A5044787928- Acute Myocardial Infarction Research
- Coronary Interventions and Diagnostics
- Antiplatelet Therapy and Cardiovascular Diseases
- Cardiac Imaging and Diagnostics
- Venous Thromboembolism Diagnosis and Management
- Atrial Fibrillation Management and Outcomes
- Mechanical Circulatory Support Devices
- Cardiac Arrest and Resuscitation
- Cardiac Structural Anomalies and Repair
- Health Systems, Economic Evaluations, Quality of Life
- Heart Failure Treatment and Management
- Cardiac electrophysiology and arrhythmias
- Lipoproteins and Cardiovascular Health
- Cardiac, Anesthesia and Surgical Outcomes
- Cardiac Health and Mental Health
- Cardiac pacing and defibrillation studies
- Cardiovascular Function and Risk Factors
- Healthcare cost, quality, practices
- Cardiac Valve Diseases and Treatments
- Heparin-Induced Thrombocytopenia and Thrombosis
- Cardiac Arrhythmias and Treatments
- Blood Pressure and Hypertension Studies
- Cardiac and Coronary Surgery Techniques
- Healthcare Policy and Management
- Cardiovascular Disease and Adiposity
Clinical Research Institute
2015-2024
Duke Medical Center
2015-2024
Duke University
2014-2024
Amgen (United States)
2024
Thrombolysis in Myocardial Infarction Study Group
2023
Duke University Hospital
2005-2021
Cardiovascular Research Foundation
2009-2020
Duke University Health System
2017
Auckland City Hospital
2006-2016
University of Alberta
1998-2016
![Graphic][1] Myocardial infarction is a major cause of death and disability worldwide. Coronary atherosclerosis chronic disease with stable unstable periods. During periods activated inflammation in the vascular wall, patients may develop myocardial infarction. Myocardial be minor event lifelong disease, it even go undetected, but also catastrophic leading to sudden or severe haemodynamic deterioration. A first manifestation coronary artery occur, repeatedly, established disease....
Current guidelines for patients with moderate- or high-risk acute coronary syndromes recommend an early invasive approach concomitant antithrombotic therapy, including aspirin, clopidogrel, unfractionated low-molecular-weight heparin, and glycoprotein IIb/IIIa inhibitors. We evaluated the role of thrombin-specific anticoagulation bivalirudin in such patients.We assigned 13,819 to one three regimens: heparin enoxaparin plus a inhibitor, alone. The primary end points were composite ischemia...
The prognosis of patients hospitalized with acute myocardial ischemia is quite variable. We examined the value serum levels cardiac troponin T, creatine kinase MB (CK-MB) levels, and electrocardiographic abnormalities for risk stratification in ischemia.
Background— Treatments for non–ST-segment–elevation myocardial infarction (NSTEMI) reduce ischemic events but increase bleeding. Baseline prediction of bleeding risk can complement optimization NSTEMI care; however, existing models are not well suited this purpose. Methods and Results— We developed (n=71 277) validated (n=17 857) a model that identifies 8 independent baseline predictors in-hospital major among community-treated patients enrolled in the Can Rapid stratification Unstable...
Monotherapy with a P2Y12 inhibitor after minimum period of dual antiplatelet therapy is an emerging approach to reduce the risk bleeding percutaneous coronary intervention (PCI).
The effect of intensified platelet inhibition for patients with unstable angina or myocardial infarction without ST-segment elevation who do not undergo revascularization has been delineated.In this double-blind, randomized trial, in a primary analysis involving 7243 under the age 75 years receiving aspirin, we evaluated up to 30 months treatment prasugrel (10 mg daily) versus clopidogrel (75 daily). In secondary 2083 older, 5 clopidogrel.At median follow-up 17 months, end point death from...
The American College of Cardiology/American Heart Association (ACC/AHA) guidelines for the management non-ST-segment elevation acute coronary syndromes (NSTE ACS) recommend early invasive high-risk patients, given benefits with this approach demonstrated in randomized clinical trials.To determine use and predictors strategies (cardiac catheterization <48 hours following presentation) patients NSTE ACS to examine association mortality.The CRUSADE (Can Rapid Risk Stratification Unstable Angina...
Background— Outcomes in patients with mild to moderate renal function (RF) abnormalities presenting acute coronary syndromes (ACS) are not well defined. Methods and Results— A convenience sample of 4 ACS trial databases including all enrolled was assessed determine 30- 180-day outcomes. The trials were Global Use Strategies Open Occluded Coronary Arteries (GUSTO) IIb, GUSTO-III, Platelet Glycoprotein IIb/IIIa Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT),...
To determine the clinical consequences of reocclusion an infarct-related artery after reperfusion therapy, we evaluated 810 patients with acute myocardial infarction. Patients were admitted into four sequential studies similar entry criteria in which patency was assessed by coronary arteriography 90 minutes onset thrombolytic therapy. Successful established acutely 733 patients. Thrombolytic therapy included tissue-type plasminogen activator (t-PA) 517, urokinase 87, and a combination t-PA...
Abstract Objectives To evaluate the periprocedural characteristics and outcomes of patients supported with Impella 2.5 prior to percutaneous coronary intervention (pre‐PCI) versus those who received it after PCI (post‐PCI) in setting cardiogenic shock (CS) complicating an acute myocardial infarction (AMI). Background Early mechanical circulatory support may improve outcome CS AMI. However, optimal timing initiate hemodynamic has not been well characterized. Methods Data from 154 consecutive...
Microvascular obstruction (MVO) is the underlying cause for no-reflow phenomenon in ST-segment elevation myocardial infarction (STEMI). The association between MVO assessed by cardiac magnetic resonance imaging (CMR) and prognosis has not been convincingly demonstrated. We sought to determine relationship early after primary percutaneous coronary intervention (PCI) STEMI all-cause mortality, hospitalization heart failure (HF), reinfarction. performed a pooled analysis using individual...
<h3>Importance</h3> 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). <h3>Objectives</h3> To investigate incidence, extent, location obstructive non-IRA compare 30-day mortality according to presence in STEMI. <h3>Design, Setting, Participants</h3> Retrospective study pooled from a convenience sample 8 independent, international, randomized...
ContextIn patients with moderate- and high-risk acute coronary syndromes (ACS) who undergo an early, invasive treatment strategy, current guidelines recommend administration of platelet glycoprotein IIb/IIIa (Gp IIb/IIIa) inhibitors, either upstream to all prior angiography or deferred for selective use in the catheterization laboratory just angioplasty. The preferred approach is undetermined.ObjectiveTo determine optimal strategy Gp inhibitors ACS undergoing strategy.DesignProspective,...
To determine 3-year event rates in outpatients with vascular disease enrolled the REduction of Atherothrombosis for Continued Health (REACH) Registry. REACH 67 888 atherothrombosis [established coronary artery (CAD), cerebrovascular disease, or peripheral arterial (PAD)], at least three atherothrombotic risk factors, from 44 countries. Among 55 499 patients baseline symptomatic 39 675 were eligible follow-up, and 32 247 had data available (81% retention rate). 3 years, 92% taking an...
The medical profession should play a central role in evaluating the evidence related to drugs, devices, and procedures for detection, management, prevention of disease. When properly applied, expert analysis available data on benefits risks these therapies can improve quality care, optimize patient outcomes, favorably affect costs by focusing resources most effective strategies. An organized directed approach thorough review has resulted production clinical practice guidelines that assist...