A5078123052- Venous Thromboembolism Diagnosis and Management
- Acute Myocardial Infarction Research
- Coronary Interventions and Diagnostics
- Antiplatelet Therapy and Cardiovascular Diseases
- Cardiac Imaging and Diagnostics
- Heparin-Induced Thrombocytopenia and Thrombosis
- Acute Ischemic Stroke Management
- Advanced MRI Techniques and Applications
- Central Venous Catheters and Hemodialysis
- Cardiac and Coronary Surgery Techniques
- Cardiac electrophysiology and arrhythmias
- Intramuscular injections and effects
- Cardiac Valve Diseases and Treatments
- Platelet Disorders and Treatments
- Atrial Fibrillation Management and Outcomes
- Infective Endocarditis Diagnosis and Management
- Blood transfusion and management
- Cerebrovascular and Carotid Artery Diseases
- Ultrasound in Clinical Applications
- Erythropoietin and Anemia Treatment
- Pharmaceutical Economics and Policy
- Acute Kidney Injury Research
- Liver Disease and Transplantation
- Health Systems, Economic Evaluations, Quality of Life
- Radiation Dose and Imaging
University of Pennsylvania
2013-2024
Presbyterian Hospital
2024
Penn Center for AIDS Research
2024
Penn Presbyterian Medical Center
2006-2023
Johnson University
2022
Rutgers, The State University of New Jersey
2022
University of Pittsburgh Medical Center
2019
Cardiovascular Institute of the South
2010-2016
Montefiore Medical Center
2013
Albert Einstein College of Medicine
2013
Heparin-induced thrombocytopenia (HIT) is an immune-mediated syndrome caused by heparin. Complications range from to with thrombosis. We report a prospective, historical- controlled study evaluating the efficacy and safety of argatroban, direct thrombin inhibitor, as anticoagulant therapy in patients HIT or thrombosis (HITTS).Patients (isolated thrombocytopenia, n=160) HITTS (n=144) received 2 microgram. kg(-1). min(-1) IV adjusted maintain activated partial thromboplastin time 1.5 3.0 times...
The incidence and impact of clinical stroke silent radiographic cerebral infarction complicating open surgical aortic valve replacement (AVR) are poorly characterized.We performed a prospective cohort study subjects ≥65 years age who were undergoing AVR for calcific stenosis. Subjects evaluated by neurologists preoperatively postoperatively underwent postoperative magnetic resonance imaging. Over 4-year period, 196 enrolled at 2 sites (mean age, 75.8±6.2 years; 36% women; 6% nonwhite)....
Abstract Heparin‐induced thrombocytopenia (HIT) is an immune‐mediated syndrome associated with thrombosis. Alternative anticoagulation to heparin needed for HIT patients during percutaneous coronary intervention (PCI). We evaluated argatroban, a direct thrombin inhibitor, in this setting. Ninety‐one underwent 112 PCIs while on intravenous argatroban (25 μg/kg/min [350 μg/kg initial bolus], adjusted achieve activated clotting time of 300–450 sec). Primary efficacy endpoints were subjective...
Background —Previous in vitro and vivo studies have suggested an association between thrombus-related events type of contrast media. Low osmolar agents appear to improve the safety diagnostic coronary artery interventional procedures. However, no data are available on PTCA outcomes with isosmolar agent. Methods Results —A multicenter prospective randomized double-blind trial was performed 856 high-risk patients undergoing intervention. The objective compare nonionic dimer iodixanol (n=405)...
Background: CYP2C19 loss-of-function alleles impair clopidogrel effectiveness after percutaneous coronary intervention, but the clinical impact of implementing genotyping in a real-world setting is unknown. The purpose study was to determine whether returning genotype results along with genotype-guided pharmacotherapy recommendations using rapid turnaround test would change antiplatelet prescribing following intervention.The primary outcome rate prasugrel or ticagrelor each arm. Secondary...
Abstract Restoration of coronary blood flow after a heart attack can cause reperfusion injury potentially leading to impaired cardiac function, adverse tissue remodeling and failure. Iron is an essential biometal that may have pathologic role in this process. There clinical need for precise noninvasive method detect iron risk stratification patients therapy evaluation. Here, we report magnetic susceptibility imaging large animal model shows infarct paramagnetic shift associated with duration...
Abstract Objective: We compared the outcome of drug eluting stent (DES) implantation (Sirolimus or Paclitaxel) in patients with ischemic cardiomyopathy and severe left ventricular (LV) dysfunction a similar group undergoing coronary artery by‐pass grafting (CABG). Background: Revascularization provides long‐term benefits LV dysfunction. However modality to achieve it is still unsettled this high risk patients. Methods: Two‐hundred‐twenty (20% women) (LV Ejection Fraction ≤35%) underwent...
Abstract Background: Small randomized trials have shown short‐term improved outcome with drug‐eluting stents (DES) over bare metal stent (BMS) in saphenous vein graft (SVG) interventions by reducing in‐stent restenosis and target vessel revascularization (TVR). It is not clear, however, if these benefits are maintained long term. The aim of this study to compare the a larger cohort patients undergoing SVG implantation DES or BMS, at 2 years. Methods: From among 250 who underwent stenting,...
Abstract Objectives Compare in‐hospital outcomes of patients treated with either mechanical thrombectomy (MT) or catheter directed lysis (CDL) in treatment acute pulmonary embolism (PE). Methods This is a multicenter, retrospective cohort study undergoing MT CDL for PE between 2014 and 2021. The primary outcome was the composite death, significant bleed, vascular complication, need support post‐procedure. Secondary included individual components addition to blood transfusions, invasive...
To investigate the invasive hemodynamics in patients with intermediate-risk pulmonary embolism (PE) and change that occurs catheter-directed thrombolysis (CDT).Intermediate-risk PE is associated right ventricular strain worse outcomes yet have not been well described.Ninety-two consecutive referred for CDT at two tertiary medical centers Pulmonary Embolism Response Teams were included this prospective cohort study. Hemodynamics baseline after therapy was measured. Patients cardiac index (CI)...
Vasodilator agents are widely used in congestive heart failure. These may have important effects on the pulsatile aspects of right ventricular hydraulic load.Fifteen patients with severe failure were studied during cardiac catheterization by use high-fidelity pressure transducers and a catheter-mounted flow velocity probe. Three graded doses nitroprusside infused as pulmonary artery (PA) continuously recorded. From Fourier transforms signal-averaged waves, PA impedance, power, wave...
<i>Background/Aim:</i> Electron-beam computerized tomography (EBCT) is able to noninvasively quantify coronary artery calcification (CAC). Chronic kidney disease (CKD) patients frequently have CAC, and clinicians are puzzled regarding the clinical significance of this finding diagnostic accuracy EBCT in CKD. The aim study was determine correlation CKD between CAC measured by 50% stenosis determined angiography (CA), gold standard identify atherosclerotic lesions....
Patients with cirrhosis and coronary artery disease (CAD) are at high risk for morbidity during surgical revascularization so they often referred complex percutaneous intervention (PCI). Percutaneous in the cirrhotic population also has inherent risks; however, quantifiable data on long-term outcomes lacking.Patients angiographically significant CAD were identified from catheterization lab databases of University Pennsylvania Health System between 2007 2015. Outcomes obtained medical record...
To investigate whether heart failure impairs peripheral sympathetic vasoconstriction, hindlimb vascular responses to lumbar chain stimulation (0.5-20 Hz) were studied in normal dogs and with chronic produced by rapid ventricular pacing. At rates of 0.5-3 Hz, comparable both groups. However, at 5-20 significantly attenuated the failure. Vascular norepinephrine (0.1, 1, 10 micrograms/min) not altered. These findings suggest that results impaired probably because reduced neurotransmitter...