Scholars@Duke
Zubin John Eapen

Zubin John Eapen

Adjunct Associate Professor in the Department of Medicine
Medicine, Cardiology
zubin.eapen@duke.edu
Box 31118 Med Ctr, Durham, NC 27710
Dept of Medicine, Durham, NC 27710

Selected Publications

A Patch Wearable Cardioverter-Defibrillator for Patients at Risk of Sudden Cardiac Arrest.

Journal Article J Am Coll Cardiol · August 6, 2024 BACKGROUND: For many patients, sudden cardiac arrest (SCA) risk is elevated temporarily. Wearable cardioverter-defibrillators (WCDs) can monitor and treat SCA during these temporary periods. Traditional WCDs can be uncomfortable, require frequent maintenan ... Full text Link to item Cite

First human safety and effectiveness study of defibrillation with a novel patch wearable cardioverter-defibrillator.

Journal Article Europace · July 2, 2024 AIMS: Wearable cardioverter-defibrillators (WCDs) are indicated in patients at risk of sudden cardiac arrest who are not immediate candidates for implantable defibrillator therapy. Limitations of existing WCDs include poor compliance and high false alarm r ... Full text Link to item Cite

Lipid-lowering treatment among older patients with atherosclerotic cardiovascular disease.

Journal Article J Am Geriatr Soc · April 2023 BACKGROUND: The contemporary uptake of lipid-lowering therapies (LLT), including more intensive treatment with high-intensity statins and non-statin LLT, among U.S. older adults (≥75 years old) with ASCVD is unknown. METHODS: In this multicenter retrospect ... Full text Link to item Cite

High-Intensity Statin Use Among Patients With Atherosclerosis in the U.S.

Journal Article J Am Coll Cardiol · May 10, 2022 BACKGROUND: Preventive therapy among patients with established atherosclerotic cardiovascular disease (ASCVD) is generally underused. Whether new guideline recommendations and a focus on implementation have improved the use of high-intensity statins is unk ... Full text Link to item Cite

Gaps in Evidence-Based Therapy Use in Insured Patients in the United States With Type 2 Diabetes Mellitus and Atherosclerotic Cardiovascular Disease.

Journal Article J Am Heart Assoc · January 19, 2021 Background Evidence-based therapies are generally underused for cardiovascular risk reduction; however, less is known about contemporary patients with type 2 diabetes mellitus and atherosclerotic cardiovascular disease. Methods and Results Pharmacy and med ... Full text Link to item Cite

Cause of Death in Patients With Acute Heart Failure: Insights From RELAX-AHF-2.

Journal Article JACC Heart Fail · December 2020 OBJECTIVES: This study sought to better understand the discrepant results of 2 trials of serelaxin on acute heart failure (AHF) and short-term mortality after AHF by analyzing causes of death of patients in the RELAX-AHF-2 (Efficacy, Safety and Tolerabilit ... Full text Link to item Cite

Mobile phone text-messaging interventions aimed to prevent cardiovascular diseases (Text2PreventCVD): Systematic review and individual patient data meta-analysis

Journal Article Open Heart · October 1, 2019 Background: A variety of small mobile phone text-messaging interventions have indicated improvement in risk factors for cardiovascular disease (CVD). Yet the extent of this improvement and whether it impacts multiple risk factors together is uncertain. We ... Full text Cite

Utilizing mobile technologies to improve physical activity and medication adherence in patients with heart failure and diabetes mellitus: Rationale and design of the TARGET-HF-DM Trial.

Journal Article Am Heart J · May 2019 Heart failure (HF) and diabetes mellitus (DM) are major public health issues that place significant burden on patients and health care systems. Patients with both HF and DM are at higher risk of adverse cardiovascular and HF outcomes than those with either ... Full text Link to item Cite

Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome.

Journal Article N Engl J Med · November 29, 2018 BACKGROUND: Patients who have had an acute coronary syndrome are at high risk for recurrent ischemic cardiovascular events. We sought to determine whether alirocumab, a human monoclonal antibody to proprotein convertase subtilisin-kexin type 9 (PCSK9), wou ... Full text Link to item 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

Using Digital Health Technology to Better Generate Evidence and Deliver Evidence-Based Care.

Journal Article J Am Coll Cardiol · June 12, 2018 As we enter the information age of health care, digital health technologies offer significant opportunities to optimize both clinical care delivery and clinical research. Despite their potential, the use of such information technologies in clinical care an ... Full text Link to item Cite

Leveraging Behavioral Economics to Improve Heart Failure Care and Outcomes.

Journal Article Circulation · August 22, 2017 Behavioral challenges are often present in human illness, so behavioral economics is increasingly being applied in healthcare settings to better understand why patients choose healthy or unhealthy behaviors. The application of behavioral economics to healt ... Full text Link to item Cite

Acute Heart Failure: Alternatives to Hospitalization.

Journal Article JACC Heart Fail · May 2017 Acute heart failure (HF) is a major public health problem with substantial associated economic costs. Because most patients who present to hospitals are admitted irrespective of their level of risk, novel approaches to manage acute HF are needed, such as t ... Full text Link to item Cite

Moving Beyond the Walls of the Clinic: Opportunities and Challenges to the Future of Telehealth in Heart Failure.

Journal Article JACC Heart Fail · April 2017 Telehealth offers an innovative approach to improve heart failure care that expands beyond traditional management strategies. Yet the use of telehealth in heart failure is infrequent because of several obstacles. Fundamentally, the evidence is inconsistent ... Full text Link to item Cite

Is an Admission for Decompensated Heart Failure Inevitable?

Journal Article Prog Cardiovasc Dis · 2017 Given the high prevalence of heart failure (HF) and the profound impact on morbid, mortality, and health care costs, strategies to improve outcomes and reduce cost have become progressively more attractive. Reducing HF hospitalizations as a study outcome h ... Full text Link to item Cite

Text2PreventCVD: protocol for a systematic review and individual participant data meta-analysis of text message-based interventions for the prevention of cardiovascular diseases.

Journal Article BMJ Open · October 17, 2016 INTRODUCTION: Text message interventions have been shown to be effective in prevention and management of several non-communicable disease risk factors. However, the extent to which their effects might vary in different participants and settings is uncertai ... Full text Link to item Cite

Temporal Trends in Care and Outcomes of Patients Receiving Fibrinolytic Therapy Compared to Primary Percutaneous Coronary Intervention: Insights From the Get With The Guidelines Coronary Artery Disease (GWTG-CAD) Registry.

Journal Article J Am Heart Assoc · October 6, 2016 BACKGROUND: Timely reperfusion after ST-elevation myocardial infarction (STEMI) improves survival. Guidelines recommend primary percutaneous coronary intervention (PPCI) within 90 minutes of arrival at a PCI-capable hospital. The alternative is fibrinolysi ... Full text Open Access Link to item Cite

The Obesity and Heart Failure Epidemics Among African Americans: Insights From the Jackson Heart Study.

Journal Article J Card Fail · August 2016 BACKGROUND: Higher rates of obesity and heart failure have been observed in African Americans, but associations with mortality are not well-described. We examined intermediate and long-term clinical implications of obesity in African Americans and associat ... Full text Link to item Cite

Precipitating Clinical Factors, Heart Failure Characterization, and Outcomes in Patients Hospitalized With Heart Failure With Reduced, Borderline, and Preserved Ejection Fraction.

Journal Article JACC Heart Fail · June 2016 OBJECTIVES: This study assessed the comparative frequency of precipitating clinical factors leading to hospitalization among heart failure (HF) patients with reduced, borderline, and preserved ejection fraction (EF) BACKGROUND: There are few data assessing ... Full text Link to item Cite

Has Public Reporting of Hospital Readmission Rates Affected Patient Outcomes?: Analysis of Medicare Claims Data.

Journal Article J Am Coll Cardiol · March 1, 2016 BACKGROUND: In 2009, the Centers for Medicare & Medicaid Services (CMS) began publicly reporting 30-day hospital readmission rates for patients discharged with acute myocardial infarction (MI), heart failure (HF), or pneumonia. OBJECTIVES: This study asses ... Full text Link to item Cite

Clinical Effectiveness of Hydralazine-Isosorbide Dinitrate Therapy in Patients With Heart Failure and Reduced Ejection Fraction: Findings From the Get With The Guidelines-Heart Failure Registry.

Journal Article Circ Heart Fail · February 2016 BACKGROUND: In clinical trials, hydralazine-isosorbide dinitrate (H-ISDN) for heart failure with reduced ejection fraction reduced morbidity and mortality among black patients and patients with intolerance to angiotensin-converting enzyme inhibitors or ang ... Full text Link to item Cite

Temporal Trends and Variation in Early Scheduled Follow-Up After a Hospitalization for Heart Failure: Findings from Get With The Guidelines-Heart Failure.

Journal Article Circ Heart Fail · January 2016 BACKGROUND: Previous data demonstrate early follow-up (ie, within 7 days of discharge) after a hospitalization for heart failure is associated with a lower risk of readmission, yet is uncommon and varies widely across hospitals. Limited data exist on wheth ... Full text Link to item Cite

Characteristics, Treatments, and Outcomes of Hospitalized Heart Failure Patients Stratified by Etiologies of Cardiomyopathy.

Journal Article JACC Heart Fail · November 2015 OBJECTIVES: The authors sought to describe characteristics, treatments, and in-hospital outcomes of hospitalized heart failure (HF) patients stratified by etiology. BACKGROUND: Whether characteristics and outcomes of HF patients differ by cardiomyopathy et ... Full text Link to item Cite

Medication Initiation Burden Required to Comply With Heart Failure Guideline Recommendations and Hospital Quality Measures.

Journal Article Circulation · October 6, 2015 BACKGROUND: Guidelines for heart failure (HF) recommend prescription of guideline-directed medical therapy before hospital discharge; some of these therapies are included in publicly reported performance measures. The burden of new medications for individu ... Full text Link to item Cite

Thinking Outside the Box: Treating Acute Heart Failure Outside the Hospital to Improve Care and Reduce Admissions.

Journal Article J Card Fail · August 2015 The management of acute heart failure is shifting toward treatment approaches outside of a traditional hospital setting. Many heart failure providers are now treating patients in less familiar health care settings, such as acute care clinics, emergency dep ... Full text Open Access Link to item Cite

Cluster-Randomized Trial of Personalized Site Performance Feedback in Get With The Guidelines-Heart Failure.

Journal Article Circ Cardiovasc Qual Outcomes · July 2015 BACKGROUND: There is significant variation in the delivery of evidence-based care for patients with heart failure (HF), but there is limited evidence defining the best methods to improve the quality of care. METHODS AND RESULTS: We performed a cluster-rand ... Full text Link to item Cite

Variation in performance measure criteria significantly affects cardiology practice rankings: Insights from the National Cardiovascular Data Registry's Practice Innovation and Clinical Excellence Registry.

Journal Article Am Heart J · June 2015 BACKGROUND: Million Hearts is a national initiative to prevent 1 million heart attacks and strokes over 5 years by improving cardiovascular prevention. An important tool in the success of programs like Million Hearts is public ranking on the quality of pra ... Full text Link to item Cite

Hospital readmissions reduction program.

Journal Article Circulation · May 19, 2015 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

Anticoagulation in Heart Failure: a Review.

Journal Article J Atr Fibrillation · May 1, 2015 Heart failure (HF) with reduced left ventricular function inflicts a large and growing burden of morbidity and mortality in the US and across the globe. One source of this burden is stroke. While it appears that HF itself may impose some risk of stroke, it ... Link to item Cite

Heart rate at hospital discharge in patients with heart failure is associated with mortality and rehospitalization.

Journal Article J Am Heart Assoc · April 22, 2015 BACKGROUND: Whether heart rate upon discharge following hospitalization for heart failure is associated with long-term adverse outcomes and whether this association differs between patients with sinus rhythm (SR) and atrial fibrillation (AF) have not been ... Full text Link to item Cite

Ventricular conduction and long-term heart failure outcomes and mortality in African Americans: insights from the Jackson Heart Study.

Journal Article Circ Heart Fail · March 2015 BACKGROUND: QRS prolongation is associated with adverse outcomes in mostly white populations, but its clinical significance is not well established for other groups. We investigated the association between QRS duration and mortality in African Americans. M ... Full text Open Access Link to item Cite

Characteristics, quality of care, and in-hospital outcomes of Asian-American heart failure patients: Findings from the American Heart Association Get With The Guidelines-Heart Failure Program.

Journal Article Int J Cardiol · 2015 BACKGROUND: Because little was previously known about Asian-American patients with heart failure (HF), we compared clinical profiles, quality of care, and outcomes between Asian-American and non-Hispanic white HF patients using data from the American Heart ... 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

Outcomes in patients with heart failure with preserved, borderline, and reduced ejection fraction in the Medicare population.

Journal Article Am Heart J · November 2014 BACKGROUND: Studies on outcomes among patients with heart failure (HF) with preserved left ventricular ejection fraction (HFpEF), borderline left ventricular ejection fraction (HFbEF), and reduced left ventricular ejection fraction (HFrEF) remain limited. ... Full text Link to item Cite

Short- and long-term rehospitalization and mortality for heart failure in 4 racial/ethnic populations.

Journal Article J Am Heart Assoc · October 16, 2014 BACKGROUND: The degree to which outcomes following hospitalization for acute heart failure (HF) vary by racial and ethnic groups is poorly characterized. We sought to compare 30-day and 1-year rehospitalization and mortality rates for HF among 4 race/ethni ... Full text Open Access Link to item Cite

Current quality of cardiovascular prevention for Million Hearts: an analysis of 147,038 outpatients from The Guideline Advantage.

Journal Article Am Heart J · September 2014 BACKGROUND: Million Hearts is a national initiative to prevent 1 million heart attacks and strokes over 5 years. The degree to which outpatient providers are controlling risk factors has not been fully described. METHODS: We examined adherence to the Milli ... Full text Link to item Cite

An evaluation of mobile health application tools.

Journal Article JMIR Mhealth Uhealth · May 1, 2014 BACKGROUND: The rapid growth in the number of mobile health applications could have profound significance in the prevention of disease or in the treatment of patients with chronic disease such as diabetes. OBJECTIVE: The objective of this study was to desc ... Full text Link to item Cite

Trends in the use and outcomes of ventricular assist devices among medicare beneficiaries, 2006 through 2011.

Journal Article J Am Coll Cardiol · April 15, 2014 OBJECTIVES: This study sought to examine trends in mortality, readmission, and costs among Medicare beneficiaries receiving ventricular assist devices (VADs) and associations between hospital-level procedure volume and outcomes. BACKGROUND: VADs are an opt ... Full text Link to item Cite

Associations between atrial fibrillation and early outcomes of patients with heart failure and reduced or preserved ejection fraction.

Journal Article Am Heart J · March 2014 BACKGROUND: The relative impact of atrial fibrillation on early outcomes of patients with heart failure with reduced or preserved ejection fraction (EF) is unknown. METHODS: We conducted a retrospective cohort study of clinical registry data linked to Medi ... Full text Link to item Cite

Adherence and persistence in the use of warfarin after hospital discharge among patients with heart failure and atrial fibrillation.

Journal Article J Card Fail · January 2014 BACKGROUND: Postdischarge adherence and long-term persistence in the use of warfarin among patients with heart failure and atrial fibrillation without contraindications have not been fully described. METHODS AND RESULTS: We identified patients with heart f ... Full text Link to item Cite

Associations between atrial fibrillation and early outcomes of patients with heart failure and reduced or preserved ejection fraction.

Journal Article American heart journal · 2014 The relative impact of atrial fibrillation on early outcomes of patients with heart failure with reduced or preserved ejection fraction (EF) is unknown. We conducted a retrospective cohort study of clinical registry data linked to Medicare claims for patie ... Cite

Anticoagulation and clinical outcomes in heart failure patients with atrial fibrillation: Findings from the ADHERE registry

Journal Article Journal of Atrial Fibrillation · December 1, 2013 The risks and benefits of anticoagulation for patients with both heart failure and atrial fibrillation are unclear. We hypothesized that anticoagulation was associated with improved clinical outcomes of heart failure patients with atrial fibrillation indep ... Cite

Postdischarge international normalized ratio testing and long-term clinical outcomes of patients with heart failure receiving warfarin: findings from the ADHERE registry linked to Medicare claims.

Journal Article Clin Cardiol · December 2013 BACKGROUND: Effective warfarin thromboprophylaxis requires maintaining anticoagulation within the recommended international normalized ratio (INR) range. INR testing rates and associations between testing and outcomes are not well understood. HYPOTHESIS: I ... Full text Link to item Cite

Relationship between sex, ejection fraction, and B-type natriuretic peptide levels in patients hospitalized with heart failure and associations with inhospital outcomes: findings from the Get With The Guideline-Heart Failure Registry.

Journal Article Am Heart J · December 2013 BACKGROUND: In heart failure (HF), there are known differences in plasma B-type natriuretic peptide (BNP) levels between reduced and preserved ejection fraction (EF), but few HF studies have explored sex differences. We sought to evaluate the relationship ... Full text Link to item Cite

Who enrolls in the Medicare Part D prescription drug benefit program? Medication use among patients with heart failure.

Journal Article J Am Heart Assoc · September 11, 2013 BACKGROUND: Dispensing data from Medicare Part D standalone prescription drug plans are now available, but characteristics of enrollees with heart failure have not been well described. METHODS AND RESULTS: We identified 81 874 patients with prevalent heart ... Full text Open Access 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

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

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

Performance measures to promote quality improvement in sudden cardiac arrest prevention and treatment.

Journal Article Am Heart J · June 2013 Sudden cardiac arrest (SCA) is one of the most impactful public health problems in the United States. Despite the progress made in reducing the number of cardiac deaths, the incidence of sudden cardiac death remains high. Studies of life-saving interventio ... Full text Link to item Cite

Clinical effectiveness of anticoagulation therapy among older patients with heart failure and without atrial fibrillation: findings from the ADHERE registry linked to Medicare claims.

Journal Article J Card Fail · June 2013 BACKGROUND: Patients with heart failure are at higher risk for thromboembolic events, even in the absence of atrial fibrillation, but the effect of anticoagulation therapy on outcomes is uncertain. METHODS AND RESULTS: With data from a clinical registry li ... Full text Link to item Cite

Validated, electronic health record deployable prediction models for assessing patient risk of 30-day rehospitalization and mortality in older heart failure patients.

Journal Article JACC Heart Fail · June 2013 OBJECTIVES: The study sought to derive and validate risk-prediction tools from a large nationwide registry linked with Medicare claims data. BACKGROUND: Few clinical models have been developed utilizing data elements readily available in electronic health ... Full text Link to item Cite

Racial and ethnic differences in outcomes in older patients with acute ischemic stroke.

Journal Article Circ Cardiovasc Qual Outcomes · May 1, 2013 BACKGROUND: Little is known as to whether long-term outcomes of acute ischemic stroke (AIS) vary by race/ethnicity. Using the American Heart Association Get With The Guidelines-Stroke registry linked with Medicare claims data set, we examined whether 30-da ... Full text Link to item Cite

Priorities for comparative effectiveness reviews in cardiovascular disease.

Journal Article Circ Cardiovasc Qual Outcomes · March 1, 2013 BACKGROUND: Comparative effectiveness reviews offer a systematic method to critically appraise existing research and to identify unaddressed clinical areas in cardiovascular disease where significant morbidity, mortality, and variation in the use of resour ... Full text Link to item Cite

Conversion of cardiovascular conference abstracts to publications.

Journal Article Circulation · December 11, 2012 BACKGROUND: The transition of scientific knowledge from discovery into practice is less than ideal. A key step in this translation occurs when presentations from major meetings are published in peer-reviewed literature, yet the completeness and speed of th ... Full text Link to item Cite

Lecture halls without lectures.

Journal Article N Engl J Med · August 16, 2012 Full text Link to item Cite

B-type natriuretic peptide level and postdischarge thrombotic events in older patients hospitalized with heart failure: insights from the Acute Decompensated Heart Failure National Registry.

Journal Article Am Heart J · June 2012 BACKGROUND: Patients hospitalized with heart failure (HF) have elevated B-type natriuretic peptide (BNP) levels and increased risk for thromboembolic events. Associations between BNP level and thromboembolic events in patients with HF without atrial fibril ... Full text Link to item Cite

Predicting costs among medicare beneficiaries with heart failure.

Journal Article Am J Cardiol · March 1, 2012 Disease management programs that target patients with the highest risk of subsequent costs may help payers and providers control health care costs, but identifying these patients prospectively is challenging. We hypothesized that medical history and clinic ... Full text Link to item Cite

Comparison of composite measure methodologies for rewarding quality of care: an analysis from the American Heart Association's Get With The Guidelines program.

Journal Article Circ Cardiovasc Qual Outcomes · November 1, 2011 BACKGROUND: Composite indices of health care performance are an aggregation of underlying individual performance measures and are increasingly being used to rank hospitals. We sought to conduct an observational analysis to determine the influence of the op ... Full text Link to item Cite

End point selection in acute decompensated heart failure clinical trials: economic end points.

Journal Article Heart Fail Clin · October 2011 The selection of economic end points in acute decompensated heart failure (ADHF) clinical trials requires prospectively planned evaluations that are developed in tandem with clinical end points. Integrating economic end points with concrete clinical outcom ... Full text Link to item Cite

Quality of care for sudden cardiac arrest: Proposed steps to improve the translation of evidence into practice.

Journal Article Am Heart J · August 2011 Sudden cardiac arrest (SCA) is the most common cause of death in the United States. Despite national guidelines, patients at risk for SCA often fail to receive evidence-based therapies. Racial and ethnic minorities and women are at particularly high risk f ... Full text Link to item Cite

Do heart failure disease management programs make financial sense under a bundled payment system?

Journal Article Am Heart J · May 2011 BACKGROUND: Policy makers have proposed bundling payments for all heart failure (HF) care within 30 days of an HF hospitalization in an effort to reduce costs. Disease management (DM) programs can reduce costly HF readmissions but have not been economicall ... Full text Link to item Cite

Strategies to attenuate pathological remodeling in heart failure.

Journal Article Curr Opin Cardiol · May 2009 PURPOSE OF REVIEW: The incidence of heart failure is increasing due to an aging population and improved management of diseases that are precursors to ventricular dysfunction. The success of therapeutic advances has created a challenge for the next generati ... Full text Link to item Cite