A5063918424- Health Systems, Economic Evaluations, Quality of Life
- Cardiac Imaging and Diagnostics
- Atrial Fibrillation Management and Outcomes
- Acute Myocardial Infarction Research
- Cardiac pacing and defibrillation studies
- Cardiac Arrhythmias and Treatments
- Heart Failure Treatment and Management
- Cardiovascular Function and Risk Factors
- Advanced X-ray and CT Imaging
- Radiation Dose and Imaging
- Cardiovascular Syncope and Autonomic Disorders
- Statistical Methods in Clinical Trials
- Cardiac Health and Mental Health
- Cardiac Structural Anomalies and Repair
- Cardiac electrophysiology and arrhythmias
- Medication Adherence and Compliance
- Ultrasound in Clinical Applications
- Pharmaceutical studies and practices
- Cardiac Valve Diseases and Treatments
- Heart Rate Variability and Autonomic Control
- Coronary Interventions and Diagnostics
Clinical Research Institute
2016-2025
Duke University
2019-2025
Duke University Hospital
2016
Duke Medical Center
2016
National Heart Lung and Blood Institute
2016
Massachusetts General Hospital
2016
Harvard University
2016
<h3>Importance</h3> Catheter ablation is more effective than drug therapy in restoring sinus rhythm patients with atrial fibrillation (AF), but its incremental effect on long-term quality of life (QOL) uncertain. <h3>Objective</h3> To determine whether catheter beneficial conventional for improving QOL AF. <h3>Design, Setting, and Participants</h3> An open-label randomized clinical trial vs 2204 symptomatic AF older 65 years or younger at least 1 risk factor stroke. Patients were enrolled...
Importance Trials showing equivalent or better outcomes with initial evaluation using coronary computed tomography angiography (cCTA) compared stress testing in patients stable chest pain have informed guidelines but raise questions about overtesting and excess catheterization. Objective To test a modified cCTA strategy designed to improve clinical efficiency vs usual (UT). Design, Setting, Participants This was pragmatic randomized trial enrolling participants from December 3, 2018, May 18,...
In the CABANA trial (Catheter Ablation vs Antiarrhythmic Drug Therapy for Atrial Fibrillation), catheter ablation did not significantly reduce primary end point of death, disabling stroke, serious bleeding, or cardiac arrest compared with drug therapy by intention-to-treat, but improve quality life and freedom from atrial fibrillation recurrence. heart failure subgroup, improved both survival life. Cost-effectiveness was a prespecified secondary point.
Clinically detected atrial fibrillation (AF) is associated with a significant increase in mortality and other adverse cardiovascular events. Since the advent of effective methods for AF rhythm control, investigators have attempted to determine how much these prognostic effects could be mitigated by restoration sinus (SR) whether method used mattered.
BACKGROUND: The PRECISE (Prospective Randomized Trial of the Optimal Evaluation Cardiac Symptoms and Revascularization) trial compared an investigational precision diagnostic testing strategy (n=1057) with usual (n=1046) in patients stable chest pain suspected coronary artery disease. Quality life (QOL) outcomes were a prespecified secondary end point. METHODS: We assessed QOL by structured interviews all participants at baseline 45 days, 6 months, 12 months postrandomization. assessments...
The PRECISE (Prospective Randomized Trial of the Optimal Evaluation Cardiac Symptoms and Revascularization) demonstrated that a precision diagnostic strategy reduced primary composite death, nonfatal myocardial infarction, or catheterization without obstructive coronary artery disease by 65% in patients with nonacute chest pain compared usual testing. Medical cost was prespecified secondary end point. randomized 2103 between December 2018 May 2021 to testing used deferred for lowest risk...
PROMISE (PROspective Multicenter Imaging Study for Evaluation of Chest Pain) found that initial use at least 64-slice multidetector computed tomography angiography (CTA) versus functional diagnostic testing strategies did not improve clinical outcomes in stable symptomatic patients with suspected coronary artery disease (CAD) requiring noninvasive testing.To conduct an economic analysis (a major secondary aim the study).Prospective study from U.S. perspective. Comparisons were made according...
Influence of atrial fibrillation (AF) type on outcomes seen with catheter ablation vs. drug therapy is incompletely understood. This study assesses the impact AF treatment in Catheter Ablation Antiarrhythmic Drug Therapy for Atrial Fibrillation Trial (CABANA).
Background— The Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) trial found that initial use ≥64 detector-row computed tomography angiography versus standard functional testing strategies (exercise ECG, stress nuclear methods, or echocardiography) did not improve clinical outcomes in 10 003 stable symptomatic patients with suspected coronary artery disease requiring noninvasive testing. Symptom burden and quality life (QOL) were major secondary outcomes. Methods...
Background: ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) compared an initial invasive treatment strategy (INV) conservative in 5179 participants chronic coronary disease moderate or severe ischemia. The research program included a comprehensive quality-of-life (QOL) substudy. Methods: In 1819 (907 INV, 912 strategy), we collected battery disease-specific generic QOL instruments by structured interviews at baseline; 3, 12, 24, 36...
Background Women with atrial fibrillation (AF) demonstrate more AF‐related symptoms and worse quality of life (QOL). Whether increased use ablation in women reduces sex‐related QOL differences is unknown. Sex‐related outcomes for versus drug therapy was a prespecified analysis the CABANA (Catheter Ablation Versus Antiarrhythmic Drug Therapy Atrial Fibrillation) trial. Methods Results Symptoms were assessed periodically over 60 months Mayo AF‐Specific Symptom Inventory (MAFSI) frequency...
The STICH Randomized Clinical Trial (Surgical Treatment for Ischemic Heart Failure) demonstrated that coronary artery bypass grafting (CABG) reduced all-cause mortality rates out to 10 years compared with medical therapy alone (MED) in patients ischemic cardiomyopathy and left ventricular function (ejection fraction ≤35%). We examined the economic implications of these results.We used a decision-analytic patient-level simulation model estimate lifetime costs benefits CABG MED using resource...
The VICTORIA trial (Vericiguat Global Study in Subjects With Heart Failure Reduced Ejection Fraction) demonstrated that, patients with high-risk heart failure, vericiguat reduced the primary composite outcome of cardiovascular death or failure hospitalization relative to placebo. hazard ratio for all-cause mortality was 0.95 (95% CI, 0.84-1.07). In a prespecified analysis, treatment effects varied substantially as function baseline NT-proBNP (N-terminal pro-B-type natriuretic peptide)...