHODS AND RESULTS: We obtained blood at baseline; at 4, 8, and 24h into infusion; a ... Full text Link to item Cite

An automated strategy for bedside aPTT determination and unfractionated heparin infusion adjustment in acute coronary syndromes: insights from PARAGON A.

Journal Article J Thromb Thrombolysis · August 2002 BACKGROUND: Intravenous unfractionated heparin remains a cornerstone of anticoagulation therapy for patients with acute coronary syndromes, but regulation to a target aPTT is challenging. We assessed unfractionated heparin infusion regulation by bedside, w ... Full text Link to item Cite

Practitioner acceptance of the dofetilide risk-management program.

Journal Article Pharmacotherapy · August 2002 STUDY OBJECTIVE: To assess the opinions and knowledge retention of practitioners after participation in the dofetilide risk-management program. DESIGN: A 21-item questionnaire. SETTING: A large academic medical center. PARTICIPANTS: One hundred forty-six p ... Full text Link to item Cite

Sustained ventricular arrhythmias among patients with acute coronary syndromes with no ST-segment elevation: incidence, predictors, and outcomes.

Journal Article Circulation · July 16, 2002 BACKGROUND: The prognosis of ventricular arrhythmias among patients with non-ST-elevation acute coronary syndromes is unknown. We studied the incidence, predictors, and outcomes of sustained ventricular arrhythmias in 4 large randomized trials of such pati ... Full text Link to item Cite

Comparison of coronary artery bypass grafting versus medical therapy on long-term outcome in patients with ischemic cardiomyopathy (a 25-year experience from the Duke Cardiovascular Disease Databank).

Journal Article Am J Cardiol · July 15, 2002 In this observational treatment comparison in a single center over 25 years, we sought to assess long-term outcomes of coronary artery bypass surgery (CABG) or medical therapy in patients with heart failure, coronary artery disease, and left ventricular sy ... Full text Link to item Cite

Inhaled ethyl nitrite gas for persistent pulmonary hypertension of the newborn.

Journal Article Lancet · July 13, 2002 Inhaled nitric oxide is used to alleviate pulmonary hypertension and hypoxaemia, but generates toxic free radicals and oxides of nitrogen (NO(x)), which can cause rebound-hypoxia and additional pulmonary and other morbidity. To address these problems, we a ... Full text Link to item Cite

Does eptifibatide confer a greater benefit to patients with unstable angina than with non-ST segment elevation myocardial infarction? Insights from the PURSUIT Trial.

Journal Article Eur Heart J · July 2002 AIMS: To evaluate the differential effects of eptifibatide therapy on unstable angina vs non-ST elevation myocardial infarction at enrollment, since the separate impact on these two major diagnostic subsets of acute coronary syndrome patients has not been ... Full text Link to item Cite

Predicting outcome after thrombolysis in acute myocardial infarction according to ST-segment resolution at 90 minutes: a substudy of the GUSTO-III trial. Global Use of Strategies To Open occluded coronary arteries.

Journal Article Am Heart J · July 2002 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 ... Full text Link to item Cite

TARGET versus GUSTO-IV: appropriate use of glycoprotein IIb/IIIa inhibitors in acute coronary syndromes and percutaneous coronary intervention.

Journal Article Curr Opin Cardiol · July 2002 Until recently, the selection of which glycoprotein IIb/IIIa inhibitor to use for patients with acute coronary syndromes or those undergoing percutaneous coronary intervention largely reflected physician preference, costs, and any evidence supporting the c ... Full text Link to item Cite

Heparin dosing and outcome in acute coronary syndromes: the GUSTO-IIb experience. Global Use of Strategies to Open Occluded Coronary Arteries.

Journal Article Am Heart J · July 2002 BACKGROUND: This study analyzed relationships among heparin dosage, patient characteristics, and 30-day outcome because optimal unfractionated-heparin dosing in acute coronary syndromes remains uncertain. METHODS: Patients (n = 5335) randomized to heparin ... Full text Link to item Cite

Disease management in healthcare organizations: results of in-depth interviews with disease management decision makers.

Journal Article Am J Manag Care · July 2002 BACKGROUND: Despite the widening use of disease management (DM) programs throughout the country, little is understood about the "state of DM" in healthcare systems and managed care organizations. OBJECTIVE: To better characterize the range of users of DM i ... Link to item Cite

Multi-year follow-up of abciximab therapy in three randomized, placebo-controlled trials of percutaneous coronary revascularization.

Journal Article Am J Med · July 2002 There is considerable evidence supporting the use of platelet glycoprotein IIb/IIIa inhibitors to reduce ischemic complications of percutaneous coronary revascularization. However, long-term follow-up has been limited. In three large-scale randomized trial ... Full text Link to item Cite

Troponin T levels in patients with acute coronary syndromes, with or without renal dysfunction.

Journal Article N Engl J Med · June 27, 2002 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. ... Full text Link to item Cite

Early angioplasty in acute coronary syndromes without persistent ST-segment elevation improves outcome but increases the need for six-month repeat revascularization: an analysis of the PURSUIT Trial. Platelet glycoprotein IIB/IIIA in Unstable angina: Receptor Suppression Using Integrilin Therapy.

Journal Article J Am Coll Cardiol · June 19, 2002 OBJECTIVES: We explored the effect of timing of percutaneous coronary intervention (PCI) in acute coronary syndromes (ACS) without persistent ST-segment elevation on the need for repeat revascularization, and we related this effect to other events. BACKGRO ... Full text Link to item Cite

Early statin initiation and outcomes in patients with acute coronary syndromes.

Journal Article JAMA · June 19, 2002 CONTEXT: The secondary prevention benefit of therapy with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) has been clearly demonstrated; however, the role of early initiation of statins after acute coronary syndromes (ACSs) is unknown. ... Full text Link to item Cite

Prognostic significance of elevated troponin I after percutaneous coronary intervention.

Journal Article J Am Coll Cardiol · June 5, 2002 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 ... Full text Link to item Cite

The need for a national infrastructure to improve the rational use of therapeutics.

Journal Article Pharmacoepidemiol Drug Saf · June 2002 The current medical care environment has created expectations that exceed its capabilities, one effect of which has been an increasing awareness of lapses in the quality of healthcare, including medical errors. As more new therapies reach clinical applicat ... Full text Link to item Cite

The failure of orally administered glycoprotein IIb/IIIa inhibitors to prevent recurrent cardiac events.

Journal Article Am J Med · June 1, 2002 PURPOSE: Despite the success of intravenous glycoprotein IIb/IIIa antagonists, oral formulations have failed to show benefit and have been associated with increased mortality. To understand these findings, we performed a meta-analysis of results from four ... Full text Link to item Cite

Dissociation between hemodynamic changes and symptom improvement in patients with advanced congestive heart failure.

Journal Article Eur J Heart Fail · June 2002 BACKGROUND: Changes in hemodynamic measures often serve as surrogate end points in efficacy trials for advanced heart failure, although there are few objective data to support this practice. AIMS: We compared changes in hemodynamic variables vs. changes in ... Full text Link to item Cite

Outcomes of patients with chronic renal insufficiency in the bypass angioplasty revascularization investigation.

Journal Article Circulation · May 14, 2002 BACKGROUND: Although severe chronic kidney disease (CKD) is an independent predictor of mortality among patients with coronary artery disease, the impact of mild CKD on morbidity and mortality has not been fully defined. METHODS AND RESULTS: Morbidity and ... Full text Link to item Cite

Patient-reported frequency of taking aspirin in a population with coronary artery disease.

Journal Article Am J Cardiol · May 1, 2002 Despite the established benefits of antiplatelet agents in coronary artery disease (CAD), many appropriate patients are not receiving them. We investigated the prevalence of and factors associated with aspirin use and nonuse within a large referral populat ... Full text Link to item Cite

Differential influence of diabetes mellitus on increased jeopardized myocardium after initial angioplasty or bypass surgery: bypass angioplasty revascularization investigation.

Journal Article Circulation · April 23, 2002 BACKGROUND: Data are absent that compare midterm angiographic outcome between patients with and without diabetes after initial percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass graft surgery (CABG). Importantly, diabetes mell ... Full text Link to item Cite

The coxib story: some lessons and more questions.

Journal Article Am J Cardiol · April 15, 2002 Full text Link to item Cite

Effect of Hypericum perforatum (St John's wort) in major depressive disorder: a randomized controlled trial.

Journal Article JAMA · April 10, 2002 CONTEXT: Extracts of Hypericum perforatum (St John's wort) are widely used for the treatment of depression of varying severity. Their efficacy in major depressive disorder, however, has not been conclusively demonstrated. OBJECTIVE: To test the efficacy an ... Full text Link to item Cite

Short-term intravenous milrinone for acute exacerbation of chronic heart failure: a randomized controlled trial.

Journal Article JAMA · March 27, 2002 CONTEXT: Little randomized evidence is available to guide the in-hospital management of patients with an acute exacerbation of chronic heart failure. Although intravenous inotropic therapy usually produces beneficial hemodynamic effects and is labeled for ... Full text Link to item Cite

Underuse of aspirin in a referral population with documented coronary artery disease.

Journal Article Am J Cardiol · March 15, 2002 Despite substantial evidence that antiplatelet therapy saves lives and reduces adverse events in patients with coronary artery disease (CAD), use of the most widely available and lowest cost antiplatelet agent, aspirin, continues to be disappointingly low. ... Full text Link to item Cite

Long-term efficacy of platelet glycoprotein IIb/IIIa integrin blockade with eptifibatide in coronary stent intervention.

Journal Article JAMA · February 6, 2002 CONTEXT: In the Enhanced Suppression of the Platelet IIb/IIIa Receptor with Integrilin Therapy (ESPRIT) trial, treatment with eptifibatide, a platelet glycoprotein IIb/IIIa integrin blocker, was found to reduce the ischemic complications of nonurgent coron ... Full text Link to item Cite

Misreporting of myocardial infarction end points: results of adjudication by a central clinical events committee in the PARAGON-B trial. Second Platelet IIb/IIIa Antagonist for the Reduction of Acute Coronary Syndrome Events in a Global Organization Network Trial.

Journal Article Am Heart J · February 2002 BACKGROUND: Myocardial (re)infarction (MI), a common trial end point, can be difficult to identify because of inconclusive signs and symptoms. We examined disagreement between investigator and clinical events committee (CEC) reporting of MIs in an internat ... Full text Link to item Cite

Persistence of delays in presentation and treatment for patients with acute myocardial infarction: The GUSTO-I and GUSTO-III experience.

Journal Article Ann Emerg Med · February 2002 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 ... Full text Link to item Cite

Patients with acute coronary syndromes without persistent ST elevation undergoing percutaneous coronary intervention benefit most from early intervention with protection by a glycoprotein IIb/IIIa receptor blocker.

Journal Article Eur Heart J · February 2002 BACKGROUND: Many patients with acute coronary syndromes are offered percutaneous coronary intervention. However, the appropriate indications for, and optimal timing of, such procedures are uncertain. We analysed timing of intervention and associated events ... Full text Link to item Cite

Outcomes of patients with acute coronary syndromes and prior coronary artery bypass grafting: results from the platelet glycoprotein IIb/IIIa in unstable angina: receptor suppression using integrilin therapy (PURSUIT) trial.

Journal Article Circulation · January 22, 2002 BACKGROUND: Patients with prior CABG with a subsequent non-ST-segment elevation acute coronary syndrome (ACS) pose an increasingly important clinical problem. Although GP IIb/IIIa inhibitors have improved the outcome of patients with ACS, their efficacy in ... Full text Link to item Cite

Platelet glycoprotein IIb/IIIa inhibitors in acute coronary syndromes: a meta-analysis of all major randomised clinical trials.

Journal Article Lancet · January 19, 2002 BACKGROUND: Platelet glycoprotein IIb/IIIa inhibitors have been shown to reduce cardiac complications in patients undergoing percutaneous coronary intervention. The clinical efficacy of these drugs in acute coronary syndromes, however, is still unclear. We ... Full text Link to item Cite

The prognostic value of creatine kinase elevations extends across the whole spectrum of acute coronary syndromes.

Journal Article J Am Coll Cardiol · January 2, 2002 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 ... Full text Link to item Cite

Centers for Education and Research on Therapeutics (CERTs)

Journal Article Drug Information Journal · 2002 The Centers for Education and Research on Therapeutics (CERTs) program is a national initiative authorized by the Food and Drug Modernization Act of 1997 (FDAMA) (Public Law 105-115) as a public-private partnership. The program is administered by the Agenc ... Cite

Grade III ischemia on presentation with acute myocardial infarction predicts rapid progression of necrosis and less myocardial salvage with thrombolysis.

Journal Article Cardiology · 2002 We assessed the relation between baseline electrocardiographic ischemia grades and initial myocardial area at risk (AR) and final infarct size (IS) in 49 patients who had undergone (99m)Tc sestamibi single-photon emission computed tomography before and 6 + ... Full text Link to item Cite

Characteristics, treatment and outcome of patients with non-ST-elevation acute coronary syndromes and multivessel coronary artery disease: observations from PURSUIT (platelet glycoprotein IIb/IIIa in unstable angina: receptor suppression using integrelin therapy).

Journal Article Cardiology · 2002 BACKGROUND: The 6-month clinical outcome of patients with multivessel disease enrolled in PURSUIT (Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy) is described. Patients with complete angiography data were ... Full text Link to item Cite

Comparison of cefuroxime with or without intranasal fluticasone for the treatment of rhinosinusitis. The CAFFS Trial: a randomized controlled trial.

Journal Article JAMA · December 26, 2001 CONTEXT: It is not known whether intranasal corticosteroids are beneficial to treat acute rhinosinusitis in patients with a history of chronic or recurrent sinus symptoms. OBJECTIVE: To assess whether the addition of an intranasal corticosteroid to antibio ... Full text Link to item Cite

Platelet glycoprotein IIb/IIIa inhibitors reduce mortality in diabetic patients with non-ST-segment-elevation acute coronary syndromes.

Journal Article Circulation · December 4, 2001 BACKGROUND: Diabetes mellitus is a major risk factor for adverse outcomes after acute coronary syndromes (ACS). Because this disease may be associated with increased platelet aggregation, we investigated whether diabetic patients with ACS derive particular ... Full text Link to item Cite

Incidence and predictors of bleeding events after fibrinolytic therapy with fibrin-specific agents: a comparison of TNK-tPA and rt-PA.

Journal Article Eur Heart J · December 2001 BACKGROUND: Fibrinolytic therapy increases the risk of bleeding events. TNK-tPA (tenecteplase) is a variant of rt-PA with greater fibrin specificity and reduced plasma clearance that can be given as a single bolus. We compared the incidence and predictors ... Full text Link to item Cite

Thrombin-specific anticoagulation with bivalirudin versus heparin in patients receiving fibrinolytic therapy for acute myocardial infarction: the HERO-2 randomised trial.

Journal Article Lancet · December 1, 2001 BACKGROUND: The combination of fibrinolytic therapy and heparin for acute myocardial infarction fails to achieve reperfusion in 40-70% of patients, and early reocclusion occurs in a substantial number. We did a randomised, open-label trial to compare the t ... Full text Link to item Cite

Combination reperfusion therapy with eptifibatide and tenecteplase for acute myocardial infarction: Design and methodology of the INTEGRITI (Integrilin and Tenecteplase for Acute Myocardial Infarction) Trial

Journal Article Heartdrug · December 1, 2001 Combination reperfusion therapy with partial-dose fibrinolytics and glycoprotein (GP) IIb/IIIa inhibitors for patients with acute myocardial infarction has been shown to accelerate and improve reperfusion compared with fibrinolytic monotherapy. Tenecteplas ... Full text Cite

Clinical pharmacology of higher dose eptifibatide in percutaneous coronary intervention (the PRIDE study).

Journal Article Am J Cardiol · November 15, 2001 This study describes the dose-exploration phase of the PRIDE trial, an investigation of the clinical pharmacology of higher dose eptifibatide in patients who underwent elective percutaneous coronary intervention (PCI). Outcomes of treatment with the platel ... Full text Link to item Cite

Advanced coronary artery disease: Appropriate end points for trials of novel therapies.

Journal Article Am Heart J · November 2001 BACKGROUND: The segment of patients with advanced coronary artery disease, or disease that is not amenable to conventional revascularization therapies, continues to grow. Because the natural history of these patients is less defined, the appropriate end po ... Full text Link to item Cite

Prognostic usefulness of the six-minute walk in patients with advanced congestive heart failure secondary to ischemic or nonischemic cardiomyopathy.

Journal Article Am J Cardiol · November 1, 2001 Clinicians have relied on history and results from physical examinations to guide treatment of patients with advanced congestive heart failure, but these results may not reflect disease severity or hemodynamic status. We assessed how the distance walked in ... Full text Link to item Cite

Comparison of primary coronary angioplasty versus thrombolysis in patients with ST-segment elevation acute myocardial infarction and grade II and grade III myocardial ischemia on the enrollment electrocardiogram.

Journal Article Am J Cardiol · October 15, 2001 We investigated the impact of primary angioplasty compared with thrombolysis in 894 patients with ST elevation acute myocardial infarction and electrocardiographic grades II and III ischemia on enrollment. Patients were divided into 2 groups based on the e ... Full text Link to item Cite

Short-term trials and long-term effects.

Journal Article Science · September 28, 2001 Full text Link to item Cite

Early reinfarction after fibrinolysis: experience from the global utilization of streptokinase and tissue plasminogen activator (alteplase) for occluded coronary arteries (GUSTO I) and global use of strategies to open occluded coronary arteries (GUSTO III) trials.

Journal Article Circulation · September 11, 2001 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 ... Full text Link to item Cite

Comparison of two aspirin doses on ischemic stroke in post-myocardial infarction patients in the warfarin (Coumadin) Aspirin Reinfarction Study (CARS).

Journal Article Am J Cardiol · September 1, 2001 The Coumadin Aspirin Reinfarction Study demonstrated that combination treatment with fixed dose warfarin (1 or 3 mg) + aspirin 80 mg was not superior to aspirin 160 mg alone after myocardial infarction for reducing nonfatal reinfarction, nonfatal stroke, a ... Full text Link to item Cite

Using observational data to estimate prognosis: an example using a coronary artery disease registry.

Journal Article Stat Med · August 30, 2001 With the proliferation of clinical data registries and the rising expense of clinical trials, observational data sources are increasingly providing evidence for clinical decision making. These data are viewed as complementary to randomized clinical trials ... Full text Link to item Cite

Efficacy and safety of tenecteplase in combination with enoxaparin, abciximab, or unfractionated heparin: the ASSENT-3 randomised trial in acute myocardial infarction.

Journal Article Lancet · August 25, 2001 BACKGROUND: Current fibrinolytic therapies fail to achieve optimum reperfusion in many patients. Low-molecular-weight heparins and platelet glycoprotein IIb/IIIa inhibitors have shown the potential to improve pharmacological reperfusion therapy. We did a r ... Full text Link to item Cite

Relationship of depression to increased risk of mortality and rehospitalization in patients with congestive heart failure.

Journal Article Arch Intern Med · August 13, 2001 BACKGROUND: Patients with congestive heart failure (CHF) may have a high prevalence of depression, which may increase the risk of adverse outcomes. OBJECTIVE: To determine the prevalence and relationship of depression to outcomes of patients hospitalized w ... Full text Link to item Cite

The A-to-Z Trial: Methods and rationale for a single trial investigating combined use of low-molecular-weight heparin with the glycoprotein IIb/IIIa inhibitor tirofiban and defining the efficacy of early aggressive simvastatin therapy.

Journal Article Am Heart J · August 2001 BACKGROUND: The A-to-Z Trial is an ongoing international, multicenter, randomized study designed to investigate 2 issues concerning contemporary care of patients with acute coronary syndromes (ACS). The first issue is whether the use of low-molecular-weigh ... Full text Link to item Cite

Systematic adjudication of myocardial infarction end-points in an international clinical trial.

Journal Article Curr Control Trials Cardiovasc Med · July 17, 2001 BACKGROUND: Clinical events committees (CEC) are used routinely to adjudicate suspected end-points in cardiovascular trials, but little information has been published about the various processes used. We reviewed results of the CEC process used to identify ... Full text Link to item Cite

Disagreements between central clinical events committee and site investigator assessments of myocardial infarction endpoints in an international clinical trial: review of the PURSUIT study.

Journal Article Curr Control Trials Cardiovasc Med · July 17, 2001 BACKGROUND: Limited information has been published regarding how specific processes for event adjudication can affect event rates in trials. We reviewed nonfatal myocardial infarctions (MIs) reported by site investigators in the international Platelet Glyc ... Full text Link to item Cite

Risk of stroke associated with abciximab among patients undergoing percutaneous coronary intervention.

Journal Article JAMA · July 4, 2001 CONTEXT: Abciximab, a potent inhibitor of the platelet glycoprotein IIb/IIIa receptor, reduces thrombotic complications in patients undergoing percutaneous coronary intervention (PCI). Because of its potent inhibition of platelet aggregation, the effect of ... Full text Link to item Cite

Differential survival after coronary revascularization procedures among patients with renal insufficiency.

Journal Article Kidney Int · July 2001 BACKGROUND: Acute myocardial infarction, cardiac arrest, and other cardiac events are the major cause of mortality among patients with renal insufficiency. Previous studies of interventions for coronary artery disease among patients with renal insufficienc ... Full text Link to item Cite

Predictors of left ventricular function after acute myocardial infarction: effects of time to treatment, patency, and body mass index: the GUSTO-I angiographic experience.

Journal Article Am Heart J · July 2001 BACKGROUND: Despite the significant survival benefit associated with successful reperfusion therapy for acute myocardial infarction, global indices of outcome left ventricular function, such as ejection fraction, have often demonstrated little or no improv ... Full text Link to item Cite

Prognostic value of ST segment depression in acute coronary syndromes: insights from PARAGON-A applied to GUSTO-IIb. PARAGON-A and GUSTO IIb Investigators. Platelet IIb/IIIa Antagonism for the Reduction of Acute Global Organization Network.

Journal Article J Am Coll Cardiol · July 2001 OBJECTIVES: Our objectives were to develop a risk-stratification model addressing the importance of the magnitude and distribution of ST segment depression in predicting long-term outcomes and to validate the model in an analogous patient population. BACKG ... Full text Link to item Cite

Cardiac rehabilitation and survival in patients with left ventricular systolic dysfunction.

Journal Article Am Heart J · July 2001 BACKGROUND: Exercise training, the major component of cardiac rehabilitation (CR), has been shown in previous trials to improve many pathophysiologic changes found in patients with left ventricular systolic dysfunction. It remains unproven whether exercise ... Full text Link to item Cite

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

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

Benefit of glycoprotein IIb/IIIa inhibition in patients with acute coronary syndromes and troponin t-positive status: the paragon-B troponin T substudy.

Journal Article Circulation · June 19, 2001 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 ... Full text Link to item Cite

Long-term mortality benefit with abciximab in patients undergoing percutaneous coronary intervention.

Journal Article J Am Coll Cardiol · June 15, 2001 OBJECTIVES: The goal of this study was to test: 1) if platelet glycoprotein IIb/IIIa (GP IIb/IIIa) blockade with abciximab bolus plus 12-h infusion reduces mortality after percutaneous coronary intervention (PCI); 2) if prevention of early myocardial infar ... Full text Link to item Cite

Achieving optimal results with standard balloon angioplasty: can baseline and angiographic variables predict stent-like outcomes?

Journal Article J Am Coll Cardiol · June 1, 2001 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 ... Full text Link to item Cite

Hemodynamics as surrogate end points for survival in advanced heart failure: an analysis from FIRST.

Journal Article Am Heart J · June 2001 BACKGROUND: Hemodynamics often are used as surrogate end points in phase II trials of acute heart failure (HF). We reviewed the Flolan International Randomized Survival Trial (FIRST) database to identify the hemodynamic variables that best predict survival ... Full text Link to item Cite

Hemodynamic profiles of advanced heart failure: association with clinical characteristics and long-term outcomes.

Journal Article J Card Fail · June 2001 BACKGROUND: Classifying patients with advanced congestive heart failure (CHF) by baseline measures of congestion and perfusion has been used to estimate hemodynamic status and to select and titrate therapy. We describe clinical characteristics of 4 hemodyn ... Full text Link to item Cite

Association between selective serotonin-reuptake inhibitor therapy and heart valve regurgitation.

Journal Article Am J Cardiol · April 15, 2001 The identification of an association between fenfluramines and valvular disease has raised the possibility of a similar association between another class of medications that increases local levels of serotonin, the selective serotonin-reuptake inhibitors ( ... Full text Link to item Cite

Effect of lipid-lowering therapy on early mortality after acute coronary syndromes: an observational study.

Journal Article Lancet · April 7, 2001 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 ... Full text Link to item Cite

Recurrent ischemia after thrombolysis for acute myocardial infarction.

Journal Article Am Heart J · April 2001 BACKGROUND: Reliable predictors have yet to be found for recurrent ischemia after thrombolysis for acute myocardial infarction (AMI), nor do we know whether early angiography can herald recurrent ischemia. This study sought to investigate the relationship ... Full text Link to item Cite

Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE): design and rationale.

Journal Article Am Heart J · April 2001 BACKGROUND: There is little information about how to adjust pharmacologic agents in the treatment of patients with advanced congestive heart failure (CHF). Some studies have suggested that use of pulmonary artery catheterization to guide reductions in fill ... Full text Link to item Cite

Reactivation of ischemic events in acute coronary syndromes: results from GUSTO-IIb. Gobal Use of Strategies To Open occluded arteries in acute coronary syndromes.

Journal Article J Am Coll Cardiol · March 15, 2001 OBJECTIVES: We sought to determine the incidence of and risk factors for thrombotic events early after discontinuing antithrombin therapy in patients with acute coronary syndromes. BACKGROUND: Discontinuation of treatment with heparin and other thrombin in ... Full text Link to item Cite

Monitoring and ensuring safety during clinical research.

Journal Article JAMA · March 7, 2001 Increased numbers of clinical trials, many of which are large, multicenter, and sometimes international, and the marked shift of funding for clinical trials to industry have made apparent the inadequacy of mechanisms for protecting human subjects that were ... Full text Link to item Cite

Outcome of acute ST-segment elevation myocardial infarction in patients with prior coronary artery bypass surgery receiving thrombolytic therapy.

Journal Article Am Heart J · March 2001 BACKGROUND: Patients with prior coronary bypass surgery with acute ST-segment elevation myocardial infarction (MI) pose an increasingly common clinical problem. We assessed the characteristics and outcomes of such patients undergoing thrombolysis for acute ... Full text Link to item Cite

Prognostic importance of concomitant heparin with eptifibatide in acute coronary syndromes. PURSUIT Investigators. Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy.

Journal Article Am J Cardiol · March 1, 2001 Platelet glycoprotein IIb/IIIa inhibitors have been extensively studied in the treatment of patients with ischemic heart disease. Data regarding the use of these agents in the absence of concomitant intravenous heparin have been conflicting. We sought to d ... Full text Link to item Cite

Variation in patient management and outcomes for acute coronary syndromes in Latin America and North America: results from the Platelet IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) trial.

Journal Article Am Heart J · March 2001 BACKGROUND: Although more than 9500 patients have been enrolled in major clinical trials in Latin America, practice patterns in this region have rarely been examined. We sought to compare characteristics, resource utilization, and outcomes of patients trea ... Full text Link to item Cite

Treatment of reinfarction after thrombolytic therapy for acute myocardial infarction: an analysis of outcome and treatment choices in the global utilization of streptokinase and tissue plasminogen activator for occluded coronary arteries (gusto I) and assessment of the safety of a new thrombolytic (assent 2) studies.

Journal Article Circulation · February 20, 2001 BACKGROUND: Early reinfarction after thrombolytic therapy is associated with adverse outcomes and increased mortality. Among patients with reinfarction in the 1992 Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary A ... Full text Link to item Cite

Therapeutic value of eptifibatide at community hospitals transferring patients to tertiary referral centers early after admission for acute coronary syndromes. PURSUIT Investigators.

Journal Article J Am Coll Cardiol · February 2001 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 ... Full text Link to item Cite

Clopidogrel

Journal Article American Journal of Cardiovascular Drugs · January 1, 2001 Full text Cite

Shifting the open-artery hypothesis downstream: the quest for optimal reperfusion.

Journal Article J Am Coll Cardiol · January 2001 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 ... Full text Link to item Cite

Clinical, electrocardiographic, and biochemical data for immediate risk stratification in acute coronary syndromes.

Journal Article Ann Noninvasive Electrocardiol · January 2001 The recent evolution in therapeutic options for acute coronary syndromes (ACS) mandates early risk stratification in order to select the appropriate treatment strategy for individual patients. Simple clinical data derived from the patient's medical history ... Full text Link to item Cite

Depressive symptoms and outcome of coronary artery bypass grafting.

Journal Article Am 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 ... Link to item Cite

Guideline snapshot

Journal Article ACC Current Journal Review · January 1, 2001 Full text Cite

Comparison of medicine alone, coronary angioplasty, and left internal mammary artery-coronary artery bypass for one-vessel proximal left anterior descending coronary artery disease.

Journal Article Am J Cardiol · December 15, 2000 Despite the deleterious and sometimes catastrophic consequences of proximal left anterior descending (LAD) artery occlusion, there is a paucity of data to guide the treatment of patients with such disease. Our aim was to describe outcomes with medical ther ... Full text Link to item Cite

Enhanced efficacy of eptifibatide administration in patients with acute coronary syndrome requiring in-hospital coronary artery bypass grafting. PURSUIT Investigators.

Journal Article Circulation · December 12, 2000 BACKGROUND: Patients with a recent episode of non-ST-segment elevation acute coronary syndrome before CABG have higher rates of operative morbidity and mortality than patients with stable coronary syndromes. The efficacy of administering eptifibatide to th ... Full text Link to item Cite

Economic assessment of platelet glycoprotein IIb/IIIa receptor blockade with abciximab and low-dose heparin during percutaneous coronary revascularization: results from the EPILOG randomized trial. Evaluation in PTCA to Improve Long-term Outcome with abciximab GP IIb/IIIa blockade.

Journal Article Circulation · December 12, 2000 BACKGROUND: In the EPILOG trial (Evaluation in PTCA to Improve Long-term Outcome with abciximab GP IIb/IIIa blockade), abciximab administered with weight-adjusted heparin diminished the risk of ischemic complications within 30 days by 56% among patients un ... Full text Link to item Cite

Temporal evolution in the management of acute ST elevation myocardial infarction: The seven-year GUSTO experience from Canada and the United States

Journal Article Canadian 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 ... Cite

Patient characteristics associated with care by a cardiologist among adults hospitalized with severe congestive heart failure. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments.

Journal Article J Am Coll Cardiol · December 2000 OBJECTIVES: The goal of this study was to determine factors associated with receiving cardiologist care among patients with an acute exacerbation of congestive heart failure. BACKGROUND: Because cardiologist care for acute cardiovascular illness may improv ... Full text Link to item Cite

New atrial fibrillation after acute myocardial infarction independently predicts death: the GUSTO-III experience.

Journal Article Am 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 ... Full text Link to item Cite

Lack of progress in cardiogenic shock: lessons from the GUSTO trials.

Journal Article Eur Heart J · December 2000 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 ... Full text Link to item Cite

Influence of diabetes mellitus on clinical outcomes across the spectrum of acute coronary syndromes. Findings from the GUSTO-IIb study. GUSTO IIb Investigators.

Journal Article Eur 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 ... Full text Link to item Cite

Facilitation of early percutaneous coronary intervention after reteplase with or without abciximab in acute myocardial infarction: results from the SPEED (GUSTO-4 Pilot) Trial.

Journal Article J Am Coll Cardiol · November 1, 2000 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 ... Full text Link to item Cite

Valsartan in acute myocardial infarction trial (VALIANT): rationale and design.

Journal Article Am Heart J · November 2000 BACKGROUND: Survivors of acute myocardial infarction (MI) complicated by heart failure and/or resulting in left ventricular dysfunction are at heightened risk for subsequent death and major nonfatal cardiovascular events. Inhibition of the renin-angiotensi ... Full text Link to item Cite

Randomisation in the SYMPHONY trial.

Journal Article Lancet · October 28, 2000 Full text Link to item Cite

Clinical and electrocardiographic variables associated with increased risk of ventricular septal defect in acute anterior myocardial infarction.

Journal Article Am J Cardiol · October 15, 2000 It is unknown whether the risk factors associated with the development of ventricular septal defect (VSD) after acute myocardial infarction (MI) remain the same when thrombolytic therapy is used, nor have specific electrocardiographic patterns of acute MI ... Full text Link to item Cite

Clinical characteristics and long-term outcomes of patients with heart failure and preserved systolic function.

Journal Article Am J Cardiol · October 15, 2000 Although the syndrome of heart failure with preserved systolic function may occur in up to 40% of all heart failure patients, the clinical, angiographic characteristics, and long-term outcomes of these patients are poorly understood. We prospectively evalu ... Full text Link to item Cite

Survival outcomes 1 year after reperfusion therapy with either alteplase or reteplase for acute myocardial infarction: results from the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) III Trial.

Journal Article Circulation · October 10, 2000 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 ... Full text Link to item Cite

Temporal evolution in the management of acute ST elevation myocardial infarction: the seven-year GUSTO experience from canada and the united states. The North American GUSTO-I and GUSTO-III investigators.

Journal Article Can 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 ... Link to item Cite

Cigarette smoking: how much worse can it get?

Journal Article Circulation · September 19, 2000 Full text Link to item Cite

Canadian-American differences in the management of acute coronary syndromes in the GUSTO IIb trial: one-year follow-up of patients without ST-segment elevation. Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) II Investigators.

Journal Article Circulation · September 19, 2000 BACKGROUND: Little information exists concerning practice patterns between Canada and the United States in the management of myocardial infarction (MI) patients without ST-segment elevation and unstable angina. METHODS AND RESULTS: We examined the practice ... Full text Link to item Cite

Management of patients with acute coronary syndromes in the United States by platelet glycoprotein IIb/IIIa inhibition. Insights from the platelet glycoprotein IIb/IIIa in unstable angina: receptor suppression using integrilin therapy (PURSUIT) trial.

Journal Article Circulation · September 5, 2000 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 ... Full text Link to item Cite

Clinical and therapeutic profile of patients presenting with acute coronary syndromes who do not have significant coronary artery disease.The Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) Trial Investigators.

Journal Article Circulation · September 5, 2000 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 ... Full text Link to item Cite

Randomized trial of low molecular weight heparin (enoxaparin) versus unfractionated heparin for unstable coronary artery disease: one-year results of the ESSENCE Study. Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q Wave Coronary Events.

Journal Article J Am Coll Cardiol · September 2000 OBJECTIVES: We sought to determine whether the observed benefits of enoxaparin were maintained beyond the early phase; a one-year follow-up survey was undertaken for patients enrolled in the Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q wave Coro ... Full text Link to item Cite

Platelet glycoprotein IIb/IIIa blockade and outcome of cardiogenic shock complicating acute coronary syndromes without persistent ST-segment elevation.

Journal Article J Am Coll Cardiol · September 2000 OBJECTIVES: The study examined whether antiplatelet treatment with eptifibatide affected the frequency and outcome of shock among patients in the Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) tri ... Full text Link to item Cite

Negative T waves shortly after ST-elevation acute myocardial infarction are a powerful marker for improved survival rate.

Journal Article Am Heart J · September 2000 BACKGROUND: Recent studies have reported that negative T waves in the setting of acute coronary events are associated with Thrombolysis In Myocardial Infarction flow grade 3 in the infarct-related artery and with improved parameters of ventricular function ... Full text Link to item Cite

Cardiogenic shock complicating acute coronary syndromes.

Journal Article Lancet · August 26, 2000 Cardiogenic shock remains the major cause of death among patients with all types of acute coronary syndromes. Thus, there is a growing interest in the identification of patients who are at risk for developing cardiogenic shock, in the exploration of differ ... Full text Link to item Cite

Dose-finding, safety, and tolerability study of an oral platelet glycoprotein IIb/IIIa inhibitor, lotrafiban, in patients with coronary or cerebral atherosclerotic disease.

Journal Article Circulation · August 15, 2000 BACKGROUND: Antiplatelet therapy is the mainstay of the treatment and secondary prevention of cardiovascular and cerebrovascular ischemic events. We assessed the safety, tolerability, and pharmacodynamics of lotrafiban, an oral platelet glycoprotein IIb/II ... Full text Link to item Cite

Abciximab and bleeding during coronary surgery: results from the EPILOG and EPISTENT trials. Improve Long-term Outcome with abciximab GP IIb/IIIa blockade. Evaluation of Platelet IIb/IIIa Inhibition in STENTing.

Journal Article Ann Thorac Surg · August 2000 BACKGROUND: Abciximab during percutaneous coronary revascularization reduces ischemic complications, but concern exists regarding increased bleeding risk should emergency coronary surgical procedures be required. METHODS: Outcomes were assessed among 85 pa ... Full text Link to item Cite

Clinical benefit of glycoprotein IIb/IIIa blockade with Abciximab is independent of gender: pooled analysis from EPIC, EPILOG and EPISTENT trials. Evaluation of 7E3 for the Prevention of Ischemic Complications. Evaluation in Percutaneous Transluminal Coronary Angioplasty to Improve Long-Term Outcome with Abciximab GP IIb/IIIa blockade. Evaluation of Platelet IIb/IIIa Inhibitor for Stent.

Journal Article J Am Coll Cardiol · August 2000 OBJECTIVES: We sought to determine the efficacy and safety of platelet glycoprotein IIb/IIIa receptor (GP IIb/IIIa) blockade with abciximab in women undergoing percutaneous coronary intervention. BACKGROUND: Although gender differences in response to plate ... Full text Link to item Cite

Intraoperative radioisotope sentinel lymph node mapping in non-small cell lung cancer.

Journal Article Ann Thorac Surg · August 2000 BACKGROUND: Lymph node metastases are the most significant prognostic factor in localized non-small cell lung cancer (NSCLC). Nodal micrometastases may not be detected. Identification of the first nodal drainage site (sentinel node) may improve detection o ... Full text Link to item Cite

State of the art: ACS treatment at the turn of the century

Journal Article European Heart Journal Supplement · July 18, 2000 The pathophysiology of acute coronary syndromes is extremely complex. While thrombosis is known to be a major factor, the role of inflammation in the pathogenesis of these syndromes is becoming increasingly clear. As a result, simple linear pathways cannot ... Cite

Occurrence and clinical significance of pseudothrombocytopenia during abciximab therapy.

Journal Article J Am Coll Cardiol · July 2000 OBJECTIVES: This study determined the incidence of pseudothrombocytopenia during abciximab therapy administered for percutaneous coronary interventions and compared the clinical course of patients with pseudothrombocytopenia with the clinical courses of pa ... Full text Link to item Cite

Hierarchy of risk based on history and location of prior myocardial infarction in the thrombolytic era. GUSTO-I Investigators.

Journal Article Am Heart J · July 2000 BACKGROUND: Among patients receiving thrombolytic therapy for myocardial infarction, the outcome for those with a history of infarction is dramatically worse than for those with their first event. Methods And Results We performed a post hoc analysis of pat ... Full text Link to item Cite

Clinical correlates and course of thrombocytopenia during percutaneous coronary intervention in the era of abciximab platelet glycoprotein IIb/IIIa blockade.

Journal Article Am Heart J · July 2000 BACKGROUND: Thrombocytopenia is infrequently associated with abciximab therapy but may contribute to hemorrhagic risk. Factors associated with development of thrombocytopenia, the role of weight-adjustment in concomitant heparin administration, and clinica ... Full text Link to item Cite

Use of resources, quality of life, and clinical outcomes in patients with and without new Q waves after thrombolytic therapy for acute myocardial infarction (from the GUSTO-I trial).

Journal Article Am 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 ... Full text Link to item Cite

Predictors of mortality and mortality from cardiac causes in the bypass angioplasty revascularization investigation (BARI) randomized trial and registry. For the BARI Investigators.

Journal Article Circulation · June 13, 2000 BACKGROUND: The impact of percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG) on long-term mortality rates in the presence of various demographic, clinical, and angiographic factors is uncertain in the populatio ... Full text Link to item Cite

Predictors of outcome in patients with acute coronary syndromes without persistent ST-segment elevation. Results from an international trial of 9461 patients. The PURSUIT Investigators.

Journal Article Circulation · June 6, 2000 BACKGROUND: Appropriate treatment policies should include an accurate estimate of a patient's baseline risk. Risk modeling to date has been underutilized in patients with acute coronary syndromes without persistent ST-segment elevation. METHODS AND RESULTS ... Full text Link to item Cite

Design of the blockade of the glycoprotein IIb/IIIa receptor to avoid vascular occlusion (BRAVO) trial.

Journal Article Am Heart J · June 2000 BACKGROUND: Platelets play a key role in the pathogenesis of atherosclerosis, thrombosis, and acute coronary and cerebrovascular syndromes. Inhibition of platelet function by acetylsalicylic acid (aspirin) has been shown to reduce the incidence atherothrom ... Full text Link to item Cite

Predictors of recurrent ischemic events and death in unstable coronary artery disease after treatment with combination antithrombotic therapy.

Journal Article Am Heart J · June 2000 BACKGROUND: Patients with non-Q-wave acute coronary syndromes (ACS) have substantial rates of recurrent ischemic events, but prognostic studies have been small or preceded the routine use of aggressive combination antithrombotic therapy. We sought to ident ... Full text Link to item Cite

Prediction of 1-year survival after thrombolysis for acute myocardial infarction in the global utilization of streptokinase and TPA for occluded coronary arteries trial.

Journal Article Circulation · May 16, 2000 BACKGROUND: When a patient survives thrombolysis for acute myocardial infarction, little information from large studies exists from which to estimate prognosis during follow-up visits. METHODS AND RESULTS: Baseline, in-hospital, and later survival data wer ... Full text Link to item Cite

All that glitters is not gold.

Journal Article Lancet · May 6, 2000 Full text Link to item Cite

Physician understanding of patient resuscitation preferences: insights and clinical implications.

Journal Article J Am Geriatr Soc · May 2000 OBJECTIVE: To describe physician understanding of patient preferences concerning cardiopulmonary resuscitation (CPR) and to assess the relationship of physician understanding of patient preferences with do not resuscitate (DNR) orders and in-hospital CPR. ... Full text Link to item Cite

Diabetes mellitus and outcome after primary coronary angioplasty for acute myocardial infarction: lessons from the GUSTO-IIb Angioplasty Substudy. Global Use of Strategies to Open Occluded Arteries in Acute Coronary Syndromes.

Journal Article J Am Coll Cardiol · May 2000 OBJECTIVES: We sought to compare the efficacy of primary angioplasty in diabetics versus nondiabetics and to evaluate the relative benefits of angioplasty over thrombolytic therapy among diabetics. BACKGROUND: Primary angioplasty for myocardial infarction ... Full text Link to item Cite

Age and outcome after acute coronary syndromes without persistent ST-segment elevation.

Journal Article Am Heart J · May 2000 BACKGROUND: Although age is the most important variable associated with death among patients with persistent ST-segment elevation, its impact on outcome among patients without persistent ST-segment elevation remains unknown. Moreover, the impact of age on ... Full text Link to item Cite

The benefit of abciximab in percutaneous coronary revascularization is not device-specific.

Journal Article Am J Cardiol · May 1, 2000 Abciximab has been shown to decrease adverse outcomes after percutaneous coronary interventions, but it is unclear whether this beneficial effect is more or less pronounced with specific devices. This study sought to determine the relative magnitude of the ... Full text Link to item Cite

Patients who want their family and physician to make resuscitation decisions for them: observations from SUPPORT and HELP. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment. Hospitalized Elderly Longitudinal Project.

Journal Article J Am Geriatr Soc · May 2000 OBJECTIVE: To determine the extent to which older or seriously ill inpatients would prefer to have their family and physician make resuscitation decisions for them rather than having their own stated preferences followed if they were unable to decide thems ... Full text Link to item Cite

Recurrent ischemia during continuous 12-lead ECG-ischemia monitoring in patients with acute coronary syndromes treated with eptifibatide: relation with death and myocardial infarction. PURSUIT ECG-Ischemia Monitoring Substudy Investigators. Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy.

Journal Article J Electrocardiol · April 2000 Computer-assisted continuous monitoring of the ST-segment allows detection and quantification of recurrent ischemia in patients with acute coronary syndromes. In a substudy of the PURSUIT (Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Suppres ... Full text Link to item Cite

Chronic ischemic heart disease.

Journal Article Am Heart J · April 2000 Full text Link to item Cite

Randomized trial of candesartan cilexetil in the treatment of patients with congestive heart failure and a history of intolerance to angiotensin-converting enzyme inhibitors.

Journal Article Am Heart J · April 2000 BACKGROUND: Many patients with congestive heart failure do not receive the benefits of angiotensin-converting enzyme (ACE) inhibitors because of intolerance. We sought to determine the tolerability of an angiotensin II receptor blocker, candesartan cilexet ... Full text Link to item Cite

Platelet glycoprotein IIb/IIIa receptor blockade in coronary artery disease.

Journal Article J Am Coll Cardiol · April 2000 New strategies for profound inhibition of platelet activity at the injured coronary plaque focus on blockade of the platelet surface membrane glycoprotein IIb/IIIa receptor, which binds circulating fibrinogen or von Willebrand factor and crosslinks platele ... Full text Link to item Cite

Comparison of cardiac troponin T versus creatine kinase-MB for risk stratification in a chest pain evaluation unit.

Journal Article Am 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 ... Full text Link to item Cite

Cost effectiveness of early discharge after uncomplicated acute myocardial infarction.

Journal Article N Engl J Med · March 16, 2000 BACKGROUND: Reducing the length of hospitalizations can reduce short-term costs, but there are few data on the long-term clinical and economic consequences of early discharge. METHODS: Using data from the Global Utilization of Streptokinase and Tissue Plas ... Full text Link to item Cite

A comparison of ionic versus nonionic contrast medium during primary percutaneous transluminal coronary angioplasty for acute myocardial infarction (GUSTO IIb). Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes.

Journal Article Am J Cardiol · March 15, 2000 The clinical impact of contrast medium selection during primary percutaneous transluminal coronary angioplasty for acute myocardial infarction (AMI) has not been studied. We compared the clinical outcomes of patients who received ionic versus nonionic low ... Full text Link to item Cite

Relation of temporal creatine kinase-MB release and outcome after thrombolytic therapy for acute myocardial infarction. TAMI Study Group.

Journal Article Am 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 ... Full text Link to item Cite

Predictors of death and reinfarction at 30 days after primary angioplasty: the GUSTO IIb and RAPPORT trials.

Journal Article Am Heart J · March 2000 BACKGROUND: Thirty-day death among recipients of fibrinolytic therapy for acute myocardial infarction (MI) is tightly correlated with easily obtainable key demographic and clinical parameters such as age, blood pressure, heart rate, and infarct location. S ... Full text Link to item Cite

Geographic variability in outcomes within an international trial of glycoprotein IIb/IIIa inhibition in patients with acute coronary syndromes. Results from PURSUIT.

Journal Article Eur Heart J · March 2000 AIMS: Variations in outcome of patients from different geographic regions have been observed in many large international trials. We analysed the factors that might contribute to the geographic variations in patient outcome and treatment effect as observed ... Full text Link to item Cite

Cigarette smoking status and outcome among patients with acute coronary syndromes without persistent ST-segment elevation: effect of inhibition of platelet glycoprotein IIb/IIIa with eptifibatide. The PURSUIT trial investigators.

Journal Article Am Heart J · March 2000 BACKGROUND: Studies have shown that cigarette smokers constitute a substantial proportion of patients with acute coronary syndromes (ACS) and have platelet-rich coronary thrombi. We characterized the influence of smoking status on outcome of patients with ... Full text Link to item Cite

Evaluating the potential 'economic attractiveness' of new therapies in patients with non-ST elevation acute coronary syndrome.

Journal Article Pharmacoeconomics · March 2000 OBJECTIVE: To evaluate the relationship between how much a new cardiovascular therapy improves clinical outcomes over current therapies and how much more it can cost while still remaining 'economically attractive'. DESIGN: We developed a decision model to ... Full text Link to item Cite

Prognostic implications of TIMI flow grade in the infarct related artery compared with continuous 12-lead ST-segment resolution analysis. Reexamining the "gold standard" for myocardial reperfusion assessment.

Journal Article J Am Coll Cardiol · March 1, 2000 OBJECTIVE: To compare the prognostic significance of reperfusion assessment by Thrombolysis in Myocardial Infarction (TIMI) flow grade in the infarct related artery and ST-segment resolution analysis, by correlating with clinical outcomes in patients with ... Full text Link to item Cite

Early percutaneous coronary intervention, platelet inhibition with eptifibatide, and clinical outcomes in patients with acute coronary syndromes. PURSUIT Investigators.

Journal Article Circulation · February 22, 2000 BACKGROUND: Platelet glycoprotein (GP) IIb/IIIa antagonists prevent the composite end point of death or myocardial infarction (MI) in patients with acute coronary syndromes. There is uncertainty about whether this effect is confined to patients who have pe ... Full text Link to item Cite

Timing of and risk factors for myocardial ischemic events after percutaneous coronary intervention (IMPACT-II). Integrilin to Minimize Platelet Aggregation and Coronary Thrombosis.

Journal Article Am J Cardiol · February 15, 2000 We studied both the time course and risk factors for adverse clinical events after percutaneous coronary intervention (PCI). Such information is critical to clinical decision-making, but scant quantitative data exist to describe the time course of these ad ... Full text Link to item Cite

Combination therapy for acute myocardial infarction: fibrinolytic therapy and glycoprotein IIb/IIIa inhibition.

Journal Article Am Heart J · February 2000 Reperfusion with a regimen of fibrinolytic therapy, aspirin, and unfractionated heparin is limited by a less than desirable reperfusion rate, an excessive reocclusion rate, a dose-limiting intracranial hemorrhage rate, and a competitive posture relative to ... Full text Link to item Cite

Resource use and survival of patients hospitalized with congestive heart failure: differences in care by specialty of the attending physician. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments.

Journal Article Ann Intern Med · February 1, 2000 BACKGROUND: Previous studies suggest that specialty care is more costly but may produce improved outcomes for patients with acute cardiac illnesses. OBJECTIVE: To determine whether patients with congestive heart failure who are cared for by cardiologists e ... Full text Link to item Cite

Cost-effectiveness of platelet glycoprotein IIb/IIIa inhibition with eptifibatide in patients with non-ST-elevation acute coronary syndromes.

Journal Article Circulation · February 1, 2000 BACKGROUND: In the PURSUIT trial, eptifibatide significantly reduced the 30-day incidence of death and myocardial infarction relative to placebo in 9461 patients with an acute coronary syndrome (unstable angina or non-Q-wave myocardial infarction). METHODS ... Full text Link to item Cite

Reply.

Other J Infect Dis · February 2000 Full text Link to item Cite

Association between minor elevations of creatine kinase-MB level and mortality in patients with acute coronary syndromes without ST-segment elevation. PURSUIT Steering Committee. Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy.

Journal Article JAMA · January 19, 2000 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 ... Full text Link to item Cite

Risk factors, angiographic patterns, and outcomes in patients with ventricular septal defect complicating acute myocardial infarction. GUSTO-I (Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries) Trial Investigators.

Journal Article Circulation · January 4, 2000 BACKGROUND: Ventricular septal defect (VSD) complicating acute myocardial infarction has been studied primarily in small, prethrombolytic-era trials. Our goal was to determine clinical predictors and angiographic and clinical outcomes of this complication ... Full text Link to item Cite

Redefining medical treatment in the management of unstable angina.

Journal Article Am J Med · January 2000 In 1994, the Agency for Health Care Policy and Research sponsored the development of guidelines for diagnosing and managing patients with unstable angina. Since their publication, several important developments have occurred. The prognostic value of bioche ... Full text Link to item Cite

Inhibition of platelet aggregation with a glycoprotein IIb-IIIa antagonist does not prevent thrombin generation in patients undergoing thrombolysis for acute myocardial infarction.

Journal Article J 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 ... Full text Link to item Cite

Predictors of cardiogenic shock after thrombolytic therapy for acute myocardial infarction.

Journal Article J 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 ... Full text Link to item Cite

Rationale and design of the OPTIME CHF trial: outcomes of a prospective trial of intravenous milrinone for exacerbations of chronic heart failure.

Journal Article Am Heart J · January 2000 BACKGROUND: The optimal management of an acute exacerbation of chronic heart failure (CHF) is uncertain. There is little randomized evidence available to support the various treatment strategies for patients hospitalized with an exacerbation of CHF. Inotro ... Full text Link to item Cite

Introduction.

Journal Article Clin Infect Dis · January 2000 Full text Link to item Cite

Physician understanding of patient resuscitation preferences: Insights and clinical implications

Journal Article Journal of the American Geriatrics Society · 2000 OBJECTIVE: To describe physician understanding of patient preferences concerning cardiopulmonary resuscitation (CPR) and to assess the relationship of physician understanding of patient preferences with do not resuscitate (DNR) orders and in-hospital CPR. ... Cite

How should phase II trials in cardiovascular medicine be conducted?

Journal Article American Heart Journal · January 1, 2000 Full text Cite

Cardiac protection: evolving role of angiotensin receptor blockers.

Journal Article Am Heart J · January 2000 Congestive heart failure (HF) is a common and serious public health problem affecting approximately 5 million Americans. Recent treatment strategies have focused on attenuating the effects of angiotensin (Ang) II, which include vasoconstriction, sodium ret ... Full text Link to item Cite

Patient race and decisions to withhold or withdraw life-sustaining treatments for seriously ill hospitalized adults. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments.

Journal Article Am J Med · January 2000 PURPOSE: Patient race is associated with decreased resource use for seriously ill hospitalized adults. We studied whether this difference in resource use can be attributed to more frequent or earlier decisions to withhold or withdraw life-sustaining therap ... Full text Link to item Cite

Combination therapy for acute myocardial infarction: Fibrinolytic therapy and glycoprotein IIb/IIIa inhibition

Journal Article American Heart Journal · January 1, 2000 Reperfusion with a regimen of fibrinolytic therapy, aspirin, and unfractionated heparin is limited by a less than desirable reperfusion rate, an excessive reocclusion rate, a dose-limiting intracranial hemorrhage rate, and a competitive posture relative to ... Full text Cite

Outcomes at 1 year and economic implications of platelet glycoprotein IIb/IIIa blockade in patients undergoing coronary stenting: results from a multicentre randomised trial. EPISTENT Investigators. Evaluation of Platelet IIb/IIIa Inhibitor for Stenting.

Journal Article Lancet · December 11, 1999 BACKGROUND: We assessed in a randomised trial the long-term outcomes for potent adjunctive antiplatelet therapy given at the time of coronary stenting. METHODS: In 63 hospitals in the USA and Canada, 2399 patients were randomly assigned stenting with abcix ... Full text Link to item Cite

Risk stratification with a point-of-care cardiac troponin T test in acute myocardial infarction. GUSTOIII Investigators. Global Use of Strategies To Open Occluded Coronary Arteries.

Journal Article Am 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 ... Full text Link to item Cite

Cardiogenic shock in patients with acute ischemic syndromes with and without ST-segment elevation.

Journal Article Circulation · November 16, 1999 BACKGROUND: Cardiogenic shock is usually considered a sequela of ST-segment elevation myocardial infarction. There are limited prospective data on the incidence and significance of shock in non-ST-segment elevation patients. This study assessed the inciden ... Full text Link to item Cite

Platelet glycoprotein IIb/IIIa receptor inhibition in non-ST-elevation acute coronary syndromes: early benefit during medical treatment only, with additional protection during percutaneous coronary intervention.

Journal Article Circulation · November 16, 1999 BACKGROUND: Glycoprotein (GP) IIb/IIIa receptor blockers prevent life-threatening cardiac complications in patients with acute coronary syndromes without ST-segment elevation and protect against thrombotic complications associated with percutaneous coronar ... Full text Link to item Cite

Clinical outcomes of bivalirudin for ischemic heart disease.

Journal Article Circulation · November 16, 1999 BACKGROUND: Current treatment strategies for percutaneous coronary revascularization and acute coronary syndromes incorporate thrombin inhibition with either unfractionated or fractionated heparin. The peptide bivalirudin (Hirulog) is a direct thrombin inh ... Full text Link to item Cite

Outcome of Hispanic patients treated with thrombolytic therapy for acute myocardial infarction: results from the GUSTO-I and III trials. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries.

Journal Article J Am Coll Cardiol · November 15, 1999 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 ... Full text Link to item Cite

Adenosine as an adjunct to thrombolytic therapy for acute myocardial infarction: results of a multicenter, randomized, placebo-controlled trial: the Acute Myocardial Infarction STudy of ADenosine (AMISTAD) trial.

Journal Article J Am Coll Cardiol · November 15, 1999 OBJECTIVES: The Acute Myocardial Infarction STudy of ADenosine (AMISTAD) trial was designed to test the hypothesis that adenosine as an adjunct to thrombolysis would reduce myocardial infarct size. BACKGROUND: Reperfusion therapy for acute myocardial infar ... Full text Link to item Cite

Relationship of extent of revascularization with angina at one year in the Bypass Angioplasty Revascularization Investigation (BARI).

Journal Article J Am Coll Cardiol · November 15, 1999 OBJECTIVES: To determine the relative degree of revascularization obtained with bypass surgery versus angioplasty in a randomized trial of patients with multivessel disease requiring revascularization (Bypass Angioplasty Revascularization Investigation [BA ... Full text Link to item Cite

Effect of institutional volume and academic status on outcomes of coronary interventions: the IMPACT-II experience.

Journal Article Am Heart J · November 1999 BACKGROUND: Rates of morbidity and mortality after interventional procedures are reported to be inversely associated with institutional volume. METHODS: This study assessed both procedural volume and academic status at the 82 US centers that participated i ... Full text Link to item Cite

Effectiveness of early coronary angioplasty and abciximab for failed thrombolysis (reteplase or alteplase) during acute myocardial infarction (results from the GUSTO-III trial). Global Use of Strategies To Open occluded coronary arteries.

Journal Article Am 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 ... Full text Link to item Cite

Glycoprotein IIb/IIIa receptor antagonists in non-ST elevation acute coronary syndromes and percutaneous revascularisation: a review of trial reports.

Journal Article Drugs · October 1999 Acute coronary syndromes and percutaneous coronary interventions share a common pathophysiological mechanism of intimal disruption and platelet aggregation. Glycoprotein (GP) IIb/IIIa receptor antagonists, which interrupt the final common pathway of platel ... Full text Link to item Cite

Higher rates of coronary angiography and revascularization following myocardial infarction may be associated with greater survival in the United States than in Canada. The CARS Investigators (Coumadin/Aspirin Reinfarction Study).

Journal Article Can J Cardiol · October 1999 BACKGROUND: Significant differences are known to exist between the United States and Canada with respect to coronary catheterization and intervention. In a post hoc analysis, it was hypothesized that these differences may have the greatest impact on outcom ... Link to item Cite

Higher rates of coronary angiography and revascularization following myocardial infarction may be associated with greater survival in the United States than in Canada

Journal Article Canadian Journal of Cardiology · October 1, 1999 Background: Significant differences are known to exist between the United States and Canada with respect to coronary catheterization and intervention. In a post hoc analysis, it was hypothesized that these differences may have the greatest impact on outcom ... Cite

Neurosurgical evacuation of intracranial hemorrhage after thrombolytic therapy for acute myocardial infarction: experience from the GUSTO-I trial. Global Utilization of Streptokinase and tissue-plasminogen activator (tPA) for Occluded Coronary Arteries.

Journal Article Am Heart J · September 1999 BACKGROUND: Intracranial hemorrhage is an uncommon but very dangerous complication in patients receiving thrombolytic therapy for acute myocardial infarction. Neurosurgical evacuation is often an available treatment option. However, the association between ... Full text Link to item Cite

Single-bolus tenecteplase compared with front-loaded alteplase in acute myocardial infarction: the ASSENT-2 double-blind randomised trial.

Journal Article Lancet · August 28, 1999 BACKGROUND: Bolus fibrinolytic therapy facilitates early efficient institution of reperfusion therapy. Tenecteplase is a genetically engineered variant of alteplase with slower plasma clearance, better fibrin specificity, and high resistance to plasminogen ... Full text Link to item Cite

Contemporary management of patients with left ventricular systolic dysfunction. Results from the Study of Patients Intolerant of Converting Enzyme Inhibitors (SPICE) Registry.

Journal Article Eur Heart J · August 1999 AIMS: The reported prevalence of angiotensin-converting enzyme (ACE) inhibitor use in patients with heart failure varies considerably. Recent reports suggest that many patients who could benefit from such therapy are not receiving ACE inhibitors. The Study ... Full text Link to item Cite

Minimal myocardial damage during coronary intervention is associated with impaired outcome.

Journal Article Eur Heart J · August 1999 AIMS: Studies on the glycoprotein IIb-IIIa receptor blocker abciximab in patients undergoing percutaneous coronary intervention consistently show a reduction in procedure-related myocardial infarction. Some such infarcts are characterized by elevated creat ... Full text Link to item Cite

Complementary clinical benefits of coronary-artery stenting and blockade of platelet glycoprotein IIb/IIIa receptors. Evaluation of Platelet IIb/IIIa Inhibition in Stenting Investigators.

Journal Article N Engl J Med · July 29, 1999 BACKGROUND: Inhibition of the platelet glycoprotein IIb/IIIa receptor with the monoclonal-antibody fragment abciximab reduces the acute ischemic complications associated with percutaneous coronary revascularization, whereas coronary-stent implantation redu ... Full text Link to item Cite

Sex, clinical presentation, and outcome in patients with acute coronary syndromes. Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes IIb Investigators.

Journal Article N Engl J Med · July 22, 1999 BACKGROUND: Studies have reported that women with acute myocardial infarction have in-hospital and long-term outcomes that are worse than those of men. METHODS: To assess sex-based differences in presentation and outcome, we examined data from the Global U ... Full text Link to item Cite

Relationship between delay in performing direct coronary angioplasty and early clinical outcome in patients with acute myocardial infarction: results from the global use of strategies to open occluded arteries in Acute Coronary Syndromes (GUSTO-IIb) trial.

Journal Article Circulation · July 6, 1999 BACKGROUND: Time to treatment with thrombolytic therapy is a critical determinant of mortality in acute myocardial infarction. Little is known about the relationship between the time to treatment with direct coronary angioplasty and clinical outcome. The o ... Full text Link to item Cite

Glycoprotein IIb/IIIa blockade and thrombolytics: early lessons from the SPEED and GUSTO IV trials.

Journal Article Am Heart J · July 1999 Reperfusion with a regimen of thrombolytic therapy, aspirin, and unfractionated heparin is limited by a number of factors. Only 50% to 60% of patients achieve early thrombolysis in myocardial infarction grade-3 flow within 90 minutes with the most effectiv ... Full text Link to item Cite

A comparison of U.S. and Canadian cardiac catheterization practices in detecting severe coronary artery disease after myocardial infarction: efficiency, yield and long-term implications.

Journal Article J Am Coll Cardiol · July 1999 OBJECTIVES: We sought to compare U.S. and Canada's post-myocardial infarction (MI) cardiac catheterization practices in the detection of severe coronary artery disease (CAD). BACKGROUND: Little is known about the efficiency with which the aggressive post-M ... Full text Link to item Cite

Continuous intravenous dobutamine is associated with an increased risk of death in patients with advanced heart failure: insights from the Flolan International Randomized Survival Trial (FIRST).

Journal Article Am Heart J · July 1999 OBJECTIVE: To evaluate clinical characteristics and outcomes of patients with advanced heart failure receiving intravenous continuous dobutamine in the FIRST Trial (Flolan International Randomized Survival Trial). METHODS: Four hundred seventy-one patients ... Full text Link to item Cite

Cardiogenic shock complicating acute myocardial infarction: predictors of death. GUSTO Investigators. Global Utilization of Streptokinase and Tissue-Plasminogen Activator for Occluded Coronary Arteries.

Journal Article Am Heart J · July 1999 BACKGROUND: Current knowledge of predictors of death among patients with cardiogenic shock complicating myocardial infarction is limited. We aimed to develop a risk assessment prognostic algorithm of 30-day mortality, including clinical and hemodynamic dat ... Full text Link to item Cite

Clinical significance of thrombocytopenia during a non-ST-elevation acute coronary syndrome. The platelet glycoprotein IIb/IIIa in unstable angina: receptor suppression using integrilin therapy (PURSUIT) trial experience.

Journal Article Circulation · June 8, 1999 BACKGROUND: The significance of thrombocytopenia in patients experiencing an acute coronary syndrome (ACS) has not been examined systematically. We evaluated this condition in a large non-ST-elevation ACS clinical trial, with particular interest paid to it ... Full text Link to item Cite

Coronary interventions "to go": Is faster better?

Journal Article J Invasive Cardiol · June 1999 Link to item Cite

Stroke in patients with acute coronary syndromes: incidence and outcomes in the platelet glycoprotein IIb/IIIa in unstable angina. Receptor suppression using integrilin therapy (PURSUIT) trial. The PURSUIT Investigators.

Journal Article Circulation · May 11, 1999 BACKGROUND: The incidence of stroke in patients with acute coronary syndromes has not been clearly defined because few trials in this patient population have been large enough to provide stable estimates of stroke rates. METHODS AND RESULTS: We studied the ... Full text Link to item Cite

Prophylactic lidocaine use in acute myocardial infarction: incidence and outcomes from two international trials. The GUSTO-I and GUSTO-IIb Investigators.

Journal Article Am Heart J · May 1999 BACKGROUND: Early meta-analyses suggested that prophylactic lidocaine use reduces ventricular fibrillation but increases mortality rates after acute myocardial infarction. We determined the frequency and effect on clinical outcomes with its use in the thro ... Full text Link to item Cite

Sustained suppression of ischemic complications of coronary intervention by platelet GP IIb/IIIa blockade with abciximab: one-year outcome in the EPILOG trial. Evaluation in PTCA to Improve Long-term Outcome with abciximab GP IIb/IIIa blockade.

Journal Article Circulation · April 20, 1999 BACKGROUND: Blockade of the platelet glycoprotein IIb/IIIa receptor with the monoclonal antibody fragment abciximab was shown in a placebo-controlled randomized trial to reduce the incidence of acute ischemic complications within 30 days among a broad spec ... Full text Link to item Cite

Prior aspirin use predicts worse outcomes in patients with non-ST-elevation acute coronary syndromes. PURSUIT Investigators. Platelet IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy.

Journal Article Am J Cardiol · April 15, 1999 Aspirin is beneficial in the prevention and treatment of cardiovascular events, but patients who have events while taking aspirin may have worse outcomes than those not on aspirin. We investigated the association between prior aspirin use and clinical outc ... Full text Link to item Cite

Gender differences in survival in advanced heart failure. Insights from the FIRST study.

Journal Article Circulation · April 13, 1999 BACKGROUND: Previous natural history studies in broad populations of heart failure patients have associated female gender with improved survival, particularly in patients with a nonischemic etiology of ventricular dysfunction. This study investigates wheth ... Full text Link to item Cite

Smoking status and outcome after primary coronary angioplasty for acute myocardial infarction.

Journal Article Am Heart J · April 1999 BACKGROUND: Because of the increased propensity of intracoronary thrombi to form in cigarette smokers, percutaneous transluminal angioplasty (PTCA) for acute myocardial infarction (AMI) may be less effective in smokers. We sought to determine the impact of ... Full text Link to item Cite

The relationship between periprocedural myocardial infarction and subsequent target vessel revascularization following percutaneous coronary revascularization: insights from the EPIC trial. Evaluation of IIb/IIIa platelet receptor antagonist 7E3 in Preventing Ischemic Complications.

Journal Article J Am Coll Cardiol · March 1999 OBJECTIVES: We sought to determine whether periprocedural myocardial infarction complicating percutaneous coronary revascularization is associated with subsequent clinical restenosis, as judged by the need for target vessel revascularization. BACKGROUND: A ... Full text Link to item Cite

Beta-blocker therapy in advanced heart failure: clinical characteristics and long-term outcomes.

Journal Article Eur J Heart Fail · March 1999 AIMS: To evaluate the clinical characteristics and long-term outcomes of advanced heart failure patients (NYHA Class IIIb-IV) receiving beta-blocker therapy vs. those patients not receiving beta-blockers at randomization in the FIRST trial, a randomized, d ... Full text Link to item Cite

Prognostic value of the admission electrocardiogram in acute coronary syndromes.

Journal Article JAMA · 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 ... Full text Link to item Cite

One-year survival among patients with acute myocardial infarction complicated by cardiogenic shock, and its relation to early revascularization: results from the GUSTO-I trial.

Journal Article Circulation · February 23, 1999 BACKGROUND: Although 30-day survival is increased in patients with acute myocardial infarction complicated by cardiogenic shock who undergo coronary revascularization, the longer-term outcome in such patients and the duration of benefit from revascularizat ... Full text Link to item Cite

Support for the open-artery hypothesis in survivors of acute myocardial infarction: analysis of 11,228 patients treated with thrombolytic therapy.

Journal Article Am J Cardiol · February 15, 1999 We examined the possible benefits of achieving and maintaining infarct-related artery potency beyond the time when preservation of left ventricular function would be expected. The open-artery hypothesis suggests that a patent infarct-related artery confers ... Full text Link to item Cite

Coronary revascularization in diabetic patients: a comparison of the randomized and observational components of the Aypass Angioplasty Revascularization Investigation (BARI).

Journal Article Circulation · February 9, 1999 BACKGROUND: Patients with treated diabetes in the randomized-trial segment of the Bypass Angioplasty Revascularization Investigation (BARI) who were randomized to initial revascularization with PTCA had significantly worse 5-year survival than patients ass ... Full text Link to item Cite

Is all unstable angina the same? insights from the Coronary Angioplasty Versus Excisional Atherectomy Trial (CAVEAT-I). The CAVEAT-Investigators.

Journal Article Am Heart J · February 1999 BACKGROUND: Certain characteristics of unstable angina have been associated with worse clinical outcomes after percutaneous revascularization procedures. METHODS AND RESULTS: We compared outcomes of patients with (n = 690) and those without (n = 320) unsta ... Full text Link to item Cite

Effect of age on outcome with primary angioplasty versus thrombolysis.

Journal Article J Am Coll Cardiol · February 1999 OBJECTIVES: The purpose of this study was to determine how risks associated with increasing age differed in patients treated with percutaneous transluminal coronary angioplasty versus thrombolysis. BACKGROUND: Advancing age is a risk factor for adverse out ... Full text Link to item Cite

Clinical risk factors for ischemic complications after percutaneous coronary interventions: results from the EPIC trial. The EPIC Investigators.

Journal Article Am Heart J · February 1999 BACKGROUND: Most analyses of complications after percutaneous coronary intervention have been limited to angiographic predictors of abrupt closure. We sought to determine the relation between baseline clinical and angiographic characteristics and clinical ... Full text Link to item Cite

Effects of stroke on medical resource use and costs in acute myocardial infarction. GUSTO I Investigators. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries Study.

Journal Article Circulation · January 26, 1999 BACKGROUND: Stroke occurs concurrently with myocardial infarction (MI) in approximately 30 000 US patients each year. This number is expected to rise with the increasing use of thrombolytic therapy for MI. However, no data exist for the economic effect of ... Full text Link to item Cite

Death and nonfatal reinfarction within the first 24 hours after presentation with an acute coronary syndrome: experience from GUSTO-IIb. Global Utilization of Strategies for Total Occlusion.

Journal Article Am Heart J · January 1999 BACKGROUND: A large proportion of deaths among patients with myocardial infarction occurs within the first 24 hours after presentation. It is not clear whether this phenomenon is also true of patients without ST-segment elevation who may or may not have in ... Full text Link to item Cite

Frequency and clinical outcome of cardiogenic shock during acute myocardial infarction among patients receiving reteplase or alteplase. Results from GUSTO-III. Global Use of Strategies to Open Occluded Coronary Arteries.

Journal Article Eur 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 ... Full text Link to item Cite

Clinical outcomes after detection of elevated cardiac enzymes in patients undergoing percutaneous intervention. IMPACT-II Investigators. Integrilin (eptifibatide) to Minimize Platelet Aggregation and Coronary Thrombosis-II.

Journal Article J 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 ... Full text Link to item Cite

Quality-of-life outcomes for patients with severe CHF

Journal Article Cardiology Review · January 1, 1999 We studied health status perceptions, functional status, quality of life, resource use, and survival times for 1,390 adult patients hospitalized for an acute exacerbation of severe congestive heart failure. Although survival rates were only 73% at 6 months ... Cite

Dealing with success at the American Heart Journal

Journal Article American Heart Journal · January 1, 1999 Full text Cite

When I have acute coronary syndrome, treat me gingerly

Journal Article European Heart Journal Supplement · January 1, 1999 Acute coronary syndromes (ACS) map be defined as clinical symptoms or signs of prolonged or accelerating myocardial ischaemia. These conditions are caused by disruption of the atherosclerotic plaque followed by thrombus formation, and are increasingly trea ... Cite

Integrated plan of care

Journal Article Cardiology Review · January 1, 1999 Cite

The gusto trials

Journal Article Journal of Interventional Cardiology · January 1, 1999 Full text Cite

Clinical outcomes of therapeutic agents that block the platelet glycoprotein IIb/IIIa integrin in ischemic heart disease.

Journal Article Circulation · December 22, 1998 BACKGROUND: Several platelet glycoprotein (GP) IIb/IIIa receptor antagonists have been evaluated in clinical trials. We conducted a systematic overview (meta-analysis) to assess the effect of these compounds on death, myocardial infarction (MI), and revasc ... Full text Link to item Cite

Ten years of benefit from a one-hour intervention.

Journal Article Circulation · December 15, 1998 Full text Link to item Cite

Sustained ventricular arrhythmias in patients receiving thrombolytic therapy: incidence and outcomes. The GUSTO Investigators.

Journal Article Circulation · December 8, 1998 BACKGROUND: Sustained ventricular tachycardia (VT) and fibrillation (VF) occur in up to 20% of patients with acute myocardial infarction (MI) and have been associated with a poor prognosis. The relationships among the type of arrhythmia (VT versus VF or bo ... Full text Link to item Cite

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

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

Combining thrombolysis with the platelet glycoprotein IIb/IIIa inhibitor lamifiban: results of the Platelet Aggregation Receptor Antagonist Dose Investigation and Reperfusion Gain in Myocardial Infarction (PARADIGM) trial.

Journal Article J Am Coll Cardiol · December 1998 OBJECTIVES: The trial was designed to assess the safety, pharmacodynamics and effects on reperfusion of the platelet glycoprotein (GP) IIb/IIIa inhibitor lamifiban when given with thrombolysis to patients with ST segment elevation acute myocardial infarcti ... Full text Link to item Cite

Reduction in complications of angioplasty with abciximab occurs largely independently of baseline lesion morphology. EPIC and EPILOG Investigators. Evaluation of 7E3 for the Prevention of Ischemic Complications. Evaluation of PTCA To Improve Long-term Outcome with abciximab GPIIb/IIIa Receptor Blockade.

Journal Article J Am Coll Cardiol · November 15, 1998 OBJECTIVES: We investigated the hypothesis that abciximab might lead to a differential effect among patients with different lesion morphologies; hence, its cost/benefit ratio would be optimized if it were used selectively on the basis of baseline angiograp ... Full text Link to item Cite

Value of serial troponin T measures for early and late risk stratification in patients with acute coronary syndromes. The GUSTO-IIa Investigators.

Journal Article Circulation · November 3, 1998 BACKGROUND: The baseline cardiac troponin T (cTnT) level strongly predicts short-term mortality in acute coronary syndromes, but the added value of later measures to predict short- and long-term outcome and in the context of baseline clinical characteristi ... Full text Link to item Cite

Acute coronary syndromes in the GUSTO-IIb trial: prognostic insights and impact of recurrent ischemia. The GUSTO-IIb Investigators.

Journal Article Circulation · November 3, 1998 BACKGROUND: Recurrent ischemia after an acute coronary syndrome portends an unfavorable outcome and has major resource-use implications. This issue has not been studied systematically among the spectrum of patients with acute coronary presentations, encomp ... Full text Link to item Cite

Use of bedside activated partial thromboplastin time monitor to adjust heparin dosing after thrombolysis for acute myocardial infarction: results of GUSTO-I. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries.

Journal Article Am Heart J · November 1998 BACKGROUND: The safety and efficacy of bedside monitors of activated partial thromboplastin time (aPTT) have not been examined in a large population receiving intravenous heparin after thrombolytic treatment for acute myocardial infarction. We compared out ... Full text Link to item Cite

Reduction in the need for unplanned stenting with the use of platelet glycoprotein IIb/IIIa blockade in percutaneous coronary intervention.

Journal Article Am J Cardiol · November 1, 1998 Data from the 5 large randomized, double-blind, placebo-controlled trials that used glycoprotein IIb/IIIa inhibitors during percutaneous transluminal coronary angioplasty were pooled for a total of 10,691 patients. We found that the use of glycoprotein IIb ... Full text Link to item Cite

A perspective on the regulation of the evaluation of new antithrombotic drugs.

Journal Article Am J Cardiol · October 22, 1998 We have entered a period of great possibility for improving clinical outcomes for patients with arterial thrombotic disorders using new antithrombotic agents. A variety of new therapies are now in clinical trials, while several others have just received re ... Full text Link to item Cite

Prediction of 30-day mortality among patients with thrombolysis-related intracranial hemorrhage.

Journal Article Circulation · October 6, 1998 BACKGROUND: Limited information exists on risk factors for mortality after thrombolysis-related intracranial hemorrhage. We wished to determine the characteristics associated with 30-day mortality after thrombolysis-related intracranial hemorrhage. METHODS ... Full text Link to item Cite

Prognostic value of congestive heart failure history in patients undergoing percutaneous coronary interventions.

Journal Article J Am Coll Cardiol · October 1998 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 ... Full text Link to item Cite

Low-molecular-weight heparins in non-ST-segment elevation ischemia: the ESSENCE trial. Efficacy and Safety of Subcutaneous Enoxaparin versus intravenous unfractionated heparin, in non-Q-wave Coronary Events.

Journal Article Am J Cardiol · September 10, 1998 Combination antithrombotic therapy with heparin plus aspirin decreases the risk of recurrent ischemic events in patients with acute coronary syndromes without persistent ST-segment elevation. Compared with standard unfractionated heparin, low-molecular-wei ... Full text Link to item Cite

Clinical predictors of early infarct-related artery patency following thrombolytic therapy: importance of body weight, smoking history, infarct-related artery and choice of thrombolytic regimen: the GUSTO-I experience. Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries.

Journal Article J Am Coll Cardiol · September 1998 OBJECTIVES: The purpose of this study was to determine patient characteristics that are a priori predictors of early infarct related artery patency following thrombolytic therapy, and to provide a paradigm which may identify patients who would be most like ... Full text Link to item Cite

Atenolol use and clinical outcomes after thrombolysis for acute myocardial infarction: the GUSTO-I experience. Global Utilization of Streptokinase and TPA (alteplase) for Occluded Coronary Arteries.

Journal Article J Am Coll Cardiol · September 1998 OBJECTIVES: We assessed the use and effects of acute intravenous and later oral atenolol treatment in a prospectively planned post hoc analysis of the GUSTO-I dataset. BACKGROUND: Early intravenous beta blockade is generally recommended after myocardial in ... Full text Link to item Cite

Resuscitation preferences among patients with severe congestive heart failure: results from the SUPPORT project. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments.

Journal Article Circulation · August 18, 1998 BACKGROUND: We sought to describe the resuscitation preferences of patients hospitalized with an exacerbation of severe congestive heart failure, perceptions of those preferences by their physicians, and the stability of the preferences. METHODS AND RESULT ... Full text Link to item Cite

Post-procedure heparin: boon or burden?

Journal Article Am Heart J · August 1998 Full text Link to item Cite

Occurrence and clinical significance of thrombocytopenia in a population undergoing high-risk percutaneous coronary revascularization. Evaluation of c7E3 for the Prevention of Ischemic Complications (EPIC) Study Group.

Journal Article J Am Coll Cardiol · August 1998 OBJECTIVES: This study sought to determine the frequency of thrombocytopenia and its relation with clinical outcomes in high risk patients undergoing percutaneous coronary revascularization who received either the platelet glycoprotein (GP) IIb/IIIa recept ... Full text Link to item Cite

Effects of four thrombolytic regimens in elderly patients

Journal Article Cardiology Review · July 13, 1998 The relationship between outcome and age for patients with acute myocardial infarction who are given thrombolytic therapy was analyzed in a population of 41,021 infarction patients randomly assigned to one of four thrombolytic treatment regimens. Increasin ... Cite

Platelet glycoprotein IIb/IIIa receptor blockade with abciximab reduces ischemic complications in patients undergoing directional coronary atherectomy. EPILOG Investigators. Evaluation of PTCA to Improve Long-term Outcome by c7E3 GP IIb/IIIa Receptor Blockade.

Journal Article Am J Cardiol · July 1, 1998 We determined the efficacy of abciximab, a platelet glycoprotein IIb/IIIa receptor antagonist, combined with low-dose weight-adjusted heparin in reducing ischemic complications in patients undergoing directional coronary atherectomy (DCA). The Evaluation o ... Full text Link to item Cite

Randomized comparison of direct thrombin inhibition versus heparin in conjunction with fibrinolytic therapy for acute myocardial infarction: results from the GUSTO-IIb Trial. Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes (GUSTO-IIb) Investigators.

Journal Article J Am Coll Cardiol · June 1998 OBJECTIVES: We sought to show that hirudin might interact differently with streptokinase (SK) and tissue-type plasminogen activator (t-PA), which could reduce the incidence of death or reinfarction at 30 days. BACKGROUND: In a large-scale trial of patients ... Full text Link to item Cite

Modifiable risk factors for vascular access site complications in the IMPACT II Trial of angioplasty with versus without eptifibatide. Integrilin to Minimize Platelet Aggregation and Coronary Thrombosis.

Journal Article J Am Coll Cardiol · June 1998 OBJECTIVES: This study was designed to identify potential predictors of vascular access site (VAS) complications in the large-scale Integrilin to Minimize Platelet Aggregation and Coronary Thrombosis (IMPACT) II trial, which studied angioplasty with versus ... Full text Link to item Cite

Outcomes of acute exacerbation of severe congestive heart failure: quality of life, resource use, and survival. SUPPORT Investigators. The Study to Understand Prognosis and Preferences for Outcomes and Risks of Treatments.

Journal Article Arch Intern Med · May 25, 1998 BACKGROUND: Congestive heart failure (CHF) is a common disease with high health care costs and high mortality rates. Knowledge of the health-related quality of life outcomes of CHF may guide decision making and be useful in assessing new therapies for this ... Full text Link to item Cite

Diabetes mellitus, glycoprotein IIb/IIIa blockade, and heparin: evidence for a complex interaction in a multicenter trial. EPILOG Investigators.

Journal Article Circulation · May 19, 1998 BACKGROUND: After angioplasty, major complications and ischemic events occur more frequently in diabetic than nondiabetic patients. To determine whether treatment with abciximab is effective in reducing these events in diabetics, we analyzed characteristic ... Full text Link to item Cite

Economic assessment of low-molecular-weight heparin (enoxaparin) versus unfractionated heparin in acute coronary syndrome patients: results from the ESSENCE randomized trial. Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q wave Coronary Events [unstable angina or non-Q-wave myocardial infarction].

Journal Article Circulation · May 5, 1998 BACKGROUND: In the ESSENCE trial, subcutaneous low-molecular-weight heparin (enoxaparin) reduced the 30-day incidence of death, myocardial infarction, and recurrent angina relative to intravenous unfractionated heparin in 3171 patients with acute coronary ... Full text Link to item Cite

Higher T-wave amplitude associated with better prognosis in patients receiving thrombolytic therapy for acute myocardial infarction (a GUSTO-I substudy). Global Utilization of Streptokinase and Tissue plasminogen Activator for Occluded Coronary Arteries.

Journal Article Am J Cardiol · May 1, 1998 Increased T-wave amplitude is one of the earliest electrocardiographic (ECG) changes following coronary artery occlusion. Therefore, higher T waves in the presenting electrocardiogram should represent earlier time to treatment and thus be associated with l ... Full text Link to item Cite

Extended mortality benefit of early postinfarction reperfusion. GUSTO-I Angiographic Investigators. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries Trial.

Journal Article Circulation · April 28, 1998 BACKGROUND: Reperfusion therapy for myocardial infarction, understood to reduce mortality by preserving left ventricular function, was initially expected to provide increasing benefits over time. Surprisingly, large controlled thrombolysis trials demonstra ... Full text Link to item Cite

Rationale and clinical evidence for the use of GP IIb/IIIa inhibitors in acute coronary syndromes.

Journal Article Eur Heart J · April 1998 Platelet glycoprotein (GP) IIb/IIIa blockade has the potential to advance treatment of acute coronary syndromes, both as a primary pharmacologic approach and an adjunct to interventional treatment strategies. The benefits of GP IIb/IIIa inhibition with the ... Link to item Cite

Prognostic significance of ST segment shift early after resolution of ST elevation in patients with myocardial infarction treated with thrombolytic therapy: the GUSTO-I ST Segment Monitoring Substudy.

Journal Article J Am Coll Cardiol · March 15, 1998 OBJECTIVES: We sought to study the relation between recurrent ST segment shift within 6 to 24 h of initial resolution of ST elevation after thrombolytic therapy and 30-day and 1-year mortality. BACKGROUND: Rapid and stable resolution of ST segment elevatio ... Full text Link to item Cite

Abciximab therapy and unplanned coronary stent deployment: favorable effects on stent use, clinical outcomes, and bleeding complications. EPILOG Trial Investigators.

Journal Article Circulation · March 10, 1998 BACKGROUND: The clinical and angiographic demographics of patients requiring unplanned coronary stent deployment and the optimal adjunct pharmacotherapy in this population are not well described. This report details the EPILOG trial experience with unplann ... Full text Link to item Cite

Risk factors for in-hospital nonhemorrhagic stroke in patients with acute myocardial infarction treated with thrombolysis: results from GUSTO-I.

Journal Article Circulation · March 3, 1998 BACKGROUND: Nonhemorrhagic stroke occurs in 0.1% to 1.3% of patients with acute myocardial infarction who are treated with thrombolysis, with substantial associated mortality and morbidity. Little is known about the risk factors for its occurrence. METHODS ... Full text Link to item Cite

Thrombin generation, inhibition and clinical outcomes in patients with acute myocardial infarction treated with thrombolytic therapy and heparin: results from the GUSTO-I Trial. GUSTO-I Hemostasis Substudy Group. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries.

Journal Article J Am Coll Cardiol · March 1, 1998 OBJECTIVES: We sought to assess the effects of antithrombotic therapy after thrombolysis for acute myocardial infarction on markers of thrombin generation and activity and to determine the relation of these markers with clinical outcomes. BACKGROUND: Throm ... Full text Link to item Cite

Cardiac troponin T and cardiac troponin I: relative values in short-term risk stratification of patients with acute coronary syndromes. GUSTO-IIa Investigators.

Journal Article Clin 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 ... Link to item Cite

Thrombolysis-related intracranial hemorrhage: a radiographic analysis of 244 cases from the GUSTO-1 trial with clinical correlation. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries.

Journal Article Stroke · March 1998 BACKGROUND AND PURPOSE: Intracranial hemorrhage (ICH) is a serious complication of thrombolytic therapy. We systematically reviewed the radiographic features of 244 cases of symptomatic ICH complicating thrombolysis for acute myocardial infarction in the G ... Full text Link to item Cite

Thrombolytic therapy for myocardial infarction.

Journal Article N Engl J Med · February 19, 1998 Link to item Cite

Non-Q-wave versus Q-wave myocardial infarction after thrombolytic therapy: angiographic and prognostic insights from the global utilization of streptokinase and tissue plasminogen activator for occluded coronary arteries-I angiographic substudy. GUSTO-I Angiographic Investigators.

Journal Article Circulation · February 10, 1998 BACKGROUND: Although the stratification of patients with myocardial infarction into ECG subsets based on the presence or absence of new Q waves has important clinical and prognostic utility, systematic evaluation of the impact of thrombolytic therapy on th ... Full text Link to item Cite

Magnesium in in-hospital cardiac arrest.

Journal Article Lancet · February 7, 1998 Full text Link to item Cite

Prognostic significance of the initial electrocardiogram in patients with acute myocardial infarction. GUSTO-I Investigators. Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries.

Journal Article JAMA · February 4, 1998 CONTEXT: Early risk stratification of patients with myocardial infarction is critical to determine optimum treatment strategies and enhance outcomes, but knowledge of the prognostic importance of the initial electrocardiogram (ECG) is limited. OBJECTIVE: T ... Full text Link to item Cite

Influence of a randomized clinical trial on practice by participating investigators: lessons from the Coronary Angioplasty Versus Excisional Atherectomy Trial (CAVEAT). CAVEAT I and II Investigators.

Journal Article J Am Coll Cardiol · February 1998 OBJECTIVES: We sought to determine whether the results of the first Coronary Angioplasty Versus Excisional Atherectomy Trial (CAVEAT-I) influenced subsequent practice patterns among the investigators. BACKGROUND: CAVEAT-I demonstrated that directional coro ... Full text Link to item Cite

Myonecrosis after revascularization procedures.

Journal Article J 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 ... Full text Link to item Cite

Benefit of early sustained reperfusion in patients with prior myocardial infarction (the GUSTO-I trial). Global Utilization of Streptokinase and TPA for occluded arteries.

Journal Article Am J Cardiol · February 1, 1998 The primary objective of this study was to characterize a large cohort of patients receiving thrombolytic therapy for acute myocardial infarction with respect to the group with a prior event. Patients were randomly assigned to 1 of 4 thrombolytic strategie ... Full text Link to item Cite

Does intracoronary thrombus influence the outcome of high risk percutaneous transluminal coronary angioplasty? Clinical and angiographic outcomes in a large multicenter trial. EPIC Investigators. Evaluation of IIb/IIIa Platelet Receptor Antagonist 7E3 in Preventing Ischemic Complications.

Journal Article J Am Coll Cardiol · January 1998 OBJECTIVES: We sought to evaluate the impact of angiographically visible thrombus on short- and long-term clinical outcomes after percutaneous transluminal coronary angioplasty (PTCA). BACKGROUND: Intracoronary thrombus is frequently seen on angiography in ... Full text Link to item Cite

Vascular access site complications after percutaneous coronary intervention with abciximab in the Evaluation of c7E3 for the Prevention of Ischemic Complications (EPIC) trial.

Journal Article Am J Cardiol · January 1, 1998 Thrombolytic therapy or intense anticoagulation during percutaneous transluminal coronary revascularization (PTCR) increases the risk of vascular access site complications. This study evaluated the association of abciximab, a glycoprotein IIb/IIIa receptor ... Full text Link to item Cite

Recurrent ischemia after thrombolysis: importance of associated clinical findings. GUSTO-I Investigators. Global Utilization of Streptokinase and t-PA [tissue-plasminogen activator] for Occluded Coronary Arteries.

Journal Article J Am Coll Cardiol · January 1998 OBJECTIVES: We sought to assess the incidence and clinical relevance of examination data to recurrent ischemia within an international randomized trial. BACKGROUND: Ischemic symptoms commonly recur after thrombolysis for acute myocardial infarction. METHOD ... Full text Link to item Cite

Fibrinolysis for Acute Myocardial Infarction in the Elderly Patient: Is it Effective or Too Dangerous?

Journal Article Am J Geriatr Cardiol · January 1998 The incidence of myocardial infarction, and the subsequent mortality and morbidity increases markedly with age. Randomized placebo-contolled trials of fibrinolytic therapy have lacked adequate statistical power due to the relatively small numbers of older ... Link to item Cite

Introduction: Use of GP IIb/IIIa inhibitors in coronary syndromes: State of the art

Journal Article American Heart Journal · January 1, 1998 Cite

New agents, new trials, new solutions

Journal Article Journal of Thrombosis and Thrombolysis · January 1, 1998 Dramatic advances in biological understanding, coupled with improved knowledge about appropriate clinical trial design and transformation of the healthcare system into a business paradigm, have created a dynamic situation for evaluating new therapies for p ... Full text Cite

Acute myocardial infarction and complete bundle branch block at hospital admission: clinical characteristics and outcome in the thrombolytic era. GUSTO-I Investigators. Global Utilization of Streptokinase and t-PA [tissue-type plasminogen activator] for Occluded Coronary Arteries.

Journal Article J Am Coll Cardiol · January 1998 OBJECTIVES: We sought to assess the outcome of patients with acute myocardial infarction (MI) and bundle branch block in the thrombolytic era. BACKGROUND: Studies of patients with acute MI and bundle branch block have reported high mortality rates and poor ... Full text Link to item Cite

Introduction: Managing the patient with advanced heart failure

Journal Article American Heart Journal · January 1, 1998 Full text Cite

Trials in myocardial infarction [32] (multiple letters)

Journal Article Circulation · December 12, 1997 Cite

Developing systems for cost-effective auditing of clinical trials.

Journal Article Control Clin Trials · December 1997 Auditing a clinical trial is a complex process designed to ensure that the trial will provide a reliable answer to the question being posed. Traditional auditing methods are expensive, and escalate the cost of clinical trials. This paper describes approach ... Full text Link to item Cite

The GUSTO trial and the open artery theory.

Journal Article Eur Heart J · December 1997 The GUSTO trials have provided continuing insight into the complexities of a simple fundamental relationship: early and sustained coronary perfusion in patients with acute myocardial infarction leads to lower mortality and morbidity. To a large extent, the ... Full text Link to item Cite

Diabetic retinopathy should not be a contraindication to thrombolytic therapy for acute myocardial infarction: review of ocular hemorrhage incidence and location in the GUSTO-I trial. Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries.

Journal Article J Am Coll Cardiol · December 1997 OBJECTIVES: This study sought to evaluate the incidence of ocular hemorrhage in patients with and without diabetes after thrombolytic therapy for acute myocardial infarction. BACKGROUND: Ocular hemorrhage after thrombolysis has been reported rarely. Howeve ... Full text Link to item Cite

Tissue-type plasminogen activator's 10% one-year edge

Journal Article Cardiology Review · December 1, 1997 In this trial, 41,021 acute myocardial infarction patients were randomized to one of four thrombolytic regimens. Patients who received accelerated tissue-type plasminogen activator had a significantly lower one- year mortality rate (9.1%) than those who re ... Cite

Risk stratification after myocardial infarction.

Journal Article Ann Intern Med · December 1, 1997 Full text Link to item Cite

Trials in myocardial infarction.

Journal Article Circulation · November 18, 1997 Link to item Cite

Comparative prognostic significance of simultaneous versus independent resolution of ST segment depression relative to ST segment elevation during acute myocardial infarction.

Journal Article J Am Coll Cardiol · November 15, 1997 OBJECTIVES: We sought to determine the prognostic significance of simultaneous versus independent resolution of ST segment depression that occurs concomitant with ST segment elevation during acute myocardial infarction (AMI). BACKGROUND: ST segment depress ... Full text Link to item Cite

Randomised trial of magnesium in in-hospital cardiac arrest. Duke Internal Medicine Housestaff.

Journal Article Lancet · November 1, 1997 BACKGROUND: The apparent benefit of magnesium in acute myocardial infarction, and the persistently poor outcome after cardiac arrest, have led to use of magnesium in cardiopulmonary resuscitation. Because few data on its use in cardiac arrest were availabl ... Full text Link to item Cite

Relationship between diabetes mellitus and long-term survival after coronary bypass and angioplasty.

Journal Article Circulation · October 21, 1997 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 ... Full text Link to item Cite

Effect of platelet glycoprotein IIb/IIIa receptor inhibition on distal embolization during percutaneous revascularization of aortocoronary saphenous vein grafts. EPIC Investigators. Evaluation of IIb/IIIa platelet receptor antagonist 7E3 in Preventing Ischemic Complications.

Journal Article Am J Cardiol · October 15, 1997 Percutaneous treatment of narrowed aortocoronary saphenous vein graft disease represents a viable option for patients with recurrent angina following coronary artery bypass grafting. Present strategies are limited by high rates of distal embolization, non- ... Full text Link to item Cite

Patient-specific predictions of outcomes in myocardial infarction for real-time emergency use: a thrombolytic predictive instrument.

Journal Article Ann Intern Med · October 1, 1997 BACKGROUND: Thrombolytic therapy can be life-saving in patients with acute myocardial infarction. However, if given too late or insufficiently selectively, it may provide little benefit but still cause serious complications and incur substantial costs. OBJ ... Full text Link to item Cite

Clinical determinants of mortality in patients with angiographically diagnosed ischemic or nonischemic cardiomyopathy.

Journal Article J Am Coll Cardiol · October 1997 OBJECTIVES: We sought to characterize the clinical determinants of mortality in patients with angiographically diagnosed ischemic or nonischemic cardiomyopathy. BACKGROUND: Patients with ischemic cardiomyopathy may have a worse prognosis than patients with ... Full text Link to item Cite

Assessment of coronary reperfusion after thrombolysis with a model combining myoglobin, creatine kinase-MB, and clinical variables. TAMI-7 Study Group. Thrombolysis and Angioplasty in Myocardial Infarction-7.

Journal Article Circulation · September 16, 1997 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 ... Full text Link to item Cite

Use of intraaortic balloon counterpulsation in patients presenting with cardiogenic shock: observations from the GUSTO-I Study. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries.

Journal Article J 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 ... Full text Link to item Cite

A comparison of low-molecular-weight heparin with unfractionated heparin for unstable coronary artery disease. Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q-Wave Coronary Events Study Group.

Journal Article N Engl J Med · August 14, 1997 BACKGROUND: Antithrombotic therapy with heparin plus aspirin reduces the rate of ischemic events in patients with unstable coronary artery disease. Low-molecular-weight heparin has a more predictable anticoagulant effect than standard unfractionated hepari ... Full text Link to item Cite

Long-term protection from myocardial ischemic events in a randomized trial of brief integrin beta3 blockade with percutaneous coronary intervention. EPIC Investigator Group. Evaluation of Platelet IIb/IIIa Inhibition for Prevention of Ischemic Complication.

Journal Article JAMA · August 13, 1997 CONTEXT: Abciximab, a monoclonal antibody fragment against the platelet receptor alphaIIb beta3 integrin, prevents platelet aggregation. A randomized, placebo-controlled study showed that abciximab improves outcomes for patients undergoing percutaneous cor ... Full text Link to item Cite

Atrial fibrillation in the setting of acute myocardial infarction: the GUSTO-I experience. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries.

Journal Article J Am Coll Cardiol · August 1997 OBJECTIVES: We examined the clinical predictors and angiographic and clinical outcomes associated with atrial fibrillation in the setting of acute myocardial infarction (MI). BACKGROUND: This condition has been studied primarily in prethrombolytic era smal ... Full text Link to item Cite

Evidence for prevention of death and myocardial infarction with platelet membrane glycoprotein IIb/IIIa receptor blockade by abciximab (c7E3 Fab) among patients with unstable angina undergoing percutaneous coronary revascularization. EPIC Investigators. Evaluation of 7E3 in Preventing Ischemic Complications.

Journal Article J Am Coll Cardiol · July 1997 OBJECTIVES: We sought to evaluate whether patients with unstable angina undergoing coronary intervention derive particular clinical benefit from potent platelet inhibition. BACKGROUND: Plaque rupture and platelet aggregation are pathogenetic processes comm ... Full text Link to item Cite

Influence of diabetes mellitus on clinical outcome in the thrombolytic era of acute myocardial infarction. GUSTO-I Investigators. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries.

Journal Article J Am Coll Cardiol · July 1997 OBJECTIVES: This study was undertaken to define and better understand the characteristics and outcomes of patients with diabetes treated for acute myocardial infarction with contemporary thrombolysis. BACKGROUND: Although thrombolysis has substantially imp ... Full text Link to item Cite

Impact of an aggressive invasive catheterization and revascularization strategy on mortality in patients with cardiogenic shock in the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO-I) trial. An observational study.

Journal Article Circulation · July 1, 1997 BACKGROUND: Although retrospective analyses have revealed an association between survival and coronary angiography and angioplasty in patients with acute myocardial infarction complicated by cardiogenic shock, the degree to which bias in the selection of p ... Full text Link to item Cite

End-systolic volume index at 90 to 180 minutes into reperfusion therapy for acute myocardial infarction is a strong predictor of early and late mortality. The Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO)-I Angiographic Investigators.

Journal Article Circulation · July 1, 1997 BACKGROUND: Left ventricular remodeling is an important sequela of myocardial infarction (MI). Although remodeling occurs soon after MI, the effect of early left ventricular dilatation on outcome is not established and may be useful for early risk stratifi ... Full text Link to item Cite

A randomized controlled trial of epoprostenol therapy for severe congestive heart failure: The Flolan International Randomized Survival Trial (FIRST).

Journal Article Am Heart J · July 1997 This trial evaluated the effects of epoprostenol on patients with severe left ventricular failure. Patients with class IIIB/IV congestive heart failure and decreased left ventricular ejection fraction were eligible for enrollment if angiography documented ... Full text Link to item Cite

Surrogate and physician understanding of patients' preferences for living permanently in a nursing home.

Journal Article J Am Geriatr Soc · July 1997 OBJECTIVE: To evaluate patients' willingness to live permanently in a nursing home and surrogate and physician understanding of that preference. DESIGN: Evaluation of cross-sectional interview data from a cohort study. SETTING: Five academic medical center ... Full text Link to item Cite

Incidence and predictors of bleeding after contemporary thrombolytic therapy for myocardial infarction. The Global Utilization of Streptokinase and Tissue Plasminogen activator for Occluded coronary arteries (GUSTO) I Investigators.

Journal Article Circulation · June 3, 1997 BACKGROUND: Although the benefit of thrombolytic therapy in reducing mortality in acute myocardial infarction is well established, the types of bleeding and risk factors for bleeding are less well described in large trials. METHODS AND RESULTS: We analyzed ... Full text Link to item Cite

Long-term follow-up of gender-specific outcomes after thrombolytic therapy for acute myocardial infarction from the GUSTO-I trial. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries.

Journal Article J Womens Health · June 1997 Our objective was to assess gender differences in mortality 1 year after acute myocardial infarction (MI). The Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO-I) trial database of 41,021 patients w ... Full text Link to item Cite

Clinical characteristics and long-term outcome of patients in whom congestive heart failure develops after thrombolytic therapy for acute myocardial infarction: development of a predictive model.

Journal Article Am Heart J · June 1997 Ischemic heart disease is the most common cause of congestive heart failure, which often begins after acute myocardial infarction. To better delineate the clinical characteristics and outcomes of patients in whom congestive heart failure develops after acu ... Full text Link to item Cite

Selection of thrombolytic therapy for individual patients: development of a clinical model. GUSTO-I Investigators.

Journal Article Am Heart J · June 1997 We developed a logistic regression model with data from the GUSTO-I trial to predict mortality rate differences in individual patients who received accelerated tissue plasminogen activator (TPA) versus streptokinase treatment for acute myocardial infarctio ... Full text Link to item Cite

Incidence and impact on outcome of streptokinase allergy in the GUSTO-I trial. Global Utilization of Streptokinase and t-PA in Occluded Coronary Arteries.

Journal Article Am J Cardiol · May 1, 1997 We evaluated allergic reactions in 20,201 patients randomized to the streptokinase arms of The Global Utilization of Streptokinase and t-PA (Tissue Plasminogen Activator) in Occluded Coronary Arteries (GUSTO-I) trial, and tested the hypothesis that patient ... Full text Link to item Cite

Predictors of outcome of reperfusion therapy.

Journal Article Eur 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 ... Full text Link to item Cite

A double blind comparison of enoxaparin (a low molecular weight heparin) with standard heparin in the treatment of unstable coronary artery disease "The essence trial"

Journal Article Heart · May 1, 1997 Background: Combination therapy with aspirin plus heparin reduces the risk of recurrent ischaemic events in patients with unstable angina (UA) and non-Q MI. Low molecular weight heparins (LMWH), with high and Xa activity, have advantages over unfractionate ... Cite

Cardiac troponins in acute coronary syndromes.

Journal Article N Engl J Med · April 24, 1997 Full text Link to item Cite

Risk stratification after myocardial infarction.

Journal Article Ann Intern Med · April 1, 1997 PURPOSE: To review the literature on risk stratification after acute myocardial infarction in the reperfusion era and to propose an algorithm for early and continual risk assessment. DATA SOURCES: A MEDLINE search of the English-language literature on huma ... Full text Link to item Cite

The natural history of single-vessel chronic coronary occlusion: a 25-year experience.

Journal Article Am Heart J · April 1997 To determine the natural history of patients with a total occlusion of a single coronary artery, we searched the Duke Databank for Cardiovascular Disease to find all patients who underwent a first coronary angiogram >2 days after a symptomatic myocardial i ... Full text Link to item Cite

Use of evidence-based medical therapy in patients undergoing percutaneous coronary revascularization in the United States, Europe, and Canada. Coronary Angioplasty Versus Excisional Atherectomy Trial (CAVEAT-I) and Canadian Coronary Atherectomy Trial (CCAT) investigators.

Journal Article Am J Cardiol · April 1, 1997 The objective of this study was to examine whether there are international variations in the use of evidence-based medical therapy in patients undergoing percutaneous coronary revascularization. We analyzed the medical therapy of patients in the United Sta ... Full text Link to item Cite

Thrombolysis and Q wave versus non-Q wave first acute myocardial infarction: a GUSTO-I substudy. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Arteries Investigators.

Journal Article J Am Coll Cardiol · March 15, 1997 OBJECTIVES: We assessed the outcomes of patients with a first myocardial infarction with ST segment elevation, with and without the development of abnormal Q waves after thrombolysis. BACKGROUND: Prethrombolytic era studies report conflicting short-versus ... Full text Link to item Cite

Impact of diabetes mellitus on percutaneous revascularization (CAVEAT-I). CAVEAT-I Investigators. Coronary Angioplasty Versus Excisional Atherectomy Trial.

Journal Article Am J Cardiol · March 15, 1997 We examined the relation between diabetes mellitus and outcomes in patients undergoing percutaneous coronary revascularization in the Coronary Angioplasty Versus Excisional Atherectomy Trial (CAVEAT-I), a randomized trial comparing treatment with either pe ... Full text Link to item Cite

Pragmatic and mechanistic trials.

Journal Article Eur Heart J · March 1997 Full text Link to item Cite

TIMI grade 3 flow and reocclusion after intravenous thrombolytic therapy: a pooled analysis.

Journal Article Am Heart J · March 1997 Early and sustained flow of grade 3 according to Thrombolysis in Myocardial infarction (TIMI) criteria and reocclusion rates are the key measures that define the physiologic efficacy of thrombolytic agents in the treatment of acute myocardial infarction. W ... Full text Link to item Cite

Economic implications of the prophylactic use of intraaortic balloon counterpulsation in the setting of acute myocardial infarction. The Randomized IABP Study Group. Intraaortic Balloon Pump.

Journal Article Am 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 ... Full text Link to item Cite

Effects of thrombolytic regimen, early catheterization, and predischarge angiographic variables on six-week left ventricular function. The TAMI Investigators. Thrombolysis and Angioplasty in Acute Myocardial Infarction.

Journal Article Am J Cardiol · March 1, 1997 The Thrombolysis and Angioplasty in Acute Myocardial Infarction phase 5 (TAMI-5) trial randomized patients to 1 of 3 thrombolytic regimens (alteplase, urokinase, or both), then further randomized them to acute or deferred catheterization. The group of pati ... Full text Link to item Cite

Combined accelerated tissue-plasminogen activator and platelet glycoprotein IIb/IIIa integrin receptor blockade with Integrilin in acute myocardial infarction. Results of a randomized, placebo-controlled, dose-ranging trial. IMPACT-AMI Investigators.

Journal Article Circulation · 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 ... Full text Link to item Cite

Racial variation in the use of coronary-revascularization procedures. Are the differences real? Do they matter?

Journal Article N Engl J Med · February 13, 1997 BACKGROUND: Studies have reported that blacks undergo fewer coronary-revascularization procedures than whites, but it is not clear whether the clinical characteristics of the patients account for these differences or whether they indicate underuse of the p ... Full text Link to item Cite

Coronary revascularization surgery after myocardial infarction: impact of bypass surgery on survival after thrombolysis. GUSTO Investigators. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries.

Journal Article J Am Coll Cardiol · February 1997 OBJECTIVES: This study sought to investigate the impact of surgical revascularization on outcome after myocardial infarction. BACKGROUND: Small variations in rates of coronary artery bypass graft surgery (CABG) were noted among thrombolytic regimens in the ... Full text Link to item Cite

Standard versus low-dose weight-adjusted heparin in patients treated with the platelet glycoprotein IIb/IIIa receptor antibody fragment abciximab (c7E3 Fab) during percutaneous coronary revascularization. PROLOG Investigators.

Journal Article Am J Cardiol · February 1, 1997 Blockade of the platelet glycoprotein IIb/IIIa receptor by abciximab (c7E3 Fab) during coronary intervention reduces the incidence of ischemic complications, but has been associated with a doubling of the risk for bleeding complications. The present pilot ... Full text Link to item Cite

Functional status among survivors of in-hospital cardiopulmonary resuscitation. SUPPORT Investigators Study to Understand Progress and Preferences for Outcomes and Risks of Treatment.

Journal Article Arch Intern Med · January 13, 1997 OBJECTIVES: To describe functional outcomes of seriously III patients who survived 2 months after in-hospital cardiopulmonary resuscitation (CPR) and to identify patient and clinical characteristics associated with worse functional status after CPR. METHOD ... Link to item Cite

Difference in countries' use of resources and clinical outcome for patients with cardiogenic shock after myocardial infarction: results from the GUSTO trial.

Journal Article Lancet · January 11, 1997 BACKGROUND: Use of aggressive and invasive interventions is more common in the USA than in other countries. We have compared use of resources for patients with cardiogenic shock after myocardial infarction in the USA and in other countries, and assessed th ... Full text Link to item Cite

Gender and acute myocardial infarction: is there a different response to thrombolysis?

Journal Article J Am Coll Cardiol · January 1997 OBJECTIVES: This study sought to 1) determine the effect of gender on early and late infarct-related artery patency and reocclusion after thrombolytic therapy for acute myocardial infarction; 2) examine the effect of gender on left ventricular function in ... Full text Link to item Cite

Physicians' Use of Heparin Following Thrombolytic Therapy: An International Perspective.

Journal Article J Thromb Thrombolysis · 1997 Background: The current prevalence, timing, and route of heparin use after thrombolytic therapy for acute myocardial infarction both within and outside the United States (U.S.) have not been extensively studied. Method: An 18-item questionnaire was mailed ... Full text Link to item Cite

Our vision for the American Heart Journal.

Journal Article Am Heart J · January 1997 Full text Link to item Cite

Assessing the value of newer pharmacologic agents in non-ST elevation patients: a decision support system application.

Journal Article Proc AMIA Annu Fall Symp · 1997 Newer pharmacologic agents have demonstrated significant clinical and economic benefit in high-risk percutaneous transluminal coronary angioplasty (PTCA) patients. However, the higher costs of these agents may prohibit their use in lower-risk coronary arte ... Link to item Cite

Preferences for cardiopulmonary resuscitation.

Journal Article Image J Nurs Sch · 1997 PURPOSE: To examine nurse-patient communication about preferences for cardiopulmonary resuscitation (CPR). DESIGN: Prospective cohort. Sampled were patients and nurses caring for patients enrolled in SUPPORT (1989-91), a multicenter study of seriously-ill ... Full text Link to item Cite

The authors reply

Journal Article New England Journal of Medicine · 1997 Cite

The authors reply

Journal Article New England Journal of Medicine · 1997 Cite

Functional status among survivors of in-hospital cardiopulmonary resuscitation

Journal Article Archives of Internal Medicine · January 1, 1997 Objectives: To describe functional outcomes of seriously ill patients who survived 2 months after in-hospital cardiopulmonary resuscitation (CPR) and to identify patient and clinical characteristics associated with worse functional status after CPR. Method ... Full text Cite

Lessons for the editors

Journal Article American Heart Journal · January 1, 1997 Full text Cite

Outcome of acute myocardial infarction according to the specialty of the admitting physician.

Journal Article N Engl J Med · December 19, 1996 BACKGROUND: In order to limit costs, health care organizations in the United States are shifting medical care from specialists to primary care physicians. Although primary care physicians provide less resource-intensive care, there is little information co ... Full text Link to item Cite

How much do we gain by reducing time to reperfusion therapy?

Journal Article Am J Cardiol · December 19, 1996 Emphasis continues to be placed on the need to minimize the time elapsed between the onset of symptoms of myocardial infarction and the initiation of thrombolytic therapy. Numerous large-scale trials have revealed an inverse relation between time-to-treatm ... Full text Link to item Cite

Thrombolytic therapy for patients with prior percutaneous transluminal coronary angioplasty and subsequent acute myocardial infarction. GUSTO-I Investigators. Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries.

Journal Article Am J Cardiol · December 15, 1996 Our purpose was to evaluate the outcomes of patients with prior coronary angioplasty who underwent thrombolysis for new acute myocardial infarction (AMI) in the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries-I trial. Baseline c ... Full text Link to item Cite

A metaanalysis of predischarge risk stratification after acute myocardial infarction with stress electrocardiographic, myocardial perfusion, and ventricular function imaging.

Journal Article Am J Cardiol · December 15, 1996 We assessed the relation of abnormal predischarge non-invasive test results to outcomes in postmyocardial infarction patients. We included series published from 1980 to 1995 containing only myocardial infarction patients, enrolling most patients after 1980 ... Full text Link to item Cite

Angiographic findings and outcome in diabetic patients treated with thrombolytic therapy for acute myocardial infarction: the GUSTO-I experience.

Journal Article J Am Coll Cardiol · December 1996 OBJECTIVES: This study sought to determine whether diabetes mellitus, in the setting of thrombolysis for acute myocardial infarction, affects 1) early infarct-related artery patency and reocclusion rates; and 2) global and regional ventricular function ind ... Full text Link to item Cite

Relation of increased arterial blood pressure to mortality and stroke in the context of contemporary thrombolytic therapy for acute myocardial infarction. A randomized trial. GUSTO-I Investigators.

Journal Article Ann Intern Med · December 1, 1996 BACKGROUND: Despite concern that hypertension increases the risk for intracranial hemorrhage during thrombolysis for acute myocardial infarction, the exact nature of the risk remains unclear. OBJECTIVE: To assess the effects of previous hypertension and bl ... Full text Link to item Cite

Effects of integrelin, a platelet glycoprotein IIb/IIIa receptor antagonist, in unstable angina. A randomized multicenter trial.

Journal Article Circulation · November 1, 1996 BACKGROUND: Although aspirin is beneficial in patients with unstable angina, it is a relatively weak inhibitor of platelet aggregation. The effect of Integrelin, which inhibits the platelet fibrinogen receptor glycoprotein (GP) IIb/IIIa, on the frequency a ... Full text Link to item Cite

Relation between estrogen replacement therapy and restenosis after percutaneous coronary interventions.

Journal Article J 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 ... Full text Link to item Cite

A comparison of debulking versus dilatation of bifurcation coronary arterial narrowings (from the CAVEAT I Trial). Coronary Angioplasty Versus Excisional Atherectomy Trial-I.

Journal Article Am J Cardiol · November 1, 1996 We compared the effectiveness of percutaneous transluminal coronary angioplasty and directional coronary atherectomy for the management of bifurcation coronary lesions in 1,012 patients enrolled in the Coronary Angioplasty Versus Excisional Atherectomy Tri ... Full text Link to item Cite

Cardiac troponin T levels for risk stratification in acute myocardial ischemia. GUSTO IIA Investigators.

Journal Article N Engl J Med · October 31, 1996 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 ... Full text Link to item Cite

Determinants of the use of coronary angiography and revascularization after thrombolysis for acute myocardial infarction.

Journal Article N Engl J Med · October 17, 1996 BACKGROUND: Clinical trials and practice guidelines have identified clinical criteria for the use of coronary angiography and revascularization procedures after thrombolysis for acute myocardial infarction. The effect of these criteria on clinical practice ... Full text Link to item Cite

Age and outcome with contemporary thrombolytic therapy. Results from the GUSTO-I trial. Global Utilization of Streptokinase and TPA for Occluded coronary arteries trial.

Journal Article Circulation · October 15, 1996 BACKGROUND: Elderly patients with acute myocardial infarction have much to gain from reperfusion with thrombolytic therapy but are also at increased risk of adverse events. We examined outcomes according to age of patients receiving thrombolysis in an inte ... Full text Link to item Cite

Performance of an automated real-time ST-segment analysis program to detect coronary occlusion and reperfusion.

Journal Article J Electrocardiol · October 1996 Continuously updated ST-segment recovery analysis has been shown to accurately predict infarct-related artery patency. Salient principles were converted into algorithms and incorporated into a portable ST monitor for optimal application. This study tested ... Full text Link to item Cite

Increased risk of non-Q wave myocardial infarction after directional atherectomy is platelet dependent: evidence from the EPIC trial. Evaluation of c7E3 for the Prevention of Ischemic Complications.

Journal Article J Am Coll Cardiol · October 1996 OBJECTIVES: We sought to determine the effects of platelet glycoprotein IIb/IIIa receptor blockade on adverse outcomes, especially non-Q wave myocardial infarction, in patients undergoing directional atherectomy in the Evaluation of c7E3 for the Prevention ... Full text Link to item Cite

Left main stenosis.

Journal Article Ann Thorac Surg · October 1996 Full text Link to item Cite

The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators.

Journal Article JAMA · September 18, 1996 OBJECTIVE: To examine the association between the use of right heart catheterization (RHC) during the first 24 hours of care in the intensive care unit (ICU) and subsequent survival, length of stay, intensity of care, and cost of care. DESIGN: Prospective ... Full text Link to item Cite

One-year results from the Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries (GUSTO-I) trial. GUSTO-I Investigators.

Journal Article Circulation · September 15, 1996 BACKGROUND: In the randomized Global Utilization of t-PA and Streptokinase for Occluded Coronary Arteries (GUSTO-I) trial, 41021 patients received one of four thrombolytic regimens. Patients treated with accelerated tissue plasminogen activator (TPA) had a ... Full text Link to item Cite

Depression and long-term mortality risk in patients with coronary artery disease.

Journal Article Am J Cardiol · September 15, 1996 Previous research has established that patients with coronary artery disease (CAD) have an increased risk of death if they are depressed at the time of hospitalization. Follow-up periods have been short in these studies; therefore, the present investigatio ... Full text Link to item Cite

Effect of subintimal resection on initial outcome and restenosis for native coronary lesions and saphenous vein graft disease treated by directional coronary atherectomy. A report from the CAVEAT I and II investigators. Coronary Angioplasty Versus Excisional Atherectomy Trial.

Journal Article J Am Coll Cardiol · September 1996 OBJECTIVES: This study was designed to determine whether the depth of tissue resection affected either immediate outcome or subsequent restenosis in patients treated by directional coronary atherectomy (DCA) in the Coronary Angioplasty Versus Excisional At ... Full text Link to item Cite

The rationale for thrombolytic therapy.

Journal Article Eur Heart J · September 1996 Substantial progress has been made toward understanding the pathophysiological processes that lead to acute myocardial infarction. Research has shown that the mechanism of infarction is the rupture of an atherosclerotic plaque with a subsequent thrombogeni ... Full text Link to item Cite

Prediction of the infarct-related artery in acute myocardial infarction by a scoring system using summary ST-segment and T-wave changes.

Journal Article Am J Cardiol · August 15, 1996 We developed a scoring system to predict the artery responsible for an acute myocardial infarction (AMI) using ST-segment and T-wave changes on the initial electrocardiogram (ECG) using data from 228 patients (development set) with symptoms compatible with ... Full text Link to item Cite

Economic assessment of platelet glycoprotein IIb/IIIa inhibition for prevention of ischemic complications of high-risk coronary angioplasty. EPIC Investigators.

Journal Article Circulation · August 15, 1996 BACKGROUND: In the EPIC trial, c7E3 Fab, an antiplatelet IIb/ IIIa receptor antibody, reduced 30-day ischemic end points after high-risk coronary angioplasty by 35% and 6-month ischemic events by 23% but increased in-hospital bleeding episodes. METHODS AND ... Full text Link to item Cite

Factors associated with do-not-resuscitate orders: patients' preferences, prognoses, and physicians' judgments. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment.

Journal Article Ann Intern Med · August 15, 1996 BACKGROUND: Medical treatment decisions should be based on the preferences of informed patients or their proxies and on the expected outcomes of treatment. Because seriously ill patients are at risk for cardiac arrest, examination of do-not-resuscitate (DN ... Full text Link to item Cite

Increased left ventricular dysfunction in elderly patients despite successful thrombolysis: the GUSTO-I angiographic experience.

Journal Article J Am Coll Cardiol · August 1996 OBJECTIVE: This study sought to determine whether the recovery of regional and global left ventricular function is reduced in elderly patients despite successful thrombolytic therapy for acute myocardial infarction. Comparisons were made between elderly (> ... Full text Link to item Cite

Prognostic significance of precordial ST segment depression during inferior myocardial infarction in the thrombolytic era: results in 16,521 patients.

Journal Article J Am Coll Cardiol · August 1996 OBJECTIVES: We examined the prognostic significance of precordial ST segment depression among patients with an acute inferior myocardial infarction. BACKGROUND: Although precordial ST segment depression has been associated with a poor prognosis, this corre ... Full text Link to item Cite

Factors associated with change in resuscitation preference of seriously ill patients. The SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments.

Journal Article Arch Intern Med · July 22, 1996 BACKGROUND: During serious illness, patient preferences regarding life-sustaining treatments play an important role in medical decisions. However, little is known about life-sustaining preference stability in this population or about factors associated wit ... Link to item Cite

Race, resource use, and survival in seriously ill hospitalized adults. The SUPPORT Investigators.

Journal Article J Gen Intern Med · July 1996 OBJECTIVE: To examine the association between patient race and hospital resource use. DESIGN: Prospective cohort study. SETTING: Five geographically diverse teaching hospitals. PATIENTS: Patients were 9,105 hospitalized adults with one of nine illnesses as ... Full text Link to item Cite

Metaanalysis of five reported studies on the relation of early coronary patency grades with mortality and outcomes after acute myocardial infarction.

Journal Article Am J Cardiol · July 1, 1996 Coronary patency has been used as a measure of thrombolysis success after acute myocardial infarction (AMI). The Thrombolysis in Myocardial Infarction (TIMI) study grading scale for coronary perfusion has gained wide acceptance, but the significance of ind ... Full text Link to item Cite

Use of calcium channel antagonists in myocardial revascularization procedures.

Journal Article Am J Cardiol · June 20, 1996 Calcium channel antagonists possess a number of properties that may be beneficial after revascularization procedures. Therefore, we present an overview of the use of these drugs after percutaneous intervention in the Coronary Angioplasty Versus Excisional ... Full text Link to item Cite

Time from symptom onset to treatment and outcomes after thrombolytic therapy. GUSTO-1 Investigators.

Journal Article J Am Coll Cardiol · June 1996 OBJECTIVES: This study sought to examine the relations among patient characteristics, time to thrombolysis and outcomes in the international GUSTO-I trial. BACKGROUND: Studies have shown better left ventricular function and decreased infarct size as well a ... Full text Link to item Cite

Effects of platelet glycoprotein IIb/IIIa receptor blockade by a chimeric monoclonal antibody (abciximab) on acute and six-month outcomes after percutaneous transluminal coronary angioplasty for acute myocardial infarction. EPIC investigators.

Journal Article Am J Cardiol · May 15, 1996 Percutaneous transluminal coronary angioplasty (PTCA) for acute myocardial infarction is an attractive alternative to thrombolysis, but is still limited by recurrent ischemia and restenosis. We determined whether adjunctive platelet glycoprotein IIb/IIIa r ... Full text Link to item Cite

Participation of nurses in decision making for seriously ill adults.

Journal Article Clin Nurs Res · May 1996 The purpose of this study is to describe the involvement of nurses in the decision-making process of seriously ill hospitalized adults. Nurses (696) completed interviews with 1,427 patients. Patient, surrogate, and physician interviews were also completed. ... Full text Link to item Cite

Long-term survival benefits of coronary artery bypass grafting and percutaneous transluminal angioplasty in patients with coronary artery disease.

Journal Article J Thorac Cardiovasc Surg · May 1996 The purpose of this study was to evaluate long-term survival benefits of bypass surgery and angioplasty versus medical therapy in 9263 patients at Duke University Medical Center between 1984 and 1990 with coronary artery disease confirmed by cardiac cathet ... Full text Link to item Cite

Rebound increase in thrombin generation and activity after cessation of intravenous heparin in patients with acute coronary syndromes

Journal Article Journal 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 ... Cite

A randomized factorial trial of reperfusion strategies and aspirin dosing in acute myocardial infarction. The DUCCS-II Investigators.

Journal Article Am J Cardiol · April 15, 1996 The focus of new research efforts to improve the morbidity and mortality associated with acute myocardial infarction (AMI) has turned to adjuvant agents that show promise of improving outcomes following coronary thrombolysis. We enrolled 162 patients with ... Full text Link to item Cite

Overview of randomized trials of intravenous heparin in patients with acute myocardial infarction treated with thrombolytic therapy.

Journal Article Am 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 ... Full text Link to item Cite

Comparisons of characteristics and outcomes among women and men with acute myocardial infarction treated with thrombolytic therapy. GUSTO-I investigators.

Journal Article JAMA · March 13, 1996 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 ... Link to item Cite

Activated partial thromboplastin time and outcome after thrombolytic therapy for acute myocardial infarction: results from the GUSTO-I trial.

Journal Article Circulation · March 1, 1996 BACKGROUND: Although intravenous heparin is commonly used after thrombolytic therapy, few reports have addressed the relationship between the degree of anticoagulation and clinical outcomes. We examined the activated partial thromboplastin time (aPTT) in 2 ... Full text Link to item Cite

Early discharge in the thrombolytic era: an analysis of criteria for uncomplicated infarction from the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) trial.

Journal Article J Am Coll Cardiol · March 1, 1996 OBJECTIVES: This study sought to readdress the definition of uncomplicated myocardial infarction and to apply clinical criteria for early discharge of such patients in the thrombolytic era. BACKGROUND: Previous studies proposed early hospital discharge at ... Full text Link to item Cite

Electrocardiographic diagnosis of evolving acute myocardial infarction in the presence of left bundle-branch block. GUSTO-1 (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries) Investigators.

Journal Article N Engl J Med · February 22, 1996 BACKGROUND: The presence of left bundle-branch block on the electrocardiogram may conceal the changes of acute myocardial infarction, which can delay both its recognition and treatment. We tested electrocardiographic criteria for the diagnosis of acute inf ... Full text Link to item Cite

Relation between activated clotting time during angioplasty and abrupt closure.

Journal Article Circulation · February 15, 1996 BACKGROUND: The purpose of this study was to determine whether the degree of heparin anticoagulation during coronary angioplasty, as measured by the activated clotting time, is related to the risk of abrupt vessel closure. METHODS AND RESULTS: Sixty-two ca ... Full text Link to item Cite

A randomized study would answer the question.

Journal Article Ann Thorac Surg · February 1996 Full text Link to item Cite

Choices of seriously ill patients about cardiopulmonary resuscitation: correlates and outcomes. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments.

Journal Article Am J Med · February 1996 PURPOSE: For patients hospitalized with serious illnesses, we identified factors associated with a stated preference to forgo cardiopulmonary resuscitation (CPR), examined physician-patient communication about these issues, and determined the relationship ... Full text Link to item Cite

Identifying Patient Risk: The Basis for Rational Discharge Planning After Acute Myocardial Infarction.

Journal Article J Thromb Thrombolysis · 1996 Variations in the management of patients with chest pain and acute myocardial infarction (MI) can significantly affect hospital length of stay and cost. Risk stratification of such patients, combined with data about effective therapies, provides the basis ... Full text Link to item Cite

Effect of subintimal resection on initial outcome and restenosis for native coronary lesions and saphenous vein graft disease treated by directional coronary atherectomy. A report from the CAVEAT I and II investigators

Journal Article Journal of the American College of Cardiology · January 1, 1996 Objectives. This study was designed to determine whether the depth of tissue resection affected either immediate outcome or subsequent restenosis in patients treated by directional coronary atherectomy (DCA) in the Coronary Angioplasty Versus Excisional At ... Full text Cite

The natural history of single vessel chronic total occlusions

Journal Article ACC Current Journal Review · January 1, 1996 Full text Cite

The SUPPORT project and improving care for seriously ill patients [1]

Journal Article Journal of the American Medical Association · 1996 Full text Cite

The thrombolysis and angioplasty in myocardial infarction (TAMI) trials: A decade of reperfusion strategies

Journal Article Journal 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 ... Full text Cite

Immediate and reversible platelet inhibition after intravenous administration of a peptide glycoprotein IIb/IIIa inhibitor during percutaneous coronary intervention.

Journal Article Am J Cardiol · December 15, 1995 We studied the pharmacokinetic and pharmacodynamic properties of integrelin, a novel platelet glycoprotein IIb/IIIa receptor inhibitor, in patients undergoing elective percutaneous coronary intervention. Patients were randomized to placebo (n = 19) or to 1 ... Full text Link to item Cite

Treating menstruating women with thrombolytic therapy: insights from the global utilization of streptokinase and tissue plasminogen activator for occluded coronary arteries (GUSTO-I) trial.

Journal Article J Am Coll Cardiol · December 1995 OBJECTIVES: The purpose of this study was to examine the clinical implications of administering thrombolytic therapy to menstruating women with acute myocardial infarction. BACKGROUND: Although anecdotal case reports have suggested that thrombolytic therap ... Full text Link to item Cite

The way of the future redux.

Journal Article Am J Cardiol · December 1, 1995 Full text Link to item Cite

Implications for cost-effectiveness

Journal Article American Journal of Cardiology · December 1, 1995 Full text Cite

Frequency, significance, and cost of recurrent ischemia after thrombolytic therapy for acute myocardial infarction. TAMI Study Group.

Journal Article Am 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 ... Full text Link to item Cite

Abrupt closure: the CAVEAT I experience. Coronary Angioplasty Versus Excisional Atherectomy Trial.

Journal Article J Am Coll Cardiol · November 15, 1995 OBJECTIVES: This study sought to assess the incidence and consequences of abrupt closure in a series of patients undergoing directional coronary atherectomy versus percutaneous coronary angioplasty. BACKGROUND: Abrupt closure with coronary angioplasty has ... Full text Link to item Cite

Stroke after thrombolysis. Mortality and functional outcomes in the GUSTO-I trial. Global Use of Strategies to Open Occluded Coronary Arteries.

Journal Article Circulation · November 15, 1995 BACKGROUND: Stroke is the most feared complication of thrombolysis for acute myocardial infarction because of the resulting mortality and disability. We analyzed the incidence, timing, and outcomes of stroke in an international trial. METHODS AND RESULTS: ... Full text Link to item Cite

An overview of the results of the EPIC trial.

Journal Article Eur Heart J · November 1995 The Evaluation of 7E3 for the Prevention of Ischaemic Complications (EPIC) trial assessed the use of abciximab in the treatment of patients at high risk undergoing percutaneous revascularization procedures. Abciximab (c7E3) is a chimeric monoclonal antibod ... Full text Link to item Cite

Evaluation of paradoxic beneficial effects of smoking in patients receiving thrombolytic therapy for acute myocardial infarction: mechanism of the "smoker's paradox" from the GUSTO-I trial, with angiographic insights. Global Utilization of Streptokinase and Tissue-Plasminogen Activator for Occluded Coronary Arteries.

Journal Article J Am Coll Cardiol · November 1, 1995 OBJECTIVES: Our purpose was to evaluate the relation between smoking and the outcomes of patients receiving thrombolysis for acute myocardial infarction. BACKGROUND: A paradoxic beneficial effect has been observed in smokers with a myocardial infarction. W ... Full text Link to item Cite

Reduction of intimal hyperplasia by naroparcil, a 4-methylumbelliferyl beta-D-xyloside analogue, after arterial injury in the hypercholesterolemic rabbit.

Journal Article Circ Res · November 1995 4-Methylumbelliferyl beta-D-xylosides (beta-D-xylosides) inhibit proteoglycan synthesis, and this is associated with reduced proliferation and extracellular matrix production by vascular smooth muscle cells. This study evaluated whether treatment with naro ... Full text Link to item Cite

New antithrombotics.

Journal Article Chest · October 1995 Full text Link to item Cite

Peripheral vascular complications in the Coronary Angioplasty Versus Excisional Atherectomy Trial (CAVEAT-I).

Journal Article J Am Coll Cardiol · October 1995 OBJECTIVES: In-hospital peripheral vascular complications of balloon angioplasty were compared with those of directional atherectomy in the Coronary Angioplasty Versus Excisional Atherectomy Trial (CAVEAT-I) to identify patients at risk and evaluate costs ... Full text Link to item Cite

Acute ischemic syndromes.

Journal Article Med Clin North Am · September 1995 The diagnosis and treatment of patients with acute manifestations of ischemic heart disease are major public health issues. This article reviews the current state of knowledge about the problem of acute ischemic syndromes, the events leading to clinical ma ... Full text Link to item Cite

Contemporary reperfusion therapy for cardiogenic shock: the GUSTO-I trial experience. The GUSTO-I Investigators. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries.

Journal Article J Am Coll Cardiol · September 1995 OBJECTIVES: This study sought to examine the incidence, temporal profile and clinical implications of shock in a large trial of thrombolytic therapy for acute myocardial infarction. BACKGROUND: Despite advances in the treatment of acute ischemic syndromes, ... Full text Link to item Cite

Baseline and 6-month costs of primary angioplasty therapy for acute myocardial infarction: results from the primary angioplasty registry.

Journal Article J Am Coll Cardiol · September 1995 OBJECTIVES: This study sought to describe the economic outcomes from a prospective multicenter registry of primary coronary angioplasty. BACKGROUND: Interest in coronary angioplasty without preceding thrombolytic therapy as a primary reperfusion strategy h ... Full text Link to item Cite

Restenosis: the cost to society.

Journal Article Am Heart J · September 1995 Restenosis occurs in 20% to 55% of arteries subjected to percutaneous intervention procedures and is an important cause of recurrent symptomatic angina. More than half of the patients in whom angiographically defined restenosis develops will require an add ... Full text Link to item Cite

Regional variation across the United States in the management of acute myocardial infarction. GUSTO-1 Investigators. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries.

Journal Article N 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 ... Full text Link to item Cite

Predictors and sequelae of distal embolization during saphenous vein graft intervention from the CAVEAT-II trial. Coronary Angioplasty Versus Excisional Atherectomy Trial.

Journal Article Circulation · August 15, 1995 BACKGROUND: The purpose of this study was to identify the predictors and sequelae of distal embolization from a multicenter, randomized trial of saphenous vein graft intervention. The CAVEAT-II trial demonstrated that saphenous vein graft directional coron ... Full text Link to item Cite

How should clinicians interpret clinical trials?

Journal Article Cardiol Clin · August 1995 Given the rapid evolution of cardiovascular medicine, clinicians must sift through an enormous array of information about new therapies in order to determine how best to treat patients with ischemic heart disease. They should first consider the evidence fr ... Link to item Cite

Job strain and the prevalence and outcome of coronary artery disease.

Journal Article Circulation · August 1, 1995 BACKGROUND: It has been hypothesized that jobs that have both high psychological demands and low decision latitude ("job strain") can lead to coronary disease. The objective of this study was to test whether job strain was correlated with the presence of c ... Full text Link to item Cite

Percutaneous revascularization of chronic coronary occlusions: an overview.

Journal Article J Am Coll Cardiol · July 1995 Patients with a chronic coronary occlusion often undergo coronary angiography after weeks to months of occlusion. The published reports underestimate the extent of this problem because such patients are often arbitrarily assigned to receive medical therapy ... Full text Link to item Cite

Identification of comatose patients at high risk for death or severe disability. SUPPORT Investigators. Understand Prognoses and Preferences for Outcomes and Risks of Treatments.

Journal Article JAMA · June 21, 1995 OBJECTIVE: To develop and validate a simple prognostic scoring system to identify patients in nontraumatic coma at high risk for poor outcomes using data available early in the hospital course. DESIGN: Prospective cohort study. SETTING: Five geographically ... Link to item Cite

Bleeding complications with the chimeric antibody to platelet glycoprotein IIb/IIIa integrin in patients undergoing percutaneous coronary intervention. EPIC Investigators.

Journal Article Circulation · June 15, 1995 BACKGROUND: The potential for novel antiplatelet and antithrombin agents to contribute to periprocedural bleeding complications of percutaneous coronary revascularization is poorly defined. In the Evaluation of c7E3 Fab in Preventing Ischemic Complications ... Full text Link to item Cite

Noninvasive assessment of speed and stability of infarct-related artery reperfusion: results of the GUSTO ST segment monitoring study. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries.

Journal Article J Am Coll Cardiol · June 1995 OBJECTIVES: The ST segment monitoring substudy of the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO-I) trial compared the speed and stability of ST segment recovery among four thrombolytic strate ... Full text Link to item Cite

Lessons we have learned from the GUSTO trial. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Arteries.

Journal Article J Am Coll Cardiol · June 1995 Thrombolytic therapy remains a mainstay for the treatment of patients with acute myocardial infarction. This therapy has been the subject of intense investigation and multiple studies as well as substantial controversy. Controversial issues include, among ... Full text Link to item Cite

Characteristics and consequences of myocardial infarction after percutaneous coronary intervention: insights from the Coronary Angioplasty Versus Excisional Atherectomy Trial (CAVEAT).

Journal Article J 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 ... Full text Link to item Cite

Cost effectiveness of thrombolytic therapy with tissue plasminogen activator as compared with streptokinase for acute myocardial infarction.

Journal Article N Engl J Med · May 25, 1995 BACKGROUND: Patients with acute myocardial infarction who were treated with accelerated tissue plasminogen activator (t-PA) (given over a period of 1 1/2 hours rather than the conventional 3 hours, and with two thirds of the dose given in the first 30 minu ... Full text Link to item Cite

Variations in patient management and outcomes for acute myocardial infarction in the United States and other countries. Results from the GUSTO trial. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries.

Journal Article JAMA · May 24, 1995 OBJECTIVE: To examine differences in outcomes and patient management between patients in the United States and outside the United States undergoing thrombolysis for acute myocardial infarction. DESIGN, SETTING, AND PATIENTS: Patients in the United States ( ... Full text Link to item Cite

Distinguishing between early and late responders to symptoms of acute myocardial infarction.

Journal Article Am J Cardiol · May 15, 1995 The present study identified factors that distinguish early responders (i.e., requested medical assistance < 60 minutes after the onset of acute myocardial infarction [AMI] symptoms) from late responders (i.e., request made > or = 60 minutes after symptom ... Full text Link to item Cite

Significance of a coronary artery with thrombolysis in myocardial infarction grade 2 flow "patency" (outcome in the thrombolysis and angioplasty in myocardial infarction trials). Thrombolysis and Angioplasty in Myocardial Infarction Study Group.

Journal Article Am 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 ... Full text Link to item Cite

Directional atherectomy versus balloon angioplasty for coronary ostial and nonostial left anterior descending coronary artery lesions: results from a randomized multicenter trial. The CAVEAT-I investigators. Coronary Angioplasty Versus Excisional Atherectomy Trial.

Journal Article J Am Coll Cardiol · May 1995 OBJECTIVES: We hypothesized that atherectomy would be superior to balloon angioplasty for ostial and nonostial left anterior descending coronary artery lesions. BACKGROUND: Balloon angioplasty of ostial coronary artery lesions has been associated with a lo ... Full text Link to item Cite

One-year follow-up in the Coronary Angioplasty Versus Excisional Atherectomy Trial (CAVEAT I).

Journal Article Circulation · April 15, 1995 BACKGROUND: Directional atherectomy is a frequently used percutaneous revascularization strategy, but its long-term outcomes have not previously been compared with those of balloon angioplasty in a prospective trial. METHODS AND RESULTS: The 1012 patients ... Full text Link to item Cite

Multicenter, randomized, double-blind, placebo-controlled trial of the platelet integrin glycoprotein IIb/IIIa blocker Integrelin in elective coronary intervention. IMPACT Investigators.

Journal Article Circulation · April 15, 1995 BACKGROUND: Platelet aggregation and thrombosis have been implicated in the pathogenesis of coronary angioplasty complications. Integrelin, a synthetic cyclic heptapeptide with high affinity and marked specificity for platelet integrin glycoprotein IIb/III ... Full text Link to item Cite

A multicenter, randomized trial of coronary angioplasty versus directional atherectomy for patients with saphenous vein bypass graft lesions. CAVEAT-II Investigators.

Journal Article Circulation · April 1, 1995 BACKGROUND: Directional coronary atherectomy and percutaneous transluminal coronary angioplasty have both been used in symptomatic patients with coronary saphenous vein bypass graft stenoses. The relative merits of plaque excision and removal versus balloo ... Full text Link to item Cite

Link between the angiographic substudy and mortality outcomes in a large randomized trial of myocardial reperfusion. Importance of early and complete infarct artery reperfusion. GUSTO-I Investigators.

Journal Article Circulation · April 1, 1995 BACKGROUND: The Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries (GUSTO-I) trial was designed to test whether thrombolytic strategies achieving more complete, early, sustained coronary artery patency would lead to further reductio ... Full text Link to item Cite

Rebound increase in thrombin generation and activity after cessation of intravenous heparin in patients with acute coronary syndromes.

Journal Article Circulation · 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 ... Full text Link to item Cite

Effect of platelet glycoprotein IIb/IIIa integrin blockade on activated clotting time during percutaneous transluminal coronary angioplasty or directional atherectomy (the EPIC trial). Evaluation of c7E3 Fab in the Prevention of Ischemic Complications trial.

Journal Article Am J Cardiol · March 15, 1995 The activated clotting time (ACT) has been used during percutaneous transluminal coronary angioplasty (PTCA) to monitor the extent of thrombin inhibition and anti-coagulation from heparin in an attempt to minimize untoward thrombotic events and hemorrhagic ... Full text Link to item Cite

Predictors of 30-day mortality in the era of reperfusion for acute myocardial infarction. Results from an international trial of 41,021 patients. GUSTO-I Investigators.

Journal Article Circulation · March 15, 1995 BACKGROUND: Despite remarkable advances in the treatment of acute myocardial infarction, substantial early patient mortality remains. Appropriate choices among alternative therapies and the use of clinical resources depend on an estimate of the patient's r ... Full text Link to item Cite

Emerging role of PTCA in acute MI

Journal Article Journal of Myocardial Ischemia · February 17, 1995 Five different strategies have been devised for the use of percutaneous transluminal coronary angioplasty (PTCA) in acute myocardial infarction (MI): direct (or primary), immediate, rescue (or salvage), deferred, and elective (also known as 'watchful waiti ... Cite

The SUPPORT prognostic model. Objective estimates of survival for seriously ill hospitalized adults. Study to understand prognoses and preferences for outcomes and risks of treatments.

Journal Article Ann Intern Med · February 1, 1995 OBJECTIVE: To develop and validate a prognostic model that estimates survival over a 180-day period for seriously ill hospitalized adults (phase I of SUPPORT [Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments]) and to compa ... Full text Link to item Cite

Effect of cigarette smoking on outcome after thrombolytic therapy for myocardial infarction.

Journal Article Circulation · January 15, 1995 BACKGROUND: Smoking is known to be a strong risk factor for premature atherosclerosis, myocardial infarction, and sudden cardiac death. Unexpectedly, in the reperfusion era, investigators have reported that patients who smoke have a more favorable prognosi ... Full text Link to item Cite

The exclusion of women from clinical trials of thrombolytic therapy: implications for developing the thrombolytic predictive instrument database.

Journal Article Med Decis Making · 1995 The thrombolytic predictive instrument (TPI) was developed to identify those patients most likely to benefit from thrombolytic therapy for acute myocardial infarction as well as to facilitate the earliest possible administration of this treatment. The TPI ... Full text Link to item Cite

Randomized, Placebo-Controlled Study of Lamifiban with Thrombolytic Therapy for the Treatment of Acute Myocardial Infarction: Rationale and Design for the Platelet Aggregation Receptor Antagonist Dose Investigation and Reperfusion Gain in Myocardial Infarction (PARADIGM) Study.

Journal Article J Thromb Thrombolysis · 1995 The benefits of thrombolytic therapy in the treatment of acute myocardial infarction are incontrovertible. Large-scale studies combining angiographic and clinical end-points have demonstrated a perfusion-mortality relationship, with the highest survival ra ... Full text Link to item Cite

Creatine kinase MM and MB isoforms in patients receiving thrombolytic therapy and acute angiography

Journal Article Clinical 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 receivi ... Full text Cite

Cardiovascular health and disease in women: Thrombolytic therapy for women with acute myocardial infarction: Is there a gender gap?

Journal Article Cardiovascular Reviews and Reports · January 1, 1995 Intravenous thrombolytic therapy has now been established as the standard approach for all eligible patients who present early with acute myocardial infarction. Relatively little clinical investigation however, has been addressed to the potential differenc ... Cite

A pooled analysis of coronary arterial patency and left ventricular function after intravenous thrombolysis for acute myocardial infarction.

Journal Article Am J Cardiol · December 15, 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 ... Full text Link to item Cite

The value of exercise thallium imaging.

Journal Article Ann Intern Med · December 1, 1994 Full text Link to item Cite

Mortality within 24 hours of thrombolysis for myocardial infarction. The importance of early reperfusion. The GUSTO Investigators, Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries.

Journal Article Circulation · 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 ... Full text Link to item Cite

Early angiography cannot predict postthrombolytic coronary reocclusion: observations from the GUSTO angiographic study. Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries.

Journal Article J Am Coll Cardiol · November 15, 1994 OBJECTIVES: The purpose of this study was to determine whether early qualitative or quantitative angiographic features can predict reocclusion after initially successful coronary thrombolysis. BACKGROUND: Although both the benefits of early reperfusion and ... Full text Link to item Cite

Use of medical resources and quality of life after acute myocardial infarction in Canada and the United States.

Journal Article N Engl J Med · October 27, 1994 BACKGROUND: Much attention has been directed to the use of medical resources and to patients' outcomes in Canada as compared with the United States. We compared U.S. and Canadian patients with respect to their use of medical resources and their quality of ... Full text Link to item Cite

Pharmacodynamics of chimeric glycoprotein IIb/IIIa integrin antiplatelet antibody Fab 7E3 in high-risk coronary angioplasty.

Journal Article Circulation · October 1994 BACKGROUND: Thrombosis has been implicated as central to the clinical complications of coronary angioplasty (PTCA). Chimeric monoclonal 7E3 Fab (c7E3 Fab) is the first of a new class of antiplatelet drugs directed at the platelet glycoprotein IIb/IIIa inte ... Full text Link to item Cite

Predicting the risk of abrupt vessel closure after angioplasty in an individual patient.

Journal Article J Am Coll Cardiol · October 1994 OBJECTIVES: We proposed to examine the relation between angiographic morphologic characteristics and abrupt closure after coronary angioplasty and to develop an empirically based risk stratification system. BACKGROUND: Certain lesion morphologic characteri ... Full text Link to item Cite

Presenting pulse pressure predicts thrombolytic therapy-related intracranial hemorrhage. Thrombolytic Predictive Instrument (TPI) Project results.

Journal Article Circulation · October 1994 BACKGROUND: In selecting patients with acute myocardial infarction for thrombolytic therapy, it is important to identify patients who are at high risk for intracranial hemorrhage, for whom thrombolytic therapy is ill advised. We hypothesized that presentin ... Full text Link to item Cite

Trials of new antithrombin agents

Journal Article Journal of Myocardial Ischemia · August 8, 1994 With increasing pressure on the medical community to conserve resources wherever possible, practising clinicians must become more involved in clinical investigations designed to determine which therapies are effective and which are not. With this goal in m ... Cite

Use of aortic counterpulsation to improve sustained coronary artery patency during acute myocardial infarction. Results of a randomized trial. The Randomized IABP Study Group.

Journal Article Circulation · 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 ... Full text Link to item Cite

Randomized trials of directional coronary atherectomy: implications for clinical practice and future investigation.

Journal Article J Am Coll Cardiol · August 1994 OBJECTIVES: This study compared and contrasted the randomized trials of directional atherectomy and coronary angioplasty for de novo native coronary artery lesions. BACKGROUND: The results of two randomized trials, the Coronary Angioplasty Versus Excisiona ... Full text Link to item Cite

Low molecular weight heparin in prevention of restenosis after angioplasty. Results of Enoxaparin Restenosis (ERA) Trial.

Journal Article Circulation · August 1994 BACKGROUND: Heparin, an anticoagulant, possesses antiproliferative effects and has been shown to reduce neointimal proliferation and restenosis following vascular injury in experimental studies. METHODS AND RESULTS: The primary aim of this double-blind mul ... Full text Link to item Cite

More on the GUSTO trial.

Journal Article N Engl J Med · July 28, 1994 Full text Link to item Cite

Randomized evaluation of coronary angioplasty for early TIMI 2 flow after thrombolytic therapy for the treatment of acute myocardial infarction: a new look at an old study. The Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) Study Group.

Journal Article Coron 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 ... Full text Link to item Cite

Intravenous Fluosol in the treatment of acute myocardial infarction. Results of the Thrombolysis and Angioplasty in Myocardial Infarction 9 Trial. TAMI 9 Research Group.

Journal Article Circulation · July 1994 BACKGROUND: This study was performed to determine the safety and potential efficacy of an intravenous perfluorochemical emulsion (Fluosol) as an adjunct reperfusion therapy aimed at preventing reperfusion injury for patients with acute myocardial infarctio ... Full text Link to item Cite

Six-month clinical and angiographic follow-up after direct angioplasty for acute myocardial infarction. Final results from the Primary Angioplasty Registry.

Journal Article Circulation · July 1994 BACKGROUND: After direct angioplasty in the setting of acute myocardial infarction, patients were followed clinically and angiographically for 6 months at six experienced centers to evaluate outcomes. METHODS AND RESULTS: Of 258 patients with 6-month follo ... Full text Link to item Cite

Cardiogenic shock.

Journal Article N Engl J Med · June 16, 1994 Full text Link to item Cite

The last word on GUSTO, for now.

Journal Article Ann Intern Med · June 1, 1994 Full text Link to item Cite

Comparison of continuous ST-segment recovery analysis with methods using static electrocardiograms for noninvasive patency assessment during acute myocardial infarction. Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) 7 Study Group.

Journal Article Am J Cardiol · June 1, 1994 Continuous ST-segment recovery analysis and 5 static methods using ST-segment comparison between a pre- and post-treatment electrocardiogram were compared for their ability to predict infarct-related artery patency in 82 patients with acute myocardial infa ... Full text Link to item Cite

Holding GUSTO up to the light. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries.

Journal Article Ann Intern Med · May 15, 1994 The Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) trial, a recent randomized "megatrial" of thrombolytic therapies in acute myocardial infarction, showed a statistically significant decrease of ... Full text Link to item Cite

A meta-analysis of randomized trials of calcium antagonists to reduce restenosis after coronary angioplasty.

Journal Article Am 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 ... Full text Link to item Cite

Continuing evolution of therapy for coronary artery disease. Initial results from the era of coronary angioplasty.

Journal Article Circulation · May 1994 BACKGROUND: Survival after coronary artery bypass graft surgery (CABG) and medical therapy in patients with coronary artery disease (CAD) has been studied in both randomized trials and observational treatment comparisons. Over the past decade, the use of c ... Full text Link to item Cite

Absence of sex bias in the referral of patients for cardiac catheterization.

Journal Article N Engl J Med · April 21, 1994 BACKGROUND: It has been suggested that women with clinical evidence of coronary artery disease are less often referred for cardiac catheterization than are men. To determine whether there is sex-related bias in referral for cardiac catheterization, we pros ... Full text Link to item Cite

Randomised trial of coronary intervention with antibody against platelet IIb/IIIa integrin for reduction of clinical restenosis: results at six months. The EPIC Investigators.

Journal Article Lancet · April 9, 1994 Restenosis after coronary angioplasty occurs in at least 30% of patients in the first six months and, as yet, there is no known treatment to decrease this event. We tested a monoclonal antibody Fab fragment (c7E3) directed against the platelet glycoprotein ... Full text Link to item Cite

Use of a monoclonal antibody directed against the platelet glycoprotein IIb/IIIa receptor in high-risk coronary angioplasty.

Journal Article N Engl J Med · April 7, 1994 BACKGROUND: Platelets are believed to play a part in the ischemic complications of coronary angioplasty, such as abrupt closure of the coronary vessel during or soon after the procedure. Accordingly, we evaluated the effect of a chimeric monoclonal-antibod ... Full text Link to item Cite

Recombinant hirudin for unstable angina pectoris. A multicenter, randomized angiographic trial.

Journal Article Circulation · April 1994 BACKGROUND: Coronary artery thrombosis plays an important pathophysiological role in unstable angina and non-Q-wave myocardial infarction. To date, heparin and thrombolytic therapy has not provided complete or consistent benefit. We hypothesized that recom ... Full text Link to item Cite

Percutaneous intervention, surgery, and medical therapy: a perspective from the Duke Databank for Cardiovascular Diseases.

Journal Article Semin Thorac Cardiovasc Surg · April 1994 Myocardial revascularization improves survival rates and quality of life for patients with symptomatic ischemic heart disease. The less severe the anatomic disease, the smaller the benefit, particularly for survival. Patients with more severe anatomic dise ... Link to item Cite

Primary coronary angioplasty for acute myocardial infarction (the Primary Angioplasty Registry).

Journal Article Am J Cardiol · April 1, 1994 During a 14-month period, 6 experienced centers prospectively enrolled 271 patients into a registry in which percutaneous transluminal coronary angioplasty was the primary treatment for acute myocardial infarction. Patients age > 18 years who presented wit ... Full text Link to item Cite

Clinical importance of thrombocytopenia occurring in the hospital phase after administration of thrombolytic therapy for acute myocardial infarction. The Thrombolysis and Angioplasty in Myocardial Infarction Study Group.

Journal Article J Am Coll Cardiol · March 15, 1994 OBJECTIVES: The purpose of this study was to examine the incidence and clinical implications of thrombocytopenia that occurs in hospital after administration of thrombolytic therapy for acute myocardial infarction. BACKGROUND: The use of thrombolytic thera ... Full text Link to item Cite

A randomized comparison of the effects of gradual prolonged versus standard primary balloon inflation on early and late outcome. Results of a multicenter clinical trial. Perfusion Balloon Catheter Study Group.

Journal Article Circulation · 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 ... Full text Link to item Cite

Intracranial hemorrhage risk and new thrombolytic therapies in acute myocardial infarction.

Journal Article Am 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 ... Full text Link to item Cite

Thrombolytic therapy after GUSTO: Medical roundtable discussion

Journal Article Cardiovascular Reviews and Reports · January 28, 1994 Cite

Effects of coronary angioplasty, coronary bypass surgery, and medical therapy on employment in patients with coronary artery disease. A prospective comparison study.

Journal Article Ann Intern Med · January 15, 1994 OBJECTIVE: To compare return-to-work rates after coronary angioplasty, coronary bypass surgery, and medical therapy in patients with coronary disease. DESIGN: Prospective cohort study. SETTING: Tertiary care referral center. PATIENTS: Between March 1986 an ... Full text Link to item Cite

Scorecard cardiovascular medicine. Its impact and future directions.

Journal Article Ann Intern Med · January 1, 1994 Public release of operator-specific data for cardiovascular procedures has set a new precedent, introducing the "scorecard" era. Justification exists for public disclosure, but the mechanics of appropriate data release are complex from a clinical, statisti ... Full text Link to item Cite

A randomized trial of intravenous heparin in conjunction with anistreplase (anisoylated plasminogen streptokinase activator complex) in acute myocardial infarction: the Duke University Clinical Cardiology Study (DUCCS) 1.

Journal Article J Am Coll Cardiol · January 1994 OBJECTIVES: We designed a randomized trial to evaluate the effects of heparin administration in conjunction with anistreplase (anisoylated plasminogen streptokinase activator complex [APSAC]) on arterial patency and clinical end points. BACKGROUND: The rol ... Full text Link to item Cite

Reply

Journal Article The American Journal of Cardiology · 1994 Cite

GUSTO: The principal investigators respond to the criticism

Journal Article Journal of Myocardial Ischemia · January 1, 1994 In commentaries on the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) trial published in The Journal of Myocardial Ischemia this past fall and in the current issue, Drs. Elliot Rapaport, Peter Sleight/ and Norman Sharpe ... Cite

Withdrawal of digoxin after treatment of chronic heart failure

Journal Article Annals of Internal Medicine · January 1, 1994 Cite

Coronary atherectomy versus angioplasty.

Journal Article N Engl J Med · December 16, 1993 Link to item Cite

Thrombolytic therapy for women with myocardial infarction: is there a gender gap? Thrombolysis and Angioplasty in Myocardial Infarction Study Group.

Journal Article J Am Coll Cardiol · December 1993 OBJECTIVES: The goal of this study was to investigate whether female gender portends an adverse prognosis independent of the severity of the underlying disease after acute myocardial infarction treated by thrombolysis. A total of 348 women were compared wi ... Full text Link to item Cite

Lack of usefulness of prolonged bleeding times in predicting hemorrhagic events in patients receiving the 7E3 glycoprotein IIb/IIIa platelet antibody. The TAMI Study Group.

Journal Article Am J Cardiol · November 15, 1993 Hemorrhagic events remain the most worrisome complication in patients receiving drugs that alter hemostasis for treatment of acute coronary syndromes. The 7E3 Fab monoclonal antibody provides a dose-dependent inhibition of platelet aggregation via the glyc ... Full text Link to item Cite

An analysis of the cause of early mortality after administration of thrombolytic therapy. The Thrombolysis Angioplasty in Myocardial Infarction Study Group.

Journal Article Coron 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 ... Full text Link to item Cite

Noninvasive detection of reperfusion after thrombolysis based on serum creatine kinase MB changes and clinical variables. TAMI 7 Study Group. Thrombolysis and Angioplasty in Myocardial Infarction.

Journal Article Am 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 ... Full text Link to item Cite

An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction.

Journal Article N Engl J Med · September 2, 1993 BACKGROUND: The relative efficacy of streptokinase and tissue plasminogen activator and the roles of intravenous as compared with subcutaneous heparin as adjunctive therapy in acute myocardial infarction are unresolved questions. The current trial was desi ... Full text Link to item Cite

Profound inhibition of platelet aggregation with monoclonal antibody 7E3 Fab after thrombolytic therapy. Results of the Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) 8 Pilot Study.

Journal Article J 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 ... Full text Link to item Cite

Continuous 12-lead ST-segment recovery analysis in the TAMI 7 study. Performance of a noninvasive method for real-time detection of failed myocardial reperfusion.

Journal Article Circulation · August 1993 BACKGROUND: If a practical, reliable, noninvasive marker of failed reperfusion was available in real time, the benefits of further therapy in this patient subgroup could be tested. We developed a method of 12-lead ST-segment recovery analysis using continu ... Full text Link to item Cite

A comparison of directional atherectomy with coronary angioplasty in patients with coronary artery disease. The CAVEAT Study Group.

Journal Article N Engl J Med · July 22, 1993 BACKGROUND: Directional coronary atherectomy is a new technique of coronary revascularization by which atherosclerotic plaque is excised and retrieved from target lesions. With respect to the rate of restenosis and clinical outcomes, it is not known how th ... Full text Link to item Cite

Long-term outcome following successful reopening of abrupt closure after coronary angioplasty.

Journal Article Am J Cardiol · July 1, 1993 Abrupt closure after coronary angioplasty is often successfully treated by repeat dilation. Long-term follow-up, including 6-month repeat catheterization and 12-month clinical evaluation, was obtained in 1,056 patients treated with acute (n = 335) or elect ... Full text Link to item Cite

Systolic left ventricular function after reperfusion therapy for acute myocardial infarction. Analysis of determinants of improvement. The TAMI Study Group.

Journal Article Circulation · May 1993 BACKGROUND: Contrast ventriculograms of 542 patients treated with intravenous thrombolytic agents for acute myocardial infarction were examined to define changes in left ventricular ejection fraction and regional wall motion that occur during the first wee ... Full text Link to item Cite

Minimizing the risk of inappropriately administering thrombolytic therapy (Thrombolysis and Angioplasty in Myocardial Infarction [TAMI] study group).

Journal Article Am 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 ... Full text Link to item Cite

Outcome of patients with diabetes mellitus and acute myocardial infarction treated with thrombolytic agents. The Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) Study Group.

Journal Article J Am Coll Cardiol · March 15, 1993 OBJECTIVES: This study was designed to assess outcome in patients with diabetes who received thrombolytic therapy and to determine whether differences in angiographic characteristics may account for the worse outcome observed in diabetic patients. BACKGROU ... Full text Link to item Cite

Lack of impact of early catheterization and fibrin specificity on bleeding complications after thrombolytic therapy. The TAMI Study Group.

Journal Article J Am Coll Cardiol · March 1, 1993 OBJECTIVES: The aim of this study was to assess the hemorrhagic risk associated with fibrin-specific thrombolytic therapy and invasive procedures with acute myocardial infarction. BACKGROUND: Successful coronary artery reperfusion has important prognostic ... Full text Link to item Cite

Comparison of analytic models for estimating the effect of clinical factors on the cost of coronary artery bypass graft surgery.

Journal Article J Clin Epidemiol · March 1993 The cost of treating disease depends on patient characteristics, but standard tools for analyzing the clinical predictors of cost have deficiencies. To explore whether survival analysis techniques might overcome some of these deficiencies in the analysis o ... Full text Link to item Cite

Safety and antiplatelet effect of murine monoclonal antibody 7E3 Fab directed against platelet glycoprotein IIb/IIIa in patients undergoing elective coronary angioplasty.

Journal Article Coron Artery Dis · February 1993 BACKGROUND: Excessive platelet deposition at the site of arterial damage due to coronary angioplasty plays an important role in the pathophysiology of both abrupt closure and restenosis after that procedure. Even aspirin, a relatively weak platelet antagon ... Full text Link to item Cite

Continuously updated 12-lead ST-segment recovery analysis for myocardial infarct artery patency assessment and its correlation with multiple simultaneous early angiographic observations.

Journal Article Am J Cardiol · January 15, 1993 Early angiography may not adequately subgroup patients with myocardial infarction if cyclic changes in coronary flow occur frequently. From a pilot experience using a new 12-lead ST-segment monitor, a continuously updated, self-referenced ST-recovery analy ... Full text Link to item Cite

Value of the history and physical in identifying patients at increased risk for coronary artery disease.

Journal Article Ann Intern Med · January 15, 1993 OBJECTIVE: To determine whether information from the physician's initial evaluation of patients with suspected coronary artery disease predicts coronary anatomy at catheterization and 3-year survival. DESIGN: Prospective validation of regression model esti ... Full text Link to item Cite

ST-segment recovery as an endpoint in acute myocardial infarction trials. Past, present, and future.

Journal Article J Electrocardiol · 1993 Traditional, comparative acute myocardial infarction trials have used morbidity and mortality as endpoints, requiring large study populations. Left ventricular function and angiographic infarct-related artery patency have, therefore, been used as alternati ... Link to item Cite

Individual risk assessment for intracranial haemorrhage during thrombolytic therapy

Journal Article Lancet · 1993 Thrombolytic therapy improves outcome in patients with myocardial infarction but is associated with an increased risk of intracranial haemorrhage. For some patients, this risk may outweigh the potential benefits of thrombolytic treatment. Using data from o ... Full text Cite

Effect of heparin administration on fibrinogenolysis during thrombolytic therapy with tissue plasminogen activator for acute myocardial infarction

Journal Article Fibrinolysis and Proteolysis · January 1, 1993 Heparin accelerates plasminogen activation by tissue type plasminogen activator (t-PA). Previous investigators have postulated that heparin administration during t-PA therapy might lead to enhanced fibrinogenolysis. In this paper, important coagulation par ... Full text Cite

Morbidity and mortality after first myocardial infarction

Journal Article Annals of Internal Medicine · January 1, 1993 Cite

Early ischemia after myocardial infarction in low-risk patients

Journal Article Annals of Internal Medicine · January 1, 1993 Cite

Waiting for GUSTO: Current status of thrombolytic therapy. Medical panel discussion

Journal Article Cardiovascular Reviews and Reports · January 1, 1993 Thrombolytic therapy as currently administered has proved to be one of the most important advances in the treatment of coronary artery disease in our generation. Dr. Stephen Scheidt moderates a panel of acknowledged leaders in the study of thrombolytic the ... Cite

Does reperfusion improve prognosis when mitral regurgitation complicates infarction?

Journal Article Cardiology Board Review · January 1, 1993 Cite

Managing myocardial infarction complicated by mitral regurgitation

Journal Article Primary Cardiology · January 1, 1993 Acute ischemic mitral regurgitation associated with myocardial infarction can be diagnosed by Doppler echocardiography or cardiac catheterization with ventriculography. Hemodynamically stable patients should be managed medically, with afterload reduction; ... Cite

The irony of biased editors who write editorials

Journal Article British Journal of Clinical Practice · January 1, 1993 Cite

Prognosis in cardiogenic shock after acute myocardial infarction in the interventional era.

Journal Article J Am Coll Cardiol · December 1992 OBJECTIVES: The purpose of this study is to describe the outcome in cardiogenic shock treated with aggressive reperfusion therapy and to identify factors predictive of in-hospital and long-term mortality. BACKGROUND: Cardiogenic shock is the most common ca ... Full text Link to item Cite

Survival after diagnosis of idiopathic dilated cardiomyopathy

Journal Article Annals of Internal Medicine · December 1, 1992 Cite

The risk of stroke after thrombolytic therapy.

Journal Article N Engl J Med · November 19, 1992 Full text Link to item Cite

Mechanism of benefit of combination thrombolytic therapy for acute myocardial infarction: a quantitative angiographic and hematologic study.

Journal Article J Am Coll Cardiol · November 15, 1992 OBJECTIVES: The goal of this study was to lend insight into the mechanisms responsible for the beneficial effects of combination thrombolytic therapy. BACKGROUND: Combination thrombolytic therapy for acute myocardial infarction has been associated with les ... Full text Link to item Cite

Identification of patients with coronary disease at high risk for loss of employment. A prospective validation study.

Journal Article Circulation · November 1992 BACKGROUND: Work disability is common in patients with coronary artery disease and adversely affects both economic well-being and quality of life. The purpose of this study was to construct a model to predict premature departure from the work force of pati ... Full text Link to item Cite

Observational comparison of event-free survival with medical and surgical therapy in patients with coronary artery disease. 20 years of follow-up.

Journal Article Circulation · November 1992 BACKGROUND: The purpose of this study was to describe the long-term event-free survival patterns of patients with significant coronary artery disease treated medically versus patterns of those treated surgically and to evaluate the factors associated with ... Link to item Cite

Thrombolytic Therapy for Acute Myocardial Infarction : A Review.

Journal Article Drugs · September 1992 In the past 10 years, thrombolytics have become standard therapy for acute myocardial infarction. Although the ability of streptokinase to lyse clot was first recognised in the 1930s, thrombolytic therapy was not used to treat acute myocardial infarction u ... Full text Link to item Cite

Thrombolytic therapy for elderly patients.

Journal Article N Engl J Med · July 2, 1992 Full text Link to item Cite

Outcome of patients sustaining acute ischemic mitral regurgitation during myocardial infarction.

Journal Article Ann Intern Med · July 1, 1992 OBJECTIVE: To describe outcomes of patients sustaining an acute myocardial infarction complicated by mitral regurgitation managed with contemporary reperfusion therapies. DESIGN: Inception cohort case study. Long-term follow-up was obtained in 99% of all p ... Full text Link to item Cite

A randomized trial of late reperfusion therapy for acute myocardial infarction. Thrombolysis and Angioplasty in Myocardial Infarction-6 Study Group.

Journal Article Circulation · June 1992 BACKGROUND: Experimental and observational clinical studies of acute coronary occlusion have suggested that late reperfusion prevents infarct expansion and facilitates myocardial healing. The purpose of this trial was to assess whether infarct vessel paten ... Full text Link to item Cite

Referral patterns for coronary artery disease treatment: gender bias or good clinical judgment?

Journal Article Ann Intern Med · May 15, 1992 OBJECTIVE: To determine whether a gender bias exists in referral for coronary bypass graft surgery among patients with catheterization-documented coronary artery disease. DESIGN: Historical cohort study (1969 to 1984). SETTING: A referral medical center. P ... Full text Link to item Cite

Confronting the issues of patient safety and investigator conflict of interest in an international clinical trial of myocardial reperfusion. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) Steering Committee.

Journal Article J Am Coll Cardiol · May 1992 The Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) trial is a large scale international trial of new myocardial reperfusion strategies. The primary hypothesis is that early and sustained coronary ... Full text Link to item Cite

Confronting the issues of patient safety and investigator conflict of interest in an international clinical trial of myocardial reperfusion

Journal Article Journal of the American College of Cardiology · May 1, 1992 The Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) trial is a large scale international trial of new myocardial reperfusion strategies. The primary hypothesis is that early and sustained coronary ... Cite

The diagnosis of acute myocardial infarction.

Journal Article Chest · 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 ... Full text Link to item Cite

Parenteral anticoagulation with the heparinoid Lomoparan (Org 10172) in patients with heparin induced thrombocytopenia and thrombosis.

Journal Article Thromb Haemost · March 2, 1992 Progressive thrombocytopenia may develop in as many as 5% of patients receiving heparin anticoagulation. In these patients, the risk of thromboembolic complications as well as continued thrombocytopenia necessitates discontinuation of heparin and initiatio ... Link to item Cite

Accelerated plasminogen activator dose regimens for coronary thrombolysis. The TAMI-7 Study Group.

Journal Article J Am Coll Cardiol · March 1, 1992 To determine the clinical profile and efficacy of accelerated recombinant tissue-type plasminogen activator (rt-PA) dose regimens, five different strategies of thrombolytic therapy in a total of 232 patients were systematically evaluated in the setting of ... Full text Link to item Cite

Aggressive therapy of acute MI in the elderly.

Journal Article Hosp Pract (Off Ed) · February 15, 1992 In elderly patients with myocardial infarction, clinicians face a management catch-22: Mortality is increased in the absence of therapy, which is often withheld because elderly patients may succumb to its complications. What to do? Evidence from recent stu ... Full text Link to item Cite

Exploration of rapid bedside monitoring of coagulation and fibrinolysis parameters during thrombolytic therapy.

Journal Article Blood Coagul Fibrinolysis · February 1992 Monitoring coagulation parameters during thrombolytic therapy could be useful for prediction and treatment of haemorrhagic episodes. Technology based on dry reagent chemistry has been developed that allows rapid (less than 10 min) assays on small samples o ... Full text Link to item Cite

Prognostic importance of social and economic resources among medically treated patients with angiographically documented coronary artery disease.

Journal Article JAMA · January 22, 1992 OBJECTIVE: To evaluate the hypothesis that diminished social and economic resources impact adversely on cardiovascular mortality in patients with coronary artery disease. DESIGN: Inception cohort study of patients undergoing cardiac catheterization from 19 ... Link to item Cite

Clinical risks of thrombolytic therapy.

Journal Article Am J Cardiol · January 3, 1992 Understanding the clinical risks of intravenous thrombolytic therapy is critical to appropriate patient selection. The major risks can be classified into 5 major categories: intracranial hemorrhage, systemic hemorrhage, immunologic complications, hypotensi ... Full text Link to item Cite

A computerized method for the application of coronary artery disease risk classification models to a large patient population

Conference Proceedings Computers in Cardiology Cic 1992 · January 1, 1992 We have developed a flexible and powerful coronary anatomy classification system which can be applied to the development and evaluation of qualitative and quantitative methods for assessing myocardium in jeopardy on the basis of the severity and location o ... Full text Cite

Serum cholesterol in patients undergoing cardiac catheterization for suspected coronary artery disease: diagnostic and prognostic implications.

Journal Article Ann Epidemiol · 1992 The Duke Data Bank for Cardiovascular Diseases is an observational data bank capturing baseline, treatment, and follow-up information on patients referred for evaluation of suspected coronary artery disease. From 6829 patients referred between 1969 and 199 ... Full text Link to item Cite

Evolution of an automated ST-segment analysis program for dynamic real-time, noninvasive detection of coronary occlusion and reperfusion.

Journal Article J Electrocardiol · 1992 Patients in whom early and stable reperfusion through the infarct artery fails after thrombolytic treatment might benefit from further revascularization therapy. A reliable noninvasive technique able to detect both reperfusion and reocclusion would be usef ... Full text Link to item Cite

The diagnosis of acute myocardial infarction

Journal Article Chest · 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 ... Full text Cite

Small trials and new therapies [5]

Journal Article Circulation · January 1, 1992 Cite

Why are large-scale trials needed?

Journal Article Coronary Artery Disease · January 1, 1992 Full text Cite

Observational comparison of event-free survival with medical and surgical therapy in patients with coronary artery disease: 20 Years of follow-up

Journal Article Circulation · January 1, 1992 Background. The purpose of this study was to describe the long-term event-free survival patterns of patients with significant coronary artery disease treated medically versus patterns of those treated surgically and to evaluate the factors associated with ... Cite

Determinants of the need for early acute intervention in patients treated conservatively after thrombolytic therapy for acute myocardial infarction. TAMI-5 Study Group.

Journal Article J Am Coll Cardiol · December 1991 This study sought to determine whether clinical variables can be used to identify patients at high risk of recurrent spontaneous myocardial ischemia or hemodynamic compromise during the 1st 4 days after intravenous thrombolysis for acute myocardial infarct ... Full text Link to item Cite

Determinants of early versus late cardiac death in patients undergoing coronary artery bypass graft surgery.

Journal Article Circulation · November 1991 Most analyses of risk factors affecting survival after coronary artery bypass graft surgery have not differentiated among factors that influence early and late survival. For this reason, a multiphase model was applied to survival data from 2,967 patients u ... Link to item Cite

Thrombolytic therapy in patients requiring cardiopulmonary resuscitation.

Journal Article Am J Cardiol · October 15, 1991 Cardiopulmonary resuscitation (CPR) is often considered a contraindication to thrombolytic therapy for acute myocardial infarction. Of 708 patients involved in the first 3 Thrombolysis and Angioplasty in Myocardial Infarction trials of lytic therapy for ac ... Full text Link to item Cite

Failure of adjuvant heparin to reduce myocardial ischemia in the early treatment of patients with unstable angina.

Journal Article Am Heart J · October 1991 Although the efficacy of long-term administration of antithrombotic agents in unstable angina has been established, short-term effects on myocardial ischemia are unknown. A retrospective analysis was performed in 47 patients undergoing three-channel contin ... Full text Link to item Cite

Prognostic value of a treadmill exercise score in outpatients with suspected coronary artery disease.

Journal Article N Engl J Med · September 19, 1991 BACKGROUND: The treadmill exercise test identifies patients with different degrees of risk of death from cardiovascular events. We devised a prognostic score, based on the results of treadmill exercise testing, that accurately predicts outcome among inpati ... Full text Link to item Cite

Coronary bypass surgery improves global and regional left ventricular function following thrombolytic therapy for acute myocardial infarction. TAMI Study Group.

Journal Article Am Heart J · August 1991 Coronary bypass surgery was performed prior to hospital discharge in 303 (22%) of 1387 consecutive patients enrolled in the TAMI 1 to 3 and 5 trials of intravenous thrombolytic therapy for acute myocardial infarction. Bypass surgery was of emergency nature ... Full text Link to item Cite

Evaluation of combination thrombolytic therapy and timing of cardiac catheterization in acute myocardial infarction. Results of thrombolysis and angioplasty in myocardial infarction--phase 5 randomized trial. TAMI Study Group.

Journal Article Circulation · May 1991 Recent trials of myocardial reperfusion using single-agent thrombolytic therapy and sequential cardiac catheterization have supported a conservative approach to the patient with acute myocardial infarction. To evaluate combination thrombolytic therapy and ... Full text Link to item Cite

Estimating the likelihood of severe coronary artery disease.

Journal Article Am J Med · May 1991 PURPOSE: To determine which clinical characteristics obtained by a physician during an initial clinical examination are important for estimating the likelihood of severe coronary artery disease, and to determine whether estimates based on these characteris ... Link to item Cite

Restenosis after coronary angioplasty: an overview.

Journal Article J 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 ... Full text Link to item Cite

Multivessel coronary artery disease: a key predictor of short-term prognosis after reperfusion therapy for acute myocardial infarction. Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) Study Group.

Journal Article Am Heart J · April 1991 Results of recent studies have suggested that routine cardiac catheterization may be unnecessary after reperfusion therapy for acute myocardial infarction. Therefore to better define the short-term prognostic value of early coronary angiography, and specif ... Full text Link to item Cite

Identification of acute myocardial infarction patients suitable for early hospital discharge after aggressive interventional therapy. Results from the Thrombolysis and Angioplasty in Acute Myocardial Infarction Registry.

Journal Article Circulation · April 1991 BACKGROUND: Very early (day 4) hospital discharge has recently been proposed for selected patients with acute myocardial infarction (MI). The purpose of this study was to determine the most useful factors for identifying acute MI patients treated with aggr ... Full text Link to item Cite

Correlation between baseline plasminogen activator inhibitor levels and clinical outcome during therapy with tissue plasminogen activator for acute myocardial infarction.

Journal Article Thromb Haemost · March 4, 1991 Baseline plasminogen activator inhibitor (PAI) levels were examined for their influence on the responses to thrombolysis with recombinant tissue plasminogen activator (rt-PA) administered for acute myocardial infarction during the Thrombolysis and Myocardi ... Link to item Cite

The use of intraaortic balloon pumping as an adjunct to reperfusion therapy in acute myocardial infarction. The Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) Study Group.

Journal Article Am 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 ... Full text Link to item Cite

Pericardial effusion after intravenous recombinant tissue-type plasminogen activator for acute myocardial infarction.

Journal Article Am J Cardiol · March 1, 1991 The effect of thrombolytic therapy on the frequency, time course and sequelae of pericardial effusion after myocardial infarction are unknown. A prospective, serial, 2-dimensional echocardiographic study of patients with myocardial infarction who received ... Full text Link to item Cite

Complete atrioventricular block complicating inferior wall acute myocardial infarction treated with reperfusion therapy. TAMI Study Group.

Journal Article Am J Cardiol · February 1, 1991 Previous studies report larger myocardial infarcts and increased in-hospital mortality rates in patients with inferior wall acute myocardial infarction (AMI) and complete atrioventricular block (AV), but the clinical implications of these complications in ... Full text Link to item Cite

Myocardial infarction with minimal coronary atherosclerosis in the era of thrombolytic reperfusion. The Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) Study Group.

Journal Article J Am Coll Cardiol · February 1991 The incidence of minimal residual atherosclerotic coronary obstruction after successful intravenous thrombolytic therapy was evaluated in 799 patients with acute myocardial infarction. Minimal residual coronary obstruction (less than or equal to 50%) was o ... Full text Link to item Cite

Intravenous Heparin, Thrombolytics, and Medical Marketing

Journal Article Journal of Interventional Cardiology · January 1, 1991 Full text Cite

Racial differences in responses to thrombolytic therapy with recombinant tissue-type plasminogen activator. Increased fibrin(ogen)olysis in blacks. The Thrombolysis and Angioplasty in Myocardial Infarction Study Group.

Journal Article Circulation · January 1991 To determine whether there are differences in responses to thrombolytic therapy in certain populations, the data for the Thrombolysis and Angioplasty in Myocardial Infarction (phase 1) study were analyzed for black and white patients. Baseline variables in ... Full text Link to item Cite

Effectiveness of high-dose urokinase for acute myocardial infarction

Journal Article Cardiology Board Review · January 1, 1991 Cite

Intra-aortic balloon pumping: Benefits after thrombolytic therapy

Journal Article Cardiology Board Review · January 1, 1991 Cite

Usefulness of a pericardial friction rub after thrombolytic therapy during acute myocardial infarction in predicting amount of myocardial damage. The TAMI Study Group.

Journal Article Am J Cardiol · December 15, 1990 To evaluate the clinical incidence and outcomes of patients with pericarditis after thrombolytic therapy, 810 patients were prospectively studied during acute myocardial infarction (AMI). Pericarditis was defined as the presence of a pericardial friction r ... Full text Link to item Cite

Precordial ST segment depression predicts a worse prognosis in inferior infarction despite reperfusion therapy. The Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) Study Group.

Journal Article J Am Coll Cardiol · December 1990 The impact of associated precordial ST segment depression in inferior myocardial infarction on angiographic and clinical outcomes after thrombolytic therapy and selective coronary angioplasty was studied in 583 patients with acute myocardial infarction. An ... Full text Link to item Cite

Left ventricular ejection fraction may not be useful as an end point of thrombolytic therapy comparative trials.

Journal Article Circulation · November 1990 In the era of comparative and adjunctive trials in reperfusion therapy, the need to develop alternative end points for mortality reduction is clear. Left ventricular ejection fraction, which has been commonly used as a surrogate, is problematic due to miss ... Full text Link to item Cite

Resource use and cost of initial coronary revascularization. Coronary angioplasty versus coronary bypass surgery.

Journal Article Circulation · November 1990 Although there is intense interest in the cost-saving potential of therapeutic alternatives, most studies have analyzed hospital charges rather than actual economic costs. To analyze cost differences rigorously, we studied 115 patients undergoing initial e ... Link to item Cite

Prognostic value of radionuclide angiography in medically treated patients with coronary artery disease. A comparison with clinical and catheterization variables.

Journal Article Circulation · November 1990 To evaluate the usefulness of multiple measures from rest and exercise radionuclide angiography (RNA) in predicting cardiovascular death and cardiovascular events (death or nonfatal myocardial infarction) and to assess the prognostic usefulness of the RNA ... Full text Link to item Cite

Fate of patients with acute myocardial infarction with patency of the infarct-related vessel achieved with successful thrombolysis versus rescue angioplasty.

Journal Article J Am Coll Cardiol · October 1990 Patients with failure of infarct-related artery recanalization after thrombolytic therapy have a poor clinical outcome. These patients have been considered for rescue angioplasty 90 min after thrombolytic therapy at the time of emergency catheterization in ... Full text Link to item Cite

Two-year outcome after angiographically documented myocardial reperfusion for acute coronary occlusion. Thrombolysis and Angioplasty Study Group.

Journal Article Am J Cardiol · October 1, 1990 Reperfusion therapy has been clearly shown to decrease the early mortality after acute myocardial infarction, but the impact of this therapy on long-term survival has been less extensively evaluated. This study reports the extended follow-up of a large coh ... Full text Link to item Cite

Consequences of reocclusion after successful reperfusion therapy in acute myocardial infarction. TAMI Study Group.

Journal Article Circulation · 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 ... Full text Link to item Cite

Stroke and acute myocardial infarction in the thrombolytic era: clinical correlates and long-term prognosis.

Journal Article J Am Coll Cardiol · September 1990 Thirteen (1.8%) of 708 patients with acute myocardial infarction treated with recombinant tissue-type plasminogen activator in the Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) I, II and III trials developed a stroke. Four strokes were hemor ... Full text Link to item Cite

Intravenous recombinant tissue-type plasminogen activator in patients with unstable angina pectoris. Results of a placebo-controlled, randomized trial.

Journal Article Circulation · August 1990 Because thrombus formation may contribute to coronary obstruction in patients with unstable angina pectoris, we performed a pilot investigation to determine whether thrombolytic therapy can relieve coronary narrowing in this acute ischemic syndrome. Sixty- ... Full text Link to item Cite

Cardiac rupture, mortality and the timing of thrombolytic therapy: a meta-analysis.

Journal Article J Am Coll Cardiol · August 1990 This study examined the relation between the risk of cardiac rupture and the timing of thrombolytic therapy for acute myocardial infarction. To test the hypothesis that cardiac rupture is prevented by early thrombolytic therapy but is promoted by late trea ... Full text Link to item Cite

Brachial approach to emergency cardiac catheterization during thrombolytic therapy for acute myocardial infarction. TAMI Study Group.

Journal Article Cathet Cardiovasc Diagn · August 1990 The use of the brachial approach to acute coronary intervention has not been previously studied. In the course of the Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) trials, we used the transbrachial approach to cardiac catheterization with or ... Full text Link to item Cite

One-year outcome after therapy with tissue plasminogen activator: report from the Thrombolysis and Angioplasty in Myocardial Infarction trial.

Journal Article Am Heart J · April 1990 To evaluate the long-term effects of reperfusion with tissue plasminogen activator (t-PA) and an aggressive strategy of revascularization with angioplasty and coronary artery bypass grafting, we obtained 1-year follow-up results from 386 consecutive patien ... Full text Link to item Cite

At home thrombolysis.

Journal Article J Am Coll Cardiol · April 1990 Full text Link to item Cite

Relationship between antecedent angina pectoris and short-term prognosis after thrombolytic therapy for acute myocardial infarction. Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) Study Group.

Journal Article Am Heart J · February 1990 The relationship between preinfarction clinical status and short-term outcome was prospectively evaluated in 775 patients hospitalized with acute myocardial infarction after reperfusion therapy. It was anticipated that a history of angina preceding myocard ... Full text Link to item Cite

Feasibility and cost-saving potential of outpatient cardiac catheterization.

Journal Article J Am Coll Cardiol · February 1990 To determine the feasibility and cost-saving potential of substituting outpatient for inpatient cardiac catheterization, 986 consecutive procedures were studied at a large referral hospital. Patients were classified prospectively as to their eligibility fo ... Full text Link to item Cite

Results of high dose intravenous urokinase for acute myocardial infarction.

Journal Article Am J Cardiol · January 15, 1990 To determine the outcome of patients after treatment with high-dose intravenous urokinase (3 million U) 102 patients were prospectively evaluated in the setting of acute myocardial infarction. The first 61 patients received intravenous urokinase as a conti ... Full text Link to item Cite

Clinical judgment and therapeutic decision making.

Journal Article J Am Coll Cardiol · January 1990 Clinical decision making is under increased scrutiny due to concerns about the cost and quality of medical care. Variability in physician decision making is common, in part because of deficiencies in the knowledge base, but also due to the difference in ph ... Full text Link to item Cite

Detection of restenosis after elective percutaneous transluminal coronary angioplasty using the exercise treadmill test.

Journal Article Am J Cardiol · January 1, 1990 To determine the value of a 6-month exercise treadmill test for detecting restenosis after elective percutaneous transluminal coronary angioplasty (PTCA), 303 consecutive patients with successful PTCA and without a recent myocardial infarction were studied ... Full text Link to item Cite

·P-18 Need an endpoint for a clinical trial? Just ask

Journal Article Controlled Clinical Trials · January 1, 1990 Full text Cite

Resource use and cost of initial coronary revascularization: Coronary angioplasty versus coronary bypass surgery

Journal Article Circulation · 1990 Although there is intense interest in the cost-saving potential of therapeutic alternatives, most studies have analyzed hospital charges rather than actual economic costs. To analyze cost differences rigorously, we studied 115 patients undergoing initial e ... Cite

Thrombolytic therapy: overview of clinical trials

Journal Article Coronary 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 ... Full text Cite

Resource use and cost of initial coronary revascularization: Coronary angioplasty versus coronary bypass surgery

Journal Article Circulation · January 1, 1990 Although there is intense interest in the cost-saving potential of therapeutic alternatives, most studies have analyzed hospital charges rather than actual economic costs. To analyze cost differences rigorously, we studied 115 patients undergoing initial e ... Cite

Bleeding during thrombolytic therapy for acute myocardial infarction: mechanisms and management.

Journal Article Ann Intern Med · December 15, 1989 Hemorrhage is the major adverse effect of thrombolytic therapy, but its incidence can be reduced by careful selection of patients and avoidance of unnecessary invasive procedures. More than 70% of bleeding episodes occur at vascular puncture sites. Hypofib ... Full text Link to item Cite

Exercise treadmill testing is a poor predictor of anatomic restenosis after angioplasty for acute myocardial infarction.

Journal Article Circulation · December 1989 This study evaluated whether an exercise treadmill test could predict restenosis in 289 patients 6 months after a successful emergency angioplasty of the infarct-related artery for acute myocardial infarction. After excluding those with interim interventio ... Full text Link to item Cite

Pharmacodynamics of thrombolysis with recombinant tissue-type plasminogen activator. Correlation with characteristics of and clinical outcomes in patients with acute myocardial infarction. The TAMI Study Group.

Journal Article Circulation · November 1989 Coagulation analysis was performed on blood samples from 386 patients with acute myocardial infarction drawn before, during, and after a continuous intravenous infusion of 150 mg recombinant tissue-type plasminogen activator (rt-PA) (Activase). Plasma rt-P ... Full text Link to item Cite

Recurrent ischemia without warning. Analysis of risk factors for in-hospital ischemic events following successful thrombolysis with intravenous tissue plasminogen activator.

Journal Article Circulation · November 1989 Ischemic events after successful thrombolysis have been reported to occur in 18-32% of patients treated for acute myocardial infarction with thrombolytic therapy, and previous studies in which patients received streptokinase suggest that risk of early recu ... Full text Link to item Cite

Combined tissue-type plasminogen activator and prostacyclin therapy for acute myocardial infarction. Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) 4 Study Group.

Journal Article J Am Coll Cardiol · October 1989 Current limitations of recombinant tissue-type plasminogen activator (rt-PA) therapy for acute myocardial infarction include failure to achieve recanalization in 25% of patients, reocclusion and reperfusion injury. Iloprost, a stable analogue of prostacycl ... Full text Link to item Cite

Painless exercise ST deviation on the treadmill: long-term prognosis.

Journal Article J Am Coll Cardiol · October 1989 To evaluate the clinical correlates and long-term prognostic significance of silent ischemia during exercise, 1,698 consecutive symptomatic patients with coronary artery disease who had both treadmill testing and cardiac catheterization were studied. These ... Full text Link to item Cite

A brief self-administered questionnaire to determine functional capacity (the Duke Activity Status Index).

Journal Article Am J Cardiol · September 15, 1989 To develop a brief, self-administered questionnaire that accurately measures functional capacity and assesses aspects of quality of life, 50 subjects undergoing exercise testing with measurement of peak oxygen uptake were studied. All subjects were questio ... Full text Link to item Cite

Continuous computer-assisted electrocardiographic monitoring in patients with acute myocardial infarction: Early experience

Journal Article Computers in Cardiology · September 1, 1989 Results of 3311 h of continuous digital 12-lead ST segment monitoring in a pilot population of 77 patients treated early in myocardial infarction (MI) with thrombolytic therapy are reported. 'Mean beat' signal processing over 353 min of monitoring in 12 pa ... Cite

Favorable early and long-term prognosis following coronary bypass surgery therapy for myocardial infarction: results of a multicenter trial. TAMI Study Group.

Journal Article Am Heart J · August 1989 Coronary bypass surgery was performed before hospital discharge on 82 (21%) of 386 consecutive patients enrolled in the Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) multicenter trial of intravenous tissue plasminogen activator and coronary ... Full text Link to item Cite

Prognostic implications and predictors of enhanced regional wall motion of the noninfarct zone after thrombolysis and angioplasty therapy of acute myocardial infarction. The TAMI Study Groups.

Journal Article Circulation · August 1989 Although impairment of left ventricular function in acute myocardial infarction is closely related to extent of necrosis, function in the noninfarct zone also contributes to global performance and thus may be of prognostic importance. We evaluated left ven ... Full text Link to item Cite

Correlates of survival in patients with postinfarction ventricular septal defect.

Journal Article Ann Thorac Surg · June 1989 Prognostic indicators of survival in 42 consecutive patients (21 men and 21 women) with postinfarction ventricular septal defect were reviewed. Infarct location was anterior in 57%, inferior in 33%, and combined in 10%. The hospital mortality among 9 patie ... Full text Link to item Cite

Tissue plasminogen activator: why the backlash?

Journal Article J Am Coll Cardiol · June 1989 Full text Link to item Cite

Coronary bypass surgery in chronic stable angina.

Journal Article Circulation · June 1989 Over the last 20 years, operative mortality has decreased and late survival has improved for patients with chronic stable angina who have coronary artery bypass surgery. However, this favorable trend may not continue because the operation is now extended t ... Link to item Cite

Early treatment with intravenous metoprolol for suspected acute myocardial infarction: a phase IV United States trial. Phase IV Metoprolol in Myocardial Infarction Study Group.

Journal Article Int J Cardiol · May 1989 Recent randomized clinical trials have shown that total mortality and cardiovascular mortality are reduced by the early intravenous administration of beta-blockers to patients suspected of suffering from acute myocardial infarction. These trials were condu ... Full text Link to item Cite

Clinical experience and predicting survival in coronary disease.

Journal Article Arch Intern Med · May 1989 To study the accuracy with which long-term prognosis can be predicted in patients with coronary artery disease, prognostic predictions obtained from a large, diverse sample of practicing cardiologists were compared with predictions from a multivariable sta ... Link to item Cite

The evolution of medical and surgical therapy for coronary artery disease. A 15-year perspective.

Journal Article JAMA · April 14, 1989 To elucidate the factors associated with improved survival following coronary artery bypass surgery, we studied 5809 patients receiving medical or surgical therapy for coronary artery disease. Three factors were associated with a significant surgical survi ... Link to item Cite

Myocardial reperfusion: is it ever too late?

Journal Article J Am Coll Cardiol · April 1989 Full text Link to item Cite

Current management of mitral valve incompetence associated with coronary artery disease.

Journal Article J Card Surg · March 1989 At a time when hospital mortality for adult cardiac operations is continuing to fall, the combined mitral valve coronary bypass subset remains at relatively high risk. Efforts to improve results should be directed toward a more general application of mitra ... Full text Link to item Cite

Repeat percutaneous transluminal coronary angioplasty and predictors of recurrent restenosis.

Journal Article Am J Cardiol · February 15, 1989 One hundred seventeen consecutive patients undergoing repeat percutaneous transluminal coronary angioplasty (PTCA) were studied to assess procedural success and recurrent restenosis rates. Clinical, anatomic and procedural variables were examined as predic ... Full text Link to item Cite

Prediction of early recurrent myocardial ischemia and coronary reocclusion after successful thrombolysis: a qualitative and quantitative angiographic study.

Journal Article Am J Cardiol · February 15, 1989 To determine the association of qualitative and quantitative measurements of the myocardial infarct-related coronary narrowing with subsequent recurrent ischemia/reocclusion after successful thrombolysis, 47 patients treated with high-dose (150 mg) tissue ... Full text Link to item Cite

A randomized controlled trial of intravenous tissue plasminogen activator and early intravenous heparin in acute myocardial infarction.

Journal Article Circulation · February 1989 To evaluate the coronary thrombolytic efficacy of tissue plasminogen activator (t-PA) and early intravenous heparin, 134 patients with acute myocardial infarction were randomly assigned to combination therapy or t-PA only. At a median of 2.78 hours from sy ... Full text Link to item Cite

Thrombolysis and Angioplasty in Myocardial Infarction (TAMI-1) trial: influence of infarct location on arterial patency, left ventricular function and mortality.

Journal Article J Am Coll Cardiol · January 1989 The influence of infarct location on arterial patency, left ventricular function and mortality after 150 mg of intravenous recombinant tissue-type plasminogen activator (rt-PA) and selective coronary angioplasty was studied in 386 patients with acute myoca ... Full text Link to item Cite

Coronary bypass surgery in chronic stable angina

Journal Article Circulation · 1989 Over the last 20 years, operative mortality has decreased and late survival has improved for patients with chronic stable angina who have coronary artery bypass surgery. However, this favorable trend may not continue because the operation is now extended t ... Cite

Coronary bypass surgery in chronic stable angina

Journal Article Circulation · January 1, 1989 Over the last 20 years, operative mortality has decreased and late survival has improved for patients with chronic stable angina who have coronary artery bypass surgery. However, this favorable trend may not continue because the operation is now extended t ... Cite

Insights derived from the thrombolysis and angioplasty in myocardial infarction (TAMI) trials.

Journal Article J Am Coll Cardiol · December 1988 In the first three phases of Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) multicenter trials, 708 patients received intravenous recombinant tissue-type plasminogen activator (rt-PA) and underwent detailed assessment of clinical, angiographi ... Full text Link to item Cite

Administration of thrombolytic therapy in the community hospital: established principles and unresolved issues.

Journal Article J Am Coll Cardiol · December 1988 In patients with acute myocardial infarction presenting to community hospitals, thrombolytic therapy should be initiated as rapidly as possible under the supervision of a physician. Paramedic or nurse-initiated pre-hospital therapy is currently investigati ... Full text Link to item Cite

Experience with the use of tPA in the treatment of acute myocardial infarction.

Journal Article Ann Emerg Med · November 1988 Early experience with the use of tissue plasminogen activator (tPA) in acute myocardial infarction is reviewed, including comparisons with other thrombolytic agents, a summary of hemorrhagic complications associated with its use, and the rationale for adju ... Full text Link to item Cite

Hemorrhagic complications associated with the use of intravenous tissue plasminogen activator in treatment of acute myocardial infarction.

Journal Article Am J Med · September 1988 PURPOSE: Little attention has been paid to the importance of clinical factors associated with bleeding complications caused by the use of thrombolytic agents. The goal of our study was to examine clinical and hematologic factors associated with an increase ... Full text Link to item Cite

Heart attack.

Journal Article N C Med J · September 1988 Link to item Cite

Current prognosis of ischemic mitral regurgitation. Implications for future management.

Journal Article Circulation · September 1988 Ischemic mitral regurgitation is a serious and increasingly common clinical disorder, but at present, little is known of the associated prognostic implications, especially in specific therapeutic subgroups. Over a 6.5-year period beginning January 1, 1981, ... Link to item Cite

Surgical survival benefits for coronary disease patients with left ventricular dysfunction.

Journal Article Circulation · September 1988 Controversy still exists about the proper selection of patients with coronary artery disease and left ventricular dysfunction for coronary bypass surgery. To examine this issue, we studied 710 patients with significant coronary artery disease and left vent ... Link to item Cite

Changing efficacy of coronary revascularization. Implications for patient selection.

Journal Article Circulation · September 1988 To evaluate the potential impact of patient selection for coronary artery bypass graft surgery on long-term survival, the outcomes of 5,809 consecutive patients with symptomatic coronary disease documented by angiography at Duke University Medical Center w ... Link to item Cite

Survival and cardiac event rates in the first year after emergency coronary angioplasty for acute myocardial infarction.

Journal Article J Am Coll Cardiol · June 1988 One year survival and event-free survival rates were analyzed in 342 patients with acute myocardial infarction who were consecutively enrolled in a treatment protocol of early intravenous thrombolytic therapy followed by emergency coronary angioplasty. Nin ... Full text Link to item Cite

Coronary arterial thrombolysis with combined infusion of recombinant tissue-type plasminogen activator and urokinase in patients with acute myocardial infarction.

Journal Article Circulation · May 1988 To determine whether tissue-type plasminogen activator (t-PA) and urokinase (UK) act synergistically to achieve coronary thrombolysis, incremental doses of both drugs were infused intravenously over 60 min. In 146 consecutive patients treated 3.0 +/- 1.0 h ... Full text Link to item Cite

Characteristics and outcome of patients in whom reperfusion with intravenous tissue-type plasminogen activator fails: results of the Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) I trial.

Journal Article Circulation · May 1988 To examine the outcome of patients with persistent coronary artery occlusion despite treatment with intravenous tissue-type plasminogen activator (t-PA), the clinical course of 96 patients with persistent occlusion after 90 min of therapy was evaluated. Al ... Full text Link to item Cite

Emergency coronary artery bypass surgery preserves global and regional left ventricular function after intravenous tissue plasminogen activator therapy for acute myocardial infarction.

Journal Article J Am Coll Cardiol · May 1988 Emergency coronary bypass surgery was performed in 24 (6.2%) of 386 consecutive patients enrolled in the Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) Multicenter Trial. Intravenous tissue plasminogen activator was administered 2.6 +/- 0.7 h ... Full text Link to item Cite

Comparison of time domain and frequency domain variables from the signal-averaged electrocardiogram: a multivariable analysis.

Journal Article J Am Coll Cardiol · May 1988 The relative values of the unprocessed signal-averaged electrocardiogram (ECG) and time domain analysis and frequency domain analysis of the signal-averaged ECG were compared in 36 patients with sustained monomorphic ventricular tachycardia and a remote my ... Full text Link to item Cite

Failure of simple clinical measurements to predict perfusion status after intravenous thrombolysis.

Journal Article Ann Intern Med · May 1988 To determine whether coronary patency could be detected early during thrombolytic therapy, commonly used markers of perfusion were recorded in 386 patients with acute myocardial infarction treated with tissue plasminogen activator. Infarct artery angiograp ... Full text Link to item Cite

Comparison of two dose regimens of intravenous tissue plasminogen activator for acute myocardial infarction.

Journal Article Am J Cardiol · April 1, 1988 Two dosing schedules of intravenous tissue plasminogen activator (t-PA) for acute myocardial infarction were compared in a multicenter trial. At 2.95 +/- 1.1 hours from onset of chest pain, 386 patients received 150 mg of intravenous t-PA. For the first 17 ... Full text Link to item Cite

Late restenosis after emergent coronary angioplasty for acute myocardial infarction: comparison with elective coronary angioplasty.

Journal Article J Am Coll Cardiol · April 1988 The late restenosis rate after emergent percutaneous transluminal coronary angioplasty for acute myocardial infarction was assessed by performing outpatient follow-up cardiac catheterization in 79 (87%) of 91 consecutive patients who had been discharged fr ... Full text Link to item Cite

Helicopter transport of patients during acute myocardial infarction.

Journal Article Am J Cardiol · April 1, 1988 Initial experience with a regional system of emergency helicopter transport of patients with acute myocardial infarction (AMI) referred for emergent cardiac catheterization and percutaneous transluminal coronary angioplasty (PTCA) is described. Two hundred ... Full text Link to item Cite

Trends in physician management of uncomplicated acute myocardial infarction, 1970 to 1987.

Journal Article Am J Cardiol · March 1, 1988 To document current management of uncomplicated acute myocardial infarction (AMI), a national survey of 1,065 physicians was performed. Items from previous surveys in 1970 and 1979 were included to permit analysis of time trends in management. Median hospi ... Full text Link to item Cite

Adoption of thrombolytic therapy in the management of acute myocardial infarction.

Journal Article Am J Cardiol · March 1, 1988 A national survey of 1,065 physicians was carried out to document current use of thrombolytic therapy for acute myocardial infarction (AMI). In early 1987, thrombolytic therapy was used by 66% of respondents. Among those who used thrombolytic therapy, 92% ... Full text Link to item Cite

A clinical comparison of mitral valve repair versus valve replacement in ischemic mitral regurgitation.

Journal Article J Thorac Cardiovasc Surg · February 1988 Severe mitral regurgitation caused by acute myocardial infarction has been a particularly difficult management problem with disappointing clinical results. Over a 75-month period, ending March 31, 1987, 611 patients underwent mitral valve operations at Duk ... Link to item Cite

Comparison of predictions based on observational data with the results of randomized controlled clinical trials of coronary artery bypass surgery.

Journal Article J Am Coll Cardiol · February 1988 Clinical decisions are most secure when based on findings from several large randomized clinical trials, but relevant randomized trial data are often unavailable. Analyses using clinical data bases might provide useful information if statistical methods ca ... Full text Link to item Cite

Quantitative analysis of right and left ventricular infarction in the presence of postinfarction ventricular septal defect.

Journal Article Circulation · January 1988 To quantitate the amount of right and left ventricular infarction in patients dying with postinfarction ventricular septal defect (PIVSD), hearts from 54 patients with anterior or inferior myocardial infarction were studied at autopsy. Fifteen hearts had m ... Full text Link to item Cite

Prognostic value of the simplified Selvester QRS score in patients with coronary artery disease.

Journal Article J Am Coll Cardiol · January 1988 The relation of the simplified Selvester QRS scoring system for the estimation of myocardial infarct size to survival was studied in 1,915 nonsurgically treated patients with documented coronary artery disease. Electrocardiograms (ECGs) were scored accordi ... Full text Link to item Cite

Importance of clinical measures of ischemia in the prognosis of patients with documented coronary artery disease.

Journal Article J Am Coll Cardiol · January 1988 To examine the value of clinical measures of ischemia for stratifying prognosis, 5,886 consecutive patients who had symptomatic significant (greater than or equal to 75% stenosis) coronary artery disease were studied. Using the Cox regression model in a ra ... Full text Link to item Cite

Coronary perfusion during acute myocardial infarction with a combined therapy of coronary angioplasty and high-dose intravenous streptokinase.

Journal Article Circulation · January 1988 Two hundred and sixteen patients with acute myocardial infarction were treated with immediate infusion of high-dose (1.5 million units) intravenous streptokinase followed by emergency coronary angioplasty. The infarct lesion was crossed and dilated in 99% ... Full text Link to item Cite

Interventional Cardiac Catheterization at Duke Medical Center - The Duke Interventional Cardiac Catheterization Program

Journal Article American Journal of Cardiology · January 1, 1988 Clinical perspective: Cardiac revascularization in a wide range of patients with coronary artery disease is the underlying mission of Duke University's Interventional Cardiac Catheterization Program, one of the largest of its kind in the United States. Und ... Cite

New international technology: The autoperfusion balloon catheter

Journal Article American Journal of Cardiology · January 1, 1988 Clinical perspective: Balloon angioplasty reduces mortality and morbidity in AMI and coronary artery disease patients, but the procedure has major limitations. Acute failure requiring an emergency response is not uncommon, and the restenosis rate is greate ... Cite

Limitations of balloon angioplasty: Possible causes of restenosis

Journal Article American Journal of Cardiology · January 1, 1988 Clinical perspective: Much needs to be learned about the precise physiologic and biochemical actions and effects of thrombolytic therapy and PTCA in various settings. In particular, the factors influencing restenosis must be elucidated. ... Cite

Current prognosis of ischemic mitral regurgitation. Implications for future management

Journal Article Circulation · 1988 Ischemic mitral regurgitation is a serious and increasingly common clinical disorder, but at present, little is known of the associated prognostic implications, especially in specific therapeutic subgroups. Over a 6.5-year period beginning January 1, 1981, ... Cite

Balloon angioplasty in acute myocardial infarction - Limitations of thrombolytic therapy when used alone

Journal Article American Journal of Cardiology · 1988 Clinical perspective: Although thrombolytic therapy offers important, often life-preserving benefits to many AMI patients, its effectiveness is limited in several crucial respects: it does not achieve reperfusion in a substantial percentage of patients, no ... Cite

Surgical survival benefits for coronary disease patients with left ventricular dysfunction

Journal Article Circulation · 1988 Controversy still exists about the proper selection of patients with coronary artery disease and left ventricular dysfunction for coronary bypass surgery. To examine this issue, we studied 710 patients with significant coronary artery disease and left vent ... Cite

Current prognosis of ischemic mitral regurgitation. Implications for future management

Journal Article Circulation · January 1, 1988 Ischemic mitral regurgitation is a serious and increasingly common clinical disorder, but at present, little is known of the associated prognostic implications, especially in specific therapeutic subgroups. Over a 6.5-year period beginning January 1, 1981, ... Cite

Surgical survival benefits for coronary disease patients with left ventricular dysfunction

Journal Article Circulation · January 1, 1988 Controversy still exists about the proper selection of patients with coronary artery disease and left ventricular dysfunction for coronary bypass surgery. To examine this issue, we studied 710 patients with significant coronary artery disease and left vent ... Cite

Changing efficacy of coronary revascularization. Implications for patient selection

Journal Article Circulation · January 1, 1988 To evaluate the potential impact of patient selection for coronary artery bypass graft surgery on long-term survival, the outcomes of 5,809 consecutive patients with symptomatic coronary disease documented by angiography at Duke University Medical Center w ... Cite

USE OF COMPUTERIZED STATISTICAL MODELS TO EDUCATE MEDICAL HOUSESTAFF IN ESTIMATING CLINICAL OUTCOMES.

Journal Article Proceedings Annual Symposium on Computer Applications in Medical Care · December 1, 1987 The suggestion that computerized diagnostic and prognostic predictions from statistical models would improve the ability of medical housestaff to estimate outcomes in patients with coronary artery disease (CAD) was experimentally tested. Interns made estim ... Cite

Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) trial.

Journal Article J Am Coll Cardiol · November 1987 The Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) trial was a randomized, multicenter study performed to determine whether immediate or elective (7 day) coronary angioplasty was preferable once infarct vessel recanalization had been confirme ... Full text Link to item Cite

The changing survival benefits of coronary revascularization over time.

Journal Article Circulation · November 1987 Previous comparisons of medical and surgical therapy for coronary artery disease were performed in the 1970s and may need to be updated to reflect current treatment efficacy. The purpose of this investigation was to determine the impact on long-term patien ... Link to item Cite

Outcome in suspected acute myocardial infarction with normal or minimally abnormal admission electrocardiographic findings.

Journal Article Am J Cardiol · October 1, 1987 Seven hundred seventy-five consecutive patients with symptoms suggestive of acute myocardial infarction (AMI) who were admitted to the cardiac care unit from the emergency room were studied; 107 had normal electrocardiographic findings and 73 had only mini ... Full text Link to item Cite

A randomized trial of immediate versus delayed elective angioplasty after intravenous tissue plasminogen activator in acute myocardial infarction.

Journal Article N Engl J Med · September 3, 1987 We compared the efficacy of immediate coronary angioplasty after acute myocardial infarction with that of elective angioplasty at 7 to 10 days in patients treated initially with intravenous tissue plasminogen activator. The plasminogen activator (150 mg) w ... Full text Link to item Cite

Exercise treadmill score for predicting prognosis in coronary artery disease.

Journal Article Ann Intern Med · June 1987 To determine the prognostic value of the treadmill exercise test, we evaluated 2842 consecutive patients with chest pain who had both treadmill testing cardiac catheterization. The population was randomly divided into two equal-sized groups and the Cox reg ... Full text Link to item Cite

Rethinking sensitivity and specificity.

Journal Article Am J Cardiol · May 1, 1987 Full text Link to item Cite

Cine MR determination of left ventricular ejection fraction.

Journal Article AJR Am J Roentgenol · May 1987 Cine MR imaging provides tomographic images of the heart with both high spatial and high temporal resolution. As many as 32 images per cardiac cycle can be acquired with up to four separate anatomic slices and a total imaging time of 128 cardiac cycles. En ... Full text Link to item Cite

Prognostic effect of bundle branch block related to coronary artery bypass grafting.

Journal Article Am J Cardiol · April 1, 1987 The incidence and prognostic effect of the development of new perioperative ventricular conduction abnormalities were examined in all patients undergoing coronary artery bypass surgery at Duke University Medical Center between 1976 and 1981. Of the 913 pat ... Full text Link to item Cite

Medical approaches to prevention of restenosis after coronary angioplasty.

Journal Article J Am Coll Cardiol · April 1987 Although initial success rates for coronary angioplasty have improved, the rate of restenosis within 6 months of the procedure has persisted at 30 to 40%. The relation of restenosis to initial success, recurrence of symptoms and risk factors suggests that ... Full text Link to item Cite

Identification of the optimal electrocardiographic leads for detecting acute epicardial injury in acute myocardial infarction.

Journal Article Am J Cardiol · January 1, 1987 Current coronary care electrocardiographic (ECG) monitoring techniques are aimed at detection of cardiac arrhythmias rather than myocardial ischemia. However, in patients with acute myocardial infarction (AMI) who undergo reperfusion therapy, monitoring ST ... Full text Link to item Cite

Localizing coronary artery obstructions with the exercise treadmill test.

Journal Article Ann Intern Med · January 1987 To determine if patterns of ST depression or elevation during exercise testing provide reliable information about the location of an underlying coronary lesion, we studied 452 consecutive patients with one-vessel disease who underwent treadmill testing. Ex ... Full text Link to item Cite

Prognosis in angiographically normal or near-normal coronary arteries

Journal Article Cardiology Board Review · January 1, 1987 Cite

The changing survival benefits of coronary revascularization over time

Journal Article Circulation · January 1, 1987 Previous comparisons of medical and surgical therapy for coronary artery disease were performed in the 1970s and may need to be updated to reflect current treatment efficacy. The purpose of this investigation was to determine the impact on long-term patien ... Cite

Prognostic implications of angiographically normal and insignificantly narrowed coronary arteries.

Journal Article Am J Cardiol · December 1, 1986 The clinical presentation and prognosis of 1,977 consecutive patients with normal coronary arteries or "insignificant" coronary artery disease (CAD) (no major epicardial artery with 75% or more luminal diameter narrowing) were examined. Compared with patie ... Full text Link to item Cite

Rate-related left bundle branch block with chest pain and normal coronary arteriograms treated by exercise training.

Journal Article Am J Med Sci · November 1986 A clinical observation of chest pain associated with the onset of rate-related left bundle branch block has been described in patients with normal coronary arteriograms. The authors used standard cardiac rehabilitation techniques for exercise training in a ... Full text Link to item Cite

Medical, psychological and social correlates of work disability among men with coronary artery disease.

Journal Article Am J Cardiol · November 1, 1986 This study identifies the medical, psychologic and social factors that independently affect employment in patients with coronary artery disease (CAD). At coronary angiography, extensive clinical, psychological and social profiles were collected on 814 men ... Full text Link to item Cite

Isotretinoin and Staphylococcus aureus infection. A possible association.

Journal Article Arch Dermatol · July 1986 The use of isotretinoin (13-cis-retinoic acid) in the treatment of numerous dermatologic disorders, as well as the side effects encountered with use of the drug, have increased remarkably since its release. We encountered a case of Staphylococcus aureus en ... Link to item Cite

A simplified method to predict occurrence of complete heart block during acute myocardial infarction.

Journal Article Am J Cardiol · June 1, 1986 Data were analyzed from 698 patients with proved acute myocardial infarction (AMI) to develop a method to predict the occurrence of complete heart block (CHB). The presence of electrocardiographic abnormalities of atrioventricular or intraventricular condu ... Full text Link to item Cite

Predicting outcome in coronary disease. Statistical models versus expert clinicians.

Journal Article Am J Med · April 1986 To study the accuracy with which long-term prognosis can be predicted in patients with coronary artery disease, prognostic predictions from a data-based multivariable statistical model were compared with predictions from senior clinical cardiologists. Test ... Full text Link to item Cite

Psychosocial and physical predictors of anginal pain relief with medical management.

Journal Article Psychosom Med · 1986 This study was undertaken to identify psychosocial and physical characteristics that independently predict anginal pain relief. The original study group comprised over 570 patients in whom the characteristics were identified at the time of coronary arterio ... Full text Link to item Cite

Randomized trials of coronary artery bypass surgery: impact on clinical practice at Duke University Medical Center.

Journal Article Circulation · December 1985 Trends in practice patterns at Duke University Medical Center were assessed in patient groups comparable to those enrolled in the three major randomized trials of coronary artery bypass grafting (CABG). In addition, changes in practice patterns that appear ... Link to item Cite

Randomized trials of coronary artery bypass surgery: Impact on clinical practice at Duke University Medical Center

Journal Article Circulation · December 1, 1985 Trends in practice patterns at Duke University Medical Center were assessed in patient groups comparable to those enrolled in the three major randomized trials of coronary artery bypass grafting (CABG). In addition, changes in practice patterns that appear ... Cite

Diagnostic and prognostic significance of minimally elevated creatine kinase-MB in suspected acute myocardial infarction.

Journal Article Am J Cardiol · June 1, 1985 CK-MB changes were studied using agarose gel electrophoresis in 244 patients admitted to a coronary care unit for suspected acute myocardial infarction (AMI). A range of minimally elevated CK-MB levels, from 1 to 24 IU/liter, was identified as representing ... Full text Link to item Cite

Prognostic value of a coronary artery jeopardy score.

Journal Article J Am Coll Cardiol · May 1985 The prognostic value of a coronary artery jeopardy score was evaluated in 462 consecutive nonsurgically treated patients with significant coronary artery disease, but without significant left main coronary stenosis. The jeopardy score is a simple method fo ... Full text Link to item Cite

Value of radionuclide angiography for predicting specific cardiac events after acute myocardial infarction.

Journal Article Am J Cardiol · February 1, 1985 The value of rest and exercise radionuclide angiography (RNA) for predicting specific events including death, recurrent acute myocardial infarction (AMI), coronary care unit readmission for unstable chest pain, and medically refractory angina after AMI was ... Full text Link to item Cite

Prognostic significance of precordial ST-segment depression during inferior acute myocardial infarction.

Journal Article Am J Cardiol · February 1, 1985 To study the mechanism and prognostic importance of precordial ST-segment depression during inferior acute myocardial infarction, 162 patients admitted during 1969 through 1982 were identified. Patients with ST depression in leads V1, V2 and V3 had signifi ... Full text Link to item Cite

Myocardial infarction and stroke.

Journal Article Neurology · November 1984 We used a computer data bank to evaluate 740 consecutive patients admitted to a cardiac care unit with myocardial infarction. Stroke occurred in 18 (2.4%) patients in the hospital; the anterior circulation was involved in 76% of strokes. Hospital mortality ... Full text Link to item Cite

Prospective demonstration of myocardial infarction by CT.

Journal Article AJR Am J Roentgenol · November 1984 Full text Link to item Cite

Clinical characteristics and current management of medically refractory unstable angina.

Journal Article Ann Surg · October 1984 Of 531 patients admitted to the Duke Coronary Care Unit with unstable angina (UA) from June 1981 to September 1982, 100 had persistent angina despite optimal medical therapy of nitrates, propranolol, and nifedipine. At catheterization, 70% of the refractor ... Full text Link to item Cite

Effects of physical conditioning on left ventricular ejection fraction in patients with coronary artery disease.

Journal Article Circulation · July 1984 To address the hypothesis that physical conditioning may improve left ventricular function in patients with coronary artery disease, we performed first-pass radionuclide ventriculography in 53 patients at rest and during upright bicycle exercise before and ... Full text Link to item Cite

Factors affecting sensitivity and specificity of exercise electrocardiography. Multivariable analysis.

Journal Article Am J Med · July 1984 Unlike the predictive value of a diagnostic test, which depends on the prevalence of disease in the population tested, its sensitivity and specificity have been assumed to be constants. This assumption was examined in patients who had both exercise electro ... Full text Link to item Cite

"Left main equivalent" coronary artery disease: its clinical presentation and prognostic significance with nonsurgical therapy.

Journal Article Am J Cardiol · June 1, 1984 The clinical characteristics and nonsurgical prognosis of 55 patients with "left main (LM) equivalent" coronary artery disease (CAD) were evaluated and defined as: (1) greater than or equal to 75% diameter reduction of the left anterior descending coronary ... Full text Link to item Cite

Prognostic significance of isolated sinus tachycardia during first three days of acute myocardial infarction.

Journal Article Am J Med · June 1984 Sinus tachycardia often accompanies other indicators of poor prognosis in acute myocardial infarction. This study was performed to evaluate the prognostic significance of early (Days 1 to 3) in-hospital sinus tachycardia (isolated sinus tachycardia) in the ... Full text Link to item Cite

Accuracy and interobserver variability of coronary cineangiography: a comparison with postmortem evaluation.

Journal Article J Am Coll Cardiol · May 1984 The accuracy of interpretation of coronary cineangiography by two independent observers was tested against postmortem findings in 27 patients who died within 6 months of cardiac catheterization. Variations in cineangiographic interpretations between the an ... Full text Link to item Cite

Clinical characteristics and long-term survival of patients with variant angina.

Journal Article Circulation · May 1984 We studied 109 consecutive patients with variant angina who underwent cardiac catheterization over an 11 year period. All patients were followed for at least 6 months or until death, and 46 patients (22 treated medically and 24 treated surgically) were fol ... Full text Link to item Cite

Complete heart block in Reiter's syndrome.

Journal Article Am J Cardiol · March 15, 1984 Full text Link to item Cite

Regression modelling strategies for improved prognostic prediction.

Journal Article Stat Med · 1984 Regression models such as the Cox proportional hazards model have had increasing use in modelling and estimating the prognosis of patients with a variety of diseases. Many applications involve a large number of variables to be modelled using a relatively s ... Full text Link to item Cite

Prognostic indicators from radionuclide angiography in medically treated patients with coronary artery disease.

Journal Article Am J Cardiol · January 1, 1984 The purpose of this investigation was to determine which variables obtained when performing radionuclide angiography predict subsequent survival or total events (cardiovascular death or nonfatal myocardial infarction) in stable patients with symptomatic co ... Full text Link to item Cite

Prognostic value of ventricular arrhythmias associated with treadmill exercise testing in patients studied with cardiac catheterization for suspected ischemic heart disease.

Journal Article J Am Coll Cardiol · December 1983 The prognostic information provided by ventricular arrhythmias associated with treadmill exercise testing was evaluated in 1,293 consecutive nonsurgically treated patients undergoing an exercise test within 6 weeks of cardiac catheterization. The 236 patie ... Full text Link to item Cite

USING EXPERIENCE TO IMPROVE CLINICAL DECISION MAKING.

Journal Article Proceedings Annual Symposium on Computer Applications in Medical Care · December 1, 1983 Cite

Estimating the likelihood of significant coronary artery disease.

Journal Article Am J Med · November 1983 Among 23 clinical characteristics examined in 3,627 consecutive, symptomatic patients referred for cardiac catheterization between 1969 and 1979, nine were found to be important for estimating the likelihood a patient had significant coronary artery diseas ... Full text Link to item Cite

The prognosis for patients with new-onset angina who have undergone cardiac catheterization.

Journal Article Circulation · November 1983 We investigated the prognostic significance of new-onset angina in patients in whom coronary anatomic characteristics were known. New onset angina was defined as angina of less than 3 months duration. Consecutive patients (n = 1727) with significant corona ... Full text Link to item Cite

Early discharge after acute myocardial infarction.

Journal Article Ann Intern Med · October 1983 Approximately 50% of patients hospitalized with acute myocardial infarction have an uncomplicated course and an excellent prognosis. To be considered as having an uncomplicated course, patients should not have ventricular tachycardia or fibrillation, secon ... Full text Link to item Cite

An improving prognosis over time in medically treated patients with coronary artery disease.

Journal Article Am J Cardiol · September 1, 1983 The national mortality rate from coronary heart disease has decreased during the past decade, for reasons that are not yet clear. The mortality rate and the total number of cardiovascular events both decreased during the last 10 years in 1,911 medically tr ... Full text Link to item Cite

Natural history of patients with single-vessel disease suitable for percutaneous transluminal coronary angioplasty.

Journal Article Am J Cardiol · August 1983 To permit comparison of percutaneous transluminal coronary angioplasty (PTCA) with conventional therapy, the clinical outcome was established in patients who would have been suitable candidates for PTCA but who presented before the technique was available. ... Full text Link to item Cite

Clinical value of coronary bypass graft evaluation with CT.

Journal Article AJR Am J Roentgenol · April 1983 Computed tomography (CT) has a reported accuracy of 45%-97% in assessment of patency of coronary artery bypass grafts. Dynamic CT was done in 26 patients (47 grafts) with recurrent cardiac symptoms after graft surgery. Although CT was 79% accurate (with se ... Full text Link to item Cite

Comparative rates of resolution of QRS changes after operative and nonoperative acute myocardial infarcts.

Journal Article Am J Cardiol · February 1983 An independently developed and previously validated QRS scoring system for estimating myocardial infarct size has been used to compare the development and regression of changes associated with myocardial infarcts occurring in 2 different clinical settings. ... Full text Link to item Cite

Outcome in one-vessel coronary artery disease.

Journal Article Circulation · February 1983 We analyzed the clinical outcomes in 688 patients with isolated stenosis of one major coronary artery. The survival rate among patients with disease of the right coronary artery (RCA) was higher than that among patients with left anterior descending (LAD) ... Full text Link to item Cite

Continuing medical education cardiac rehabilitation: A new frontier for behavioral medicine

Journal Article Journal of Cardiac Rehabilitation · January 1, 1983 Secondary prevention of coronary disease has traditionally involved primarily surgery and pharmacologic management. However, it has become increasingly evident that successful rehabilitation also involves modification of those overt behaviors that place ca ... Cite

Assessment of the use of the age- and sex-specific United States population as a control group for analysis of survival in coronary artery disease.

Journal Article Am J Cardiol · December 1982 The use of the age- and sex-specific U.S. population as a control group for analysis of survival in coronary artery disease was assessed. Population-based survival rates were calculated for nonsurgically treated patients evaluated for coronary artery disea ... Full text Link to item Cite

FEATURES OF TMR FOR A SUCCESSFUL CLINICAL AND RESEARCH DATABASE.

Journal Article Proceedings Annual Symposium on Computer Applications in Medical Care · December 1, 1982 Cite

Prognostic implications of ventricular arrhythmias during 24 hour ambulatory monitoring in patients undergoing cardiac catheterization for coronary artery disease.

Journal Article Am J Cardiol · July 1982 The prognostic importance of ventricular arrhythmias detected during 24 hour ambulatory monitoring was evaluated in 395 patients with and 260 patients without significant coronary artery disease. Ventricular arrhythmias were found to be strongly related to ... Full text Link to item Cite

Problems and advantages of an observational data base approach to evaluating the effect of therapy on outcome.

Journal Article Circulation · June 1982 In this report, we summarize the strengths and problems of an observational data base approach to evaluating therapy and studying patient outcomes in long-term chronic disease. Because this approach includes a greater spectrum of patients than randomized c ... Full text Link to item Cite

Evaluating the yield of medical tests.

Journal Article JAMA · May 14, 1982 A method is presented for evaluating the amount of information a medical test provides about individual patients. Emphasis is placed on the role of a test in the evaluation of patients with a chronic disease. In this context, the yield of a test is best in ... Link to item Cite

Duke University's Preventive Approach to Cardiology - DUPAC

Journal Article Journal of Cardiac Rehabilitation · 1982 Cite

Problem and advantages of an observational data base approach to evaluating the effect of therapy on outcome

Journal Article Circulation · 1982 In this report, we summarize the strengths and problems of an observational data base approach to evaluating therapy and studying patient outcomes in long-term chronic disease. Because this approach includes a greater spectrum of patients than randomized c ... Cite

Problem and advantages of an observational data base approach to evaluating the effect of therapy on outcome

Journal Article Circulation · January 1, 1982 In this report, we summarize the strengths and problems of an observational data base approach to evaluating therapy and studying patient outcomes in long-term chronic disease. Because this approach includes a greater spectrum of patients than randomized c ... Cite

The doctor and the computer.

Journal Article West J Med · October 1981 Link to item Cite

Relationships among ventricular arrhythmias, coronary artery disease, and angiographic and electrocardiographic indicators of myocardial fibrosis.

Journal Article Circulation · April 1978 This study was performed to determine the relationships among angiographic, hemodynamic, clinical, and electrocardiographic data and premature ventricular contractions (PVCs). Arrhythmias were analyzed by 24 hour Holter monitor in 244 patients evaluated fo ... Full text Link to item Cite