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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ahj.2010.06.014 Byline: Kevin L. Thomas, Emily Honeycutt, Linda K. Shaw, Eric D. Peterson Abstract: Cardiovascular disease is the leading cause of death among blacks and whites in the United States. Despite this, there are insufficient data on the long-term prognosis of black patients with coronary artery disease (CAD) as well as the major clinical related determinants of outcome. Author Affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC Article History: Received 3 May 2010; Accepted 7 June 2010 Article Note: (footnote) There are no relationships with industry to disclose relevant to this submission., Funding was provided by the Duke Clinical Research Institute.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ahj.2008.05.033 Byline: Rajendra H. Mehta (a)(b), Emily Honeycutt (b), Linda K. Shaw (b), Michael H. Sketch (a) Abstract: Limited data exist on the long-term outcomes among diabetic patients undergoing saphenous vein graft (SVG) interventions. Thus, the baseline clinical factors associated with long-term adverse events in these patients are less known. Author Affiliation: (a) Duke University Medical Center, Durham, NC (b) The Duke Clinical Research Institute, Durham, NC Article History: Received 9 March 2008; Accepted 17 May 2008 Article Note: (footnote) Dr Mehta is funded by the Duke Clinical Research Institute, Durham, NC.

The association between clopidogrel use and long-term clinical outcomes of patients receiving drug-eluting stents (DES) and bare-metal stents (BMS) for treatment of coronary artery disease is assessed. The results have shown that the extended use of clopidogrel in patients with DES might be associated with reduced risk for death and myocardial infarction (MI), but the appropriate duration for clopidogrel administration can be determined within the context of a large-scale randomized clinical trial.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ahj.2006.06.004 Byline: Rajendra H. Mehta, Emily Honeycutt, Linda K. Shaw, Donald Glower, Robert A. Harrington, Michael H. Sketch Abstract: Increasing number of patients undergo percutaneous intervention of saphenous vein grafts (SVGs). However, the clinical factors associated with long-term mortality after SVG interventions are currently less known. Accordingly, the goal of present study was to evaluate clinical correlates of long-term mortality and to develop a simple bedside tool for risk stratification in patients undergoing SVG interventions. Author Affiliation: Department of Internal Medicine, Division of Cardiology, Duke University Medical Center and the Duke Clinical Research Institute, Durham, NC Article History: Received 6 March 2006; Accepted 6 June 2006 Article Note: (footnote) This study was funded by the Duke Clinical Research Institute, Durham, NC., Guest editor of this manuscript is David Hasdai, MD.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ahj.2005.03.056 Byline: G. Michael Felker, Linda K. Shaw, Wendy Gattis Stough, Christopher M. O'Connor Abstract: Anemia has been shown to be a predictor of mortality in patients with heart failure and impaired left ventricular systolic function (ISF). Although heart failure in the setting of preserved systolic function (PSF) is an important clinical problem, the relationship between anemia and outcomes in patients with PSF has not been carefully evaluated. Author Affiliation: Duke Clinical Research Institute, Durham, NC Article History: Received 12 November 2004; Accepted 30 March 2005 Article Note: (footnote) Dr Felker is supported in part by NIH K23 HL72357-01A1. This research was funded independently by the Duke Clinical Research Institute.

Blacks with coronary artery disease appear to be less likely to receive coronary revascularization procedures than whites. These are procedures to open blocked arteries and include angioplasty and coronary bypass surgery. Researchers analyzed the use of revascularization procedures in 12,402 patients with coronary artery disease, of whom 10.3% were black. Even after adjusting for the severity of disease, blacks were 13% less likely to receive angioplasty and 32% less likely to have bypass surgery. This was true even in those with severe symptoms and those most likely to benefit from the procedures.

The lower rate of cardiac catheterization among women appears to be a result of the lower rates of probability for cardiac disease in women, not the result of sex bias in physician referrals. Cardiologists were asked to diagnose the probability of heart disease and survival in 410 patients based upon the patients' electrocardiography readings and certain risk factors. These diagnoses were then compared to similar diagnoses made through validated statistical models. The doctors referred 27% of the men and 18% of the women for catheterization without knowing the exercise test results. Of those with positive exercise tests, 48% of men and 44% of women were referred for catheterization, suggesting that exercise test results are often a determining factor in referral. The objective statistical diagnoses were compared to the doctors' diagnoses and revealed that doctors overestimated the evidence of heart disease in 47% of the women, as compared to only 20% of the men. Overall, the doctors' diagnoses were more consistent with objective analyses for men than for women.