14 results on '"DeFilippi, Christopher"'
Search Results
2. Statistical Plan
- Author
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Damluji, Abdulla, deFilippi, Christopher, and Bruce, Scott
- Abstract
We propose to measure circulating biomarkers at baseline, and their change over 3 months, representing generalized inflammation, renal function, ventricular wall stress, and myocyte cell injury. Given recent evidence identifying that the cardiac isoform of troponin T is re-expressed in diseased skeletal muscle we will also aim to evaluate whether measuring the circulating cardiac isoforms for troponin I and T can provide insight into improvements in skeletal muscle function.9 Utilizing previously frozen serum samples from pre-randomization and at 3 months following completion of physical rehabilitation from the REHAB-HF study we propose the following mechanistic and prognostic aims.
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- 2023
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3. The Association Between Baseline and Change in Circulating Biomarkers with Geriatric Syndromes after Physical Therapy Following a Heart failure Hospitalization: The Rehab-HF Trial'
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deFilippi, Christopher, Damluji, Abdulla, and Bruce, Scott
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Medical Sciences ,Musculoskeletal, Neural, and Ocular Physiology ,Geriatrics ,Cardiovascular Diseases ,troponin ,Cardiology ,Medicine and Health Sciences ,Medical Specialties ,heart failure ,Diseases ,Biomarker ,Circulatory and Respiratory Physiology ,Chemicals and Drugs - Abstract
This is a secondary analysis of the REHAB-HF study to evaluate circulating biomarkers of cardiac physiology, inflammation and renal function at baseline and upon completion of a physical rehabilitation program (12 weeks) in these older adults recently hospitalized with specific aims directed and mechanistic insights and prognosis
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- 2023
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4. Symptoms Predictive of Acute Myocardial Infarction in the Troponin Era: Analysis From the TRAPID-AMI Study
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McCord, James, Aurora, Lindsey, Lindahl, Bertil, Giannitsis, Evangelos, Calle-Muller, Carlos, Nowak, Richard, Body, Richard, Christ, Michael, deFilippi, Christopher R, Christenson, Robert H, Jacobsen, Gordon, Alquezar, Aitor, Panteghini, Mauro, Melki, Dina, Plebani, Mario, Verschuren, Franck, French, John, Bendig, Garnet, Weiser, Silvia, Mueller, Christian, TRAPID-AMI Investigators, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, and UCL - (SLuc) Service des urgences
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Male ,medicine.medical_specialty ,Time Factors ,Myocardial Infarction ,030204 cardiovascular system & hematology ,Chest pain ,Diagnosis, Differential ,Electrocardiography ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,Multicenter trial ,myocardial infarction ,symptoms ,troponin ,Humans ,Medicine ,cardiovascular diseases ,Myocardial infarction ,health care economics and organizations ,Aged ,Retrospective Studies ,biology ,business.industry ,Reproducibility of Results ,Electrocardiography in myocardial infarction ,Odds ratio ,Middle Aged ,medicine.disease ,Troponin ,Predictive value of tests ,Cardiology ,biology.protein ,Female ,Myocardial infarction diagnosis ,medicine.symptom ,Emergency Service, Hospital ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,Follow-Up Studies - Abstract
The TRAPID-AMI (High Sensitivity Cardiac Troponin T assay for rapid Rule-out of Acute Myocardial Infarction) study evaluated a rapid "rule-out" acute myocardial infarction (AMI). We evaluated what symptoms were associated with AMI as part of a substudy of TRAPID-AMI. There were 1282 patients evaluated from 12 centers in Europe, the United States of America, and Australia from 2011 to 2013. Multiple symptom variables were prospectively obtained and evaluated for association with the final diagnosis of AMI. Multivariate logistic regression analysis was done, and odds ratios (OR) were calculated. There were 213/1282 (17%) AMIs. Four independent predictors for the diagnosis of AMI were identified: radiation to right arm or shoulder [OR = 3.0; confidence interval (CI): 1.8-5.0], chest pressure (OR = 2.5; CI: 1.3-4.6), worsened by physical activity (OR = 1.7; CI: 1.2-2.5), and radiation to left arm or shoulder (OR = 1.7; CI: 1.1-2.4). In the entire group, 131 (10%) had radiation to right arm or shoulder, 897 (70%) had chest pressure, 385 (30%) worsened with physical activity, and 448 (35%) had radiation to left arm or shoulder. Duration of symptoms was not predictive of AMI. There were no symptoms predictive of non-AMI. Relationship between AMI size and symptoms was also studied. For 213 AMI patients, cardiac troponins I values were divided into 4 quartiles. Symptoms including pulling chest pain, supramammillary right location, and right arm/shoulder radiation were significantly more likely to occur in patients with larger AMIs. In a large multicenter trial, only 4 symptoms were associated with the diagnosis of AMI, and no symptoms that were associated with a non-AMI diagnosis.
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- 2019
5. Combining Biomarkers and Imaging for Short-Term Assessment of Cardiovascular Disease Risk in Apparently Healthy Adults
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Gore, Maria Odette, Ayers, Colby R, Khera, Amit, deFilippi, Christopher R, Wang, Thomas J, Seliger, Stephen L, Nambi, Vijay, Selvin, Elizabeth, Berry, Jarett D, Hundley, W Gregory, Budoff, Matthew, Greenland, Philip, Drazner, Mark H, Ballantyne, Christie M, Levine, Benjamin D, and de Lemos, James A
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Male ,Aging ,carotid intima-media thickness ,carotid intima‐media thickness ,Cardiorespiratory Medicine and Haematology ,Cardiovascular ,Risk Assessment ,N‐terminal pro B‐type natriuretic peptide ,plaque ,Electrocardiography ,Troponin T ,Natriuretic Peptide ,Risk Factors ,Clinical Research ,high‐sensitivity C‐reactive protein ,high-sensitivity cardiac troponin T ,80 and over ,N-terminal pro B-type natriuretic peptide ,Humans ,cardiovascular diseases ,Heart Disease - Coronary Heart Disease ,coronary artery calcium ,Aged ,screening and diagnosis ,Prevention ,Brain ,Middle Aged ,Atherosclerosis ,Peptide Fragments ,high‐sensitivity cardiac troponin T ,Detection ,C-Reactive Protein ,Heart Disease ,Cardiovascular Diseases ,Female ,high-sensitivity C-reactive protein ,Biomarkers ,4.2 Evaluation of markers and technologies - Abstract
Background Current strategies for cardiovascular disease (CVD) risk assessment focus on 10-year or longer timeframes. Shorter-term CVD risk is also clinically relevant, particularly for high-risk occupations, but is under-investigated. Methods and Results We pooled data from participants in the ARIC (Atherosclerosis Risk in Communities study), MESA (Multi-Ethnic Study of Atherosclerosis), and DHS (Dallas Heart Study), free from CVD at baseline (N=16581). Measurements included N-terminal pro-B-type natriuretic peptide (>100pg/mL prospectively defined as abnormal); high-sensitivity cardiac troponin T (abnormal >5ng/L); high-sensitivity C-reactive protein (abnormal >3mg/L); left ventricular hypertrophy by ECG (abnormal if present); carotid intima-media thickness, and plaque (abnormal >75th percentile for age and sex or presence of plaque); and coronary artery calcium (abnormal >10Agatston U). Each abnormal test result except left ventricular hypertrophy by ECG was independently associated with increased 3-year risk of global CVD (myocardial infarction, stroke, coronary revascularization, incident heart failure, or atrial fibrillation), even after adjustment for traditional CVD risk factors and the other test results. When a simple integer score counting the number of abnormal tests was used, 3-year multivariable-adjusted global CVD risk was increased among participants with integer scores of 1, 2, 3, and 4, by ≈2-, 3-, 4.5- and 8-fold, respectively, when compared with those with a score of 0. Qualitatively similar results were obtained for atherosclerotic CVD (fatal or non-fatal myocardial infarction or stroke). Conclusions A strategy incorporating multiple biomarkers and atherosclerosis imaging improved assessment of 3-year global and atherosclerotic CVD risk compared with a standard approach using traditional risk factors.
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- 2020
6. Trends in Blood Pressure and High-Sensitivity Cardiac Troponin-T With Cardiovascular Disease: The Cardiovascular Health Study
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Tehrani, David M, Fan, Wenjun, Nambi, Vijay, Gardin, Julius, Hirsch, Calvin H, Amsterdam, Ezra, deFilippi, Christopher R, Polonsky, Tamar, and Wong, Nathan D
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Male ,Aging ,Time Factors ,hypertension ,Incidence ,Prevention ,Clinical Sciences ,Blood Pressure ,Cardiovascular ,Risk Assessment ,United States ,Heart Disease ,Good Health and Well Being ,Cardiovascular System & Hematology ,Troponin T ,Cardiovascular Diseases ,Risk Factors ,cardiovascular disease ,high-sensitivity troponin ,Humans ,Female ,Longitudinal Studies ,Biomarkers ,Aged - Abstract
BackgroundHigh-sensitivity cardiac troponin T (hs-cTnT) is individually associated with incident hypertension (HTN) and cardiovascular disease (CVD) events. We hypothesize that the increases in hs-cTnT with increases in blood pressure will be related to higher incidence of CVD.MethodsThe Cardiovascular Health Study is a longitudinal cohort of older adults. Those with hs-cTnT data and CVD risk factors at baseline and follow-up (2-3 years later) were stratified based on systolic blood pressure (SBP; optimal
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- 2019
7. Cardiac Biomarkers and Risk of Atrial Fibrillation in Chronic Kidney Disease: The CRIC Study
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Lamprea-Montealegre, Julio A, Zelnick, Leila R, Shlipak, Michael G, Floyd, James S, Anderson, Amanda H, He, Jiang, Christenson, Rob, Seliger, Stephen L, Soliman, Elsayed Z, Deo, Rajat, Ky, Bonnie, Feldman, Harold I, Kusek, John W, deFilippi, Christopher R, Wolf, Myles S, Shafi, Tariq, Go, Alan S, Bansal, Nisha, and CRIC Study Investigators
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Adult ,Male ,Kidney Disease ,Cardiorespiratory Medicine and Haematology ,Cardiovascular ,Risk Assessment ,Young Adult ,Clinical Research ,Humans ,2.1 Biological and endogenous factors ,atrial fibrillation ,Prospective Studies ,Renal Insufficiency ,Chronic ,Aetiology ,Aged ,screening and diagnosis ,Middle Aged ,Detection ,Heart Disease ,Good Health and Well Being ,CRIC Study Investigators ,biomarker ,Female ,Biomarkers ,chronic kidney disease ,4.2 Evaluation of markers and technologies - Abstract
Background We tested associations of cardiac biomarkers of myocardial stretch, injury, inflammation, and fibrosis with the risk of incident atrial fibrillation (AF) in a prospective study of chronic kidney disease patients. Methods and Results The study sample was 3053 participants with chronic kidney disease in the multicenter CRIC (Chronic Renal Insufficiency Cohort) study who were not identified as having AF at baseline. Cardiac biomarkers, measured at baseline, were NT-proBNP (N-terminal pro-B-type natriuretic peptide), high-sensitivity troponin T, galectin-3, growth differentiation factor-15, and soluble ST-2. Incident AF ("AF event") was defined as a hospitalization for AF. During a median follow-up of 8years, 279 (9%) participants developed a new AF event. In adjusted models, higher baseline log-transformed NT-proBNP (N-terminal pro-B-type natriuretic peptide) was associated with incident AF (adjusted hazard ratio [HR] per SD higher concentration: 2.11; 95% CI, 1.75, 2.55), as was log-high-sensitivity troponin T (HR 1.42; 95% CI, 1.20, 1.68). These associations showed a dose-response relationship in categorical analyses. Although log-soluble ST-2 was associated with AF risk in continuous models (HR per SD higher concentration 1.35; 95% CI, 1.16, 1.58), this association was not consistent in categorical analyses. Log-galectin-3 (HR 1.05; 95% CI, 0.91, 1.22) and log-growth differentiation factor-15 (HR 1.16; 95% CI, 0.96, 1.40) were not significantly associated with incident AF. Conclusions We found strong associations between higher NT-proBNP (N-terminal pro-B-type natriuretic peptide) and high-sensitivity troponin T concentrations, and the risk of incident AF in a large cohort of participants with chronic kidney disease. Increased atrial myocardial stretch and myocardial cell injury may be implicated in the high burden of AF in patients with chronic kidney disease.
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- 2019
8. NT -pro BNP as a Mediator of the Racial Difference in Incident Atrial Fibrillation and Heart Failure
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Whitman, Isaac, Vittinghoff, Eric, DeFilippi, Christopher, Gottdiener, John, Alonso, Alvaro, Psaty, Bruce, Heckbert, Susan, Hoogeveen, Ron, Arking, Dan, Selvin, Elizabeth, Chen, Lin, Dewland, Thomas, and Marcus, Gregory
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mechanisms ,congestive heart failure ,natriuretic peptide ,mediation ,cardiovascular diseases ,NT‐proBNP ,atrial fibrillation arrhythmia - Abstract
Background Blacks harbor more cardiovascular risk factors than whites, but experience less atrial fibrillation ( AF ). Conversely, whites may have a lower risk of heart failure ( CHF ). N-terminal pro-B-type natriuretic peptide ( NT -pro BNP) levels are higher in whites, predict incident AF , and have diuretic effects in the setting of increased ventricular diastolic pressures, potentially providing a unifying explanation for these racial differences. Methods and Results We used data from the CHS (Cardiovascular Health Study) to determine the degree to which baseline NT -pro BNP levels mediate the relationships between race and incident AF and CHF by comparing beta estimates between models with and without NT -pro BNP . The ARIC (Atherosclerosis Risk in Communities) study was used to assess reproducibility. Among 4731 CHS (770 black) and 12 418 ARIC (3091 black) participants, there were 1277 and 1253 incident AF events, respectively. Whites had higher baseline NT -pro BNP ( CHS : 40% higher than blacks; 95% CI , 29-53; ARIC : 39% higher; 95% CI , 33-46) and had a greater risk of incident AF compared with blacks ( CHS : adjusted hazard ratio, 1.60; 95% CI , 1.31-1.93; ARIC : hazard ratio, 1.93; 95% CI , 1.57-2.27). NT -pro BNP levels explained a significant proportion of the racial difference in AF risk ( CHS : 36.2%; 95% CI , 23.2-69.2%; ARIC : 24.6%; 95% CI , 14.8-39.6%). Contrary to our hypothesis, given an increased risk of CHF among whites in CHS (adjusted hazard ratio, 1.20; 95% CI , 1.05-1.47) and the absence of a significant association between race and CHF in ARIC (adjusted hazard ratio, 1.07; 95% CI , 0.94-1.23), CHF -related mediation analyses were not performed. Conclusions A substantial portion of the relationship between race and AF was statistically explained by baseline NT -pro BNP levels. No consistent relationship between race and CHF was observed.
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- 2019
9. Kansas City Cardiomyopathy Questionnaire Score Is Associated With Incident Heart Failure Hospitalization in Patients With Chronic Kidney Disease Without Previously Diagnosed Heart Failure: Chronic Renal Insufficiency Cohort Study
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Mishra, Rakesh K, Yang, Wei, Roy, Jason, Anderson, Amanda H, Bansal, Nisha, Chen, Jing, DeFilippi, Christopher, Delafontaine, Patrice, Feldman, Harold I, Kallem, Radhakrishna, Kusek, John W, Lora, Claudia M, Rosas, Sylvia E, Go, Alan S, Shlipak, Michael G, and CRIC Study Investigators
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Adult ,Male ,Time Factors ,Kidney Disease ,Left ,Medical Physiology ,Renal and urogenital ,heart failure ,Cardiorespiratory Medicine and Haematology ,Cardiovascular ,Risk Assessment ,renal insufficiency ,Young Adult ,Natriuretic Peptide ,Clinical Research ,Risk Factors ,Surveys and Questionnaires ,Ventricular Dysfunction ,Odds Ratio ,Humans ,Ventricular Function ,2.1 Biological and endogenous factors ,Prospective Studies ,Chronic ,Aetiology ,Proportional Hazards Models ,Aged ,Chi-Square Distribution ,Incidence ,Brain ,Hypertrophy ,Middle Aged ,Myocardial Contraction ,Peptide Fragments ,United States ,Left Ventricular ,Hospitalization ,Logistic Models ,Heart Disease ,Cardiovascular System & Hematology ,CRIC Study Investigators ,Multivariate Analysis ,Disease Progression ,Female ,Biochemistry and Cell Biology ,Cardiomyopathies ,Biomarkers - Abstract
BackgroundChronic kidney disease is a risk factor for heart failure (HF). Patients with chronic kidney disease without diagnosed HF have an increased burden of symptoms characteristic of HF. It is not known whether these symptoms are associated with occurrence of new onset HF.Methods and resultsWe studied the association of a modified Kansas City Cardiomyopathy Questionnaire with newly identified cases of hospitalized HF among 3093 participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study who did not report HF at baseline. The annually updated Kansas City Cardiomyopathy Questionnaire score was categorized into quartiles (Q1-4) with the lower scores representing the worse symptoms. Multivariable-adjusted repeated measure logistic regression models were adjusted for demographic characteristics, clinical risk factors for HF, N-terminal probrain natriuretic peptide level and left ventricular hypertrophy, left ventricular systolic and diastolic dysfunction. Over a mean (±SD) follow-up period of 4.3±1.6 years, there were 211 new cases of HF hospitalizations. The risk of HF hospitalization increased with increasing symptom quartiles; 2.62, 1.85, 1.14, and 0.74 events per 100 person-years, respectively. The median number of annual Kansas City Cardiomyopathy Questionnaire assessments per participant was 5 (interquartile range, 3-6). The annually updated Kansas City Cardiomyopathy Questionnaire score was independently associated with higher risk of incident HF hospitalization in multivariable-adjusted models (odds ratio, 3.30 [1.66-6.52]; P=0.001 for Q1 compared with Q4).ConclusionsSymptoms characteristic of HF are common in patients with chronic kidney disease and are associated with higher short-term risk for new hospitalization for HF, independent of level of kidney function, and other known HF risk factors.
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- 2015
10. Recommendations On Pre-Hospital & Early Hospital Management Of Acute Heart Failure: A Consensus Paper From The Heart Failure Association Of The European Society Of Cardiology, The European Society Of Emergency Medicine And The Society Of Academic Emergency Medicine
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Mebazaa, Alexandre, Yilmaz, M. Birhan, Levy, Phillip, Ponikowski, Piotr, Peacock, W. Frank, Laribi, Said, Ristic, Arsen D., Lambrinou, Ekaterini, Masip, Josep, Riley, Jillian P., McDonagh, Theresa, Mueller, Christian, deFilippi, Christopher, Harjola, Veli-Pekka, Thiele, Holger, Piepoli, Massimo F., Metra, Marco, Maggioni, Aldo, McMurray, John, and Dickstein, Kenneth
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Acute heart failure is a fatal syndrome. Emergency physicians, cardiologists, intensivists, nurses and other health care providers have to cooperate to provide optimal benefit. However, many treatment decisions are opinion-based and few are evidenced-based. This consensus paper provides guidance to practicing physicians and nurses to manage acute heart failure in the pre-hospital and hospital setting. Criteria of hospitalization and of discharge are described. Gaps in knowledge and perspectives in the management of acute heart failure are also detailed. This consensus paper on acute heart failure might help enable contiguous practice.
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- 2015
11. Association of cardiac troponin T with left ventricular structure and function in CKD
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Mishra, Rakesh K, Li, Yongmei, DeFilippi, Christopher, Fischer, Michael J, Yang, Wei, Keane, Martin, Chen, Jing, He, Jiang, Kallem, Radhakrishna, Horwitz, Edward J, Rafey, Mohammad, Raj, Dominic S, Go, Alan S, Shlipak, Michael G, and CRIC Study Investigators
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Adult ,Male ,Kidney Disease ,Heart Ventricles ,Left ,Clinical Sciences ,Renal and urogenital ,Cardiovascular ,Young Adult ,Troponin T ,Predictive Value of Tests ,Clinical Research ,Ventricular Dysfunction ,Humans ,Ventricular Function ,Renal Insufficiency ,Chronic ,Retrospective Studies ,Aged ,screening and diagnosis ,Prevention ,left ventricular structure ,Middle Aged ,Urology & Nephrology ,Prognosis ,4.1 Discovery and preclinical testing of markers and technologies ,Detection ,Cross-Sectional Studies ,Heart Disease ,Echocardiography ,CRIC Study Investigators ,Disease Progression ,Public Health and Health Services ,Female ,chronic kidney disease ,Glomerular Filtration Rate ,Follow-Up Studies - Abstract
BackgroundSerum cardiac troponin T (cTnT) is associated with increased risk of heart failure and cardiovascular death in several population settings. We evaluated associations of cTnT levels with cardiac structural and functional abnormalities in a cohort of patients with chronic kidney disease (CKD) without heart failure.Study designCross-sectional.Setting & participantsChronic Renal Insufficiency Cohort (CRIC; N=3,243).PredictorThe primary predictor was cTnT level. Secondary predictors included demographic and clinical characteristics, hemoglobin level, high-sensitivity C-reactive protein level, and estimated glomerular filtration rate using cystatin C.OutcomesEchocardiography was used to determine left ventricular (LV) mass and LV systolic and diastolic function.MeasurementsCirculating cTnT was measured in stored sera using the highly sensitive assay. Logistic and linear regression models were used to examine associations of cTnT level with each echocardiographic outcome.ResultscTnT was detectable in 2,735 (84%) persons; median level was 13.3 (IQR, 7.7-23.8) pg/mL. Compared with undetectable cTnT (
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- 2013
12. Association of N-terminal pro-B-type natriuretic peptide with left ventricular structure and function in chronic kidney disease (from the Chronic Renal Insufficiency Cohort [CRIC])
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Mishra, Rakesh K, Li, Yongmei, Ricardo, Ana C, Yang, Wei, Keane, Martin, Cuevas, Magdalena, Christenson, Robert, deFilippi, Christopher, Chen, Jing, He, Jiang, Kallem, Radhakrishna R, Raj, Dominic S, Schelling, Jeffrey R, Wright, Jackson, Go, Alan S, Shlipak, Michael G, and Chronic Renal Insufficiency Cohort Investigators
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Adult ,Male ,Kidney Disease ,Heart Ventricles ,Left ,Cardiorespiratory Medicine and Haematology ,Cardiovascular ,Severity of Illness Index ,Young Adult ,Natriuretic Peptide ,Clinical Research ,Ventricular Dysfunction ,Prevalence ,Humans ,Ventricular Function ,Renal Insufficiency ,Protein Precursors ,Chronic ,Retrospective Studies ,Aged ,Incidence ,Prevention ,Brain ,Middle Aged ,Prognosis ,Peptide Fragments ,United States ,Cross-Sectional Studies ,Heart Disease ,Cardiovascular System & Hematology ,Echocardiography ,Female ,Chronic Renal Insufficiency Cohort Investigators ,Follow-Up Studies - Abstract
We evaluated the cross-sectional associations of N-terminal pro-B-type natriuretic peptide (NT-proBNP) with cardiac structural and functional abnormalities in a cohort of patients with chronic kidney disease without clinical heart failure, the Chronic Renal Insufficiency Cohort (n = 3,232). The associations of NT-proBNP with echocardiographically determined left ventricular (LV) mass and LV systolic and diastolic function were evaluated using multivariate logistic and linear regression models. Reclassification of participants' predicted risk of LV hypertrophy (LVH), systolic and diastolic dysfunction was performed using a category-free net reclassification improvement index that compared a clinical model with and without NT-proBNP. The median NT-proBNP was 126.6 pg/ml (interquartile range 55.5 to 303.7). The greatest quartile of NT-proBNP was associated with a nearly threefold odds of LVH (odds ratio 2.7, 95% confidence interval [CI] 1.8 to 4.0) and LV systolic dysfunction (odds ratio 2.7, 95% CI 1.7 to 4.5) and a twofold odds of diastolic dysfunction (odds ratio 2.0, 95% CI 1.3 to 2.9) in the fully adjusted models. When evaluated alone as a screening test, NT-proBNP functioned modestly for the detection of LVH (area under the curve 0.66) and LV systolic dysfunction (area under the curve 0.62) and poorly for the detection of diastolic dysfunction (area under the curve 0.51). However, when added to the clinical model, NT-proBNP significantly reclassified participants' likelihood of having LVH (net reclassification improvement 0.14, 95% CI 0.13-0.15; p
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- 2013
13. Copeptin helps in the early detection of patients with acute myocardial infarction: primary results of the CHOPIN trial (Copeptin Helps in the early detection Of Patients with acute myocardial INfarction)
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Maisel, Alan, Mueller, Christian, Neath, Sean-Xavier, Christenson, Robert H., Morgenthaler, Nils G., McCord, James, Nowak, Richard M., Vilke, Gary, Daniels, Lori B., Hollander, Judd E., Apple, Fred S., Cannon, Chad, Nagurney, John T., Schreiber, Donald, deFilippi, Christopher, Hogan, Christopher, Diercks, Deborah B., Stein, John C., Headden, Gary, Limkakeng, Alexander T., Anand, Inder, Wu, Alan H.B., Papassotiriou, Jana, Hartmann, Oliver, Ebmeyer, Stefan, Clopton, Paul, Jaffe, Allan S., and Peacock, W. Frank
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Male ,Chest Pain ,emergency department ,troponin ,Troponin I ,Glycopeptides ,Myocardial Infarction ,copeptin ,Middle Aged ,Sensitivity and Specificity ,quality improvement ,Electrocardiography ,Early Diagnosis ,Predictive Value of Tests ,Humans ,Female ,cardiovascular diseases ,Prospective Studies ,Emergency Service, Hospital ,Biomarkers - Abstract
ObjectivesThe goal of this study was to demonstrate that copeptin levels 14 pmol/l in 23 (72%) of 32 patients. Non–ST-segment elevation myocardial infarctions undetected by cTnI at 0 h were detected with copeptin >14 pmol/l in 10 (53%) of 19 patients. Projected average time-to-decision could be reduced by 43% (from 3.0 h to 1.8 h) by the early rule out of 58% of patients. Both abnormal copeptin and cTnI were predictors of death at 180 days (p < 0.0001 for both; c index 0.784 and 0.800, respectively). Both were independent of age and each other and provided additional predictive value (all p < 0.0001).ConclusionsAdding copeptin to cTnI allowed safe rule out of AMI with a negative predictive value >99% in patients presenting with suspected acute coronary syndromes. This combination has the potential to rule out AMI in 58% of patients without serial blood draws. (Investigation of the Biomarker Copeptin in Patients With Acute Myocardial Infarction [NCT00952744])
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- 2012
14. Recommendations on pre-hospitalearly hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine
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Ekaterini Lambrinou, Kenneth Dickstein, Holger Thiele, Alexandre Mebazaa, Theresa McDonagh, Stefan D. Anker, Gerasimos Filippatos, Aldo P. Maggioni, Arsen D. Ristić, Phillip D. Levy, Jillian P. Riley, Massimo F Piepoli, Said Laribi, Abdelouahab Bellou, John J.V. McMurray, Adelino F. Leite-Moreira, Kevin Damman, Marco Metra, Josep Masip, W. Frank Peacock, M. Birhan Yilmaz, Piotr Ponikowski, Veli-Pekka Harjola, Christopher DeFilippi, Christian Mueller, Petar M. Seferovic, Frank Ruschitzka, Λαμπρινού, Αικατερίνη, [Mebazaa, Alexandre] Univ Paris Diderot, Sorbonne Paris Cite, INSERM, U942,Hop Lariboisiere,St Louis Univ Hosp, Paris, France -- [Yilmaz, M. Birhan] Cumhuriyet Univ, Fac Med, Dept Cardiol, TR-58140 Sivas, Turkey -- [Levy, Phillip] Wayne State Univ, Sch Med, Dept Emergency Med, Detroit, MI USA -- [Levy, Phillip] Wayne State Univ, Sch Med, Cardiovasc Res Inst, Detroit, MI USA -- [Ponikowski, Piotr] Wroclaw Med Univ, Mil Hosp 4, PL-50981 Wroclaw, Poland -- [Peacock, W. Frank] Baylor Coll Med, Ben Taub Gen Hosp, Houston, TX 77030 USA -- [Laribi, Said] Grp Hosp St Louis Lariboisiere, AP HP, INSERM, U942, Paris, France -- [Ristic, Arsen D.] Clin Ctr Serbia, Dept Cardiol, Belgrade, Serbia -- [Ristic, Arsen D.] Univ Belgrade, Sch Med, Belgrade, Serbia -- [Lambrinou, Ekaterini] Cyprus Univ Technol, Sch Hlth Sci, Dept Nursing, Limassol, Cyprus -- [Masip, Josep] Univ Barcelona, Hosp St Joan Despi Moises Broggi, Consorci Sanitari Integral, Barcelona, Spain -- [Masip, Josep] Univ Barcelona, Hosp Gen Hosp, Barcelona, Spain -- [Riley, Jillian P.] Univ London Imperial Coll Sci Technol & Med, London, England -- [McDonagh, Theresa] Kings Coll Hosp London, London, England -- [Mueller, Christian] Univ Basel Hosp, Dept Cardiol, CH-4031 Basel, Switzerland -- [deFilippi, Christopher] Univ Maryland, Sch Med, Div Cardiovasc Med, Baltimore, MD 21201 USA -- [Harjola, Veli-Pekka] Univ Helsinki, Helsinki Univ Hosp, Emergency Med, Helsinki, Finland -- [Thiele, Holger] Med Univ Lubeck, Univ Hosp Schleswig Holstein, Med Clin 2, D-23538 Lubeck, Germany -- [Piepoli, Massimo F.] AUSL Piacenza, Guglielmo da Saliceto Hosp, Dept Cardiac, Heart Failure Unit, Piacenza, Italy -- [Metra, Marco] Univ Brescia, Dept Med & Surg Specialties Radiol Sci & Publ Hlt, Cardiol, Brescia, Italy -- [Maggioni, Aldo] ANMCO Resarch Ctr, Florence, Italy -- [McMurray, John J. V.] Univ Glasgow, BHF Cardiovasc Res Ctr, Glasgow, Lanark, Scotland -- [Dickstein, Kenneth] Univ Bergen, Stavanger Univ Hosp, Bergen, Norway -- [Damman, Kevin] Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands -- [Seferovic, Petar M.] Univ Belgrade, Fac Med, Belgrade, Serbia -- [Seferovic, Petar M.] Univ Med Ctr, Dept Cardiol, Belgrade, Serbia -- [Ruschitzka, Frank] Univ Heart Ctr, Dept Cardiol, CH-8091 Zurich, Switzerland -- [Leite-Moreira, Adelino F.] Univ Porto, Fac Med, Dept Physiol & Cardiothorac Surg, P-4100 Oporto, Portugal -- [Leite-Moreira, Adelino F.] Ctr Hosp Sao Joao, Dept Cardiothorac Surg, Oporto, Portugal -- [Bellou, Abdelouahab] Harvard Univ, Sch Med, Boston, MA USA -- [Bellou, Abdelouahab] Beth Israel Deaconess Med Ctr, Dept Emergency Med, Boston, MA 02215 USA -- [Bellou, Abdelouahab] Univ Rennes 1, Fac Med, Rennes, France -- [Anker, Stefan D.] Charite, Dept Cardiol, Div Appl Cachexia Res, Berlin, Germany -- [Anker, Stefan D.] Univ Med Ctr Gottingen UMG, Dept Cardiol, Div Innovat Clin Trials, Gottingen, Germany -- [Filippatos, Gerasimos] Univ Athens, Sch Med, Attikon Univ Hosp, Dept Cardiol, GR-11527 Athens, Greece, YILMAZ, MEHMET BIRHAN -- 0000-0002-8169-8628, YILMAZ, Mehmet Birhan -- 0000-0002-8169-8628, Leite-Moreira, Adelino -- 0000-0001-7808-3596, piepoli, massimo francesco -- 0000-0003-1124-234X, Ponikowski, Piotr -- 0000-0002-3391-7064, Mebazaa, Alexandre -- 0000-0001-8715-7753, mcmurray, john -- 0000-0002-6317-3975, Bellou, Abdelouahab -- 0000-0003-3457-5585, University of Zurich, Mebazaa, Alexandre, Cardiovascular Centre (CVC), and [Mebazaa, Alexandre] Univ Paris Diderot, Lariboisiere St Louis Univ Hosp, AP HP, Sorbonne Paris Cite, Paris, France -- [Yilmaz, M. Birhan] Cumhuriyet Univ, Fac Med, Dept Cardiol, TR-58140 Sivas, Turkey -- [Levy, Phillip] Wayne State Univ, Sch Med, Dept Emergency Med, Detroit, MI USA -- [Levy, Phillip] Wayne State Univ, Sch Med, Cardiovasc Res Inst, Detroit, MI USA -- [Ponikowski, Piotr] Wroclaw Med Univ, Mil Hosp 4, PL-50981 Wroclaw, Poland -- [Peacock, W. Frank] Ben Taub Gen Hosp, Baylor Coll Med, Houston, TX 77030 USA -- [Laribi, Said] INSERM, UMRS 942, Paris, France -- [Ristic, Arsen D.] Clin Ctr Serbia, Dept Cardiol, Belgrade, Serbia -- [Ristic, Arsen D.] Univ Belgrade, Sch Med, Belgrade, Serbia -- [Lambrinou, Ekaterini] Cyprus Univ Technol, Sch Hlth Sci, Dept Nursing, Limassol, Cyprus -- [Masip, Josep] Univ Barcelona, Hosp St Joan DespiMoises Broggi, Consorci Sanitari Integral, Barcelona, Spain -- [Masip, Josep] Univ Barcelona, Hosp Gen Hosp, Barcelona, Spain -- [Riley, Jillian P.] Univ London Imperial Coll Sci Technol & Med, London, England -- [McDonagh, Theresa] Kings Coll Hosp London, London, England -- [Mueller, Christian] Univ Basel Hosp, Dept Cardiol, CH-4031 Basel, Switzerland -- [deFilippi, Christopher] Univ Maryland, Sch Med, Div Cardiovasc Med, Baltimore, MD 21201 USA -- [Harjola, Veli-Pekka] Univ Helsinki, Helsinki Univ Hosp, Emergency Med, Helsinki, Finland -- [Thiele, Holger] Med Univ Lubeck, Univ Hosp Schleswig Holstein, Med Clin 2, D-23538 Lubeck, Germany -- [Piepoli, Massimo F.] AUSL Piacenza, Guglielmo da Saliceto Hosp, Dept Cardiac, Heart Failure Unit, Piacenza, Italy -- [Metra, Marco] Univ Brescia, Dept Med & Surg Specialties Radiol Sci & Publ Hlt, Cardiol, Brescia, Italy -- [Maggioni, Aldo] ANMCO Resarch Ctr, Fireze, Italy -- [McMurray, John] Univ Glasgow, BHF Cardiovasc Res Ctr, Glasgow, Lanark, Scotland -- [Dickstein, Kenneth] Univ Bergen, Stavanger Univ Hosp, Bergen, Norway -- [Damman, Kevin] Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands -- [Seferovic, Petar M.] Univ Belgrade, Fac Med, Belgrade, Serbia -- [Seferovic, Petar M.] Univ Med Ctr, Dept Cardiol, Belgrade, Serbia -- [Ruschitzka, Frank] Univ Heart Ctr, Dept Cardiol, CH-8091 Zurich, Switzerland -- [Leite-Moreira, Adelino F.] Univ Porto, Fac Med, Dept Physiol & Cardiothorac Surg, P-4100 Oporto, Portugal -- [Leite-Moreira, Adelino F.] Ctr Hosp Sao Joao, Dept Cardiothorac Surg, Oporto, Portugal -- [Bellou, Abdelouahab] Harvard Univ, Sch Med, Boston, MA USA -- [Bellou, Abdelouahab] Beth Israel Deaconess Med Ctr, Dept Emergency Med, Boston, MA 02215 USA -- [Bellou, Abdelouahab] Univ Rennes 1, Fac Med, Rennes, France -- [Anker, Stefan D.] Charite, Dept Cardiol, Div Appl Cachexia Res, Berlin, Germany -- [Anker, Stefan D.] Univ Med Ctr Groningen, Dept Cardiol, Div Innovat Clin Trials, Gottingen, Germany -- [Filippatos, Gerasimos] Univ Athens, Sch Med, Attikon Univ Hosp, Dept Cardiol, GR-11527 Athens, Greece
- Subjects
Male ,Cardiac Care Facilities ,vasodilators ,Vasodilator Agents ,law.invention ,0302 clinical medicine ,DESIGN ,CLINICAL CHARACTERISTICS ,Health care ,Myocardial infarction ,Diuretics ,Societies, Medical ,Emergency Service ,OUTCOMES ,Evidence-Based Medicine ,Respiration ,cardiogenic shock ,3. Good health ,Administration ,Artificial ,Acute Disease ,10209 Clinic for Cardiology ,Emergency medicine ,TRIAL ,Emergency Service, Hospital ,Cardiology and Cardiovascular Medicine ,Oral ,medicine.medical_specialty ,Infusions ,ACUTE MYOCARDIAL-INFARCTION ,Shock, Cardiogenic ,Heart failure ,Acute ,2705 Cardiology and Cardiovascular Medicine ,03 medical and health sciences ,Hospital ,Intensive care ,Medical ,Humans ,Intensive care medicine ,Aged ,Heart Failure ,Clinical Laboratory Techniques ,NATRIURETIC PEPTIDE ,Oxygen Inhalation Therapy ,Administration, Oral ,Algorithms ,Consensus ,Critical Care ,Emergency Medical Services ,Female ,Heart-Assist Devices ,Hospitalization ,Infusions, Intravenous ,Nurse's Role ,Oxygen ,Patient Discharge ,Respiration, Artificial ,Evidence-based medicine ,medicine.disease ,Coronary care unit ,Coronary care units ,Treatment decision making ,Clinical Medicine ,TASK-FORCE ,Hospital setting ,RATIONALE ,030204 cardiovascular system & hematology ,Medical and Health Sciences ,Health administration ,law ,030212 general & internal medicine ,Cardiogenic shock ,ISOSORBIDE-DINITRATE ,Vasodilators ,Shock ,Intensive care unit ,Europe ,Practice Guidelines as Topic ,Emergency Medicine ,Noninvasive ventilation ,Medical emergency ,Intravenous ,Cardiology ,Context (language use) ,610 Medicine & health ,NONINVASIVE VENTILATION ,CARDIOGENIC PULMONARY-EDEMA ,medicine ,Task force ,business.industry ,Acute heart failure ,diuretics ,Emergency department ,Cardiogenic ,SCIENTIFIC STATEMENT ,Hospital administration ,RELAX-AHF ,Societies ,business - Abstract
WOS: 000356799600005, PubMed ID: 25999021, Acute heart failure is a fatal syndrome. Emergency physicians, cardiologists, intensivists, nurses and other health care providers have to cooperate to provide optimal benefit. However, many treatment decisions are opinion-based and few are evidenced-based. This consensus paper provides guidance to practicing physicians and nurses to manage acute heart failure in the pre-hospital and hospital setting. Criteria of hospitalization and of discharge are described. Gaps in knowledge and perspectives in the management of acute heart failure are also detailed. This consensus paper on acute heart failure might help enable contiguous practice., Bayer; Cardiorentis; Medicine Company; Critical Diagnostics; Novartis; Steering Committee member of Cardiorentis; TUBITAK; Medicines Company; Cornerstone Therapeutics; Otsuka; Janssen; Apex Innovations; Inte-Section Medical; Trevena; Vifor Pharma Ltd; Amgen; Servier; Abbott Vascular; Coridea; Respicardia; Swiss National Science Foundation; Swiss Heart Foundation; Cardiovascular Research Foundation Basel; 8sense; Abbott; ALERE; Brahms; Nanosphere; Roche; Siemens; University Hospital Basel; Astra Zeneca; BG medicine; Biomerieux; Lilly; Orion; Resmed; Roche Diagnostics; Ratiopharm; BMS; Boehringer-Ingelheim; Pfizer; Daiichi Sankyo; Boehinger Ingelheim; AstraZeneca; European Union, A.M. received speaker's honoraria from Alere, Bayer, Edwards Life Sciences, The Medicines Company, Novartis, Orion, Servier, Thermofisher, Vifor Pharma and also received fee as member of advisory board and/or Steering Committee from Bayer, Cardiorentis, The Medicine Company, Critical Diagnostics.; M.B.Y. received speaker's honoraria and research fee from Novartis and received fee as Steering Committee member of Cardiorentis, and is supported by TUBITAK.; P.L. received speaker's honoraria from Beckman Coulter and Novartis and also received fees as a member of advisory board and/or Steering Committee from Bayer, Cardiorentis, The Medicines Company, Cornerstone Therapeutics, Novartis, Otsuka, Janssen, Apex Innovations, Inte-Section Medical, and Trevena.; P.P. received speaker's honoraria from Bayer, Novartis, Servier, Vifor Pharma, Amgen, Pfizer, Cardiorentis, Merck-Serono, Abbott Vascular and Respicardia and also received fee as member of advisory board and/or Steering Committee from Bayer, Cardiorentis, Novartis, Vifor Pharma Ltd, Amgen, Servier, Abbott Vascular, Coridea and Respicardia.; E.L. received consultancy fee from Novartis.; J.M. received honoraria for speaker or advisor from Abbott, Novartis, Orion, Otsuka, and Sanofi and fee as a member of Steering Committee from Corthera, Novartis, and Cardiorentis.; C.M. received research grants from the Swiss National Science Foundation and the Swiss Heart Foundation, the Cardiovascular Research Foundation Basel, 8sense, Abbott, ALERE, Brahms, Critical Diagnostics, Nanosphere, Roche, Siemens, and the University Hospital Basel, as well as speaker/consulting honoraria from Astra Zeneca, Abbott, ALERE, BG medicine, Biomerieux, Brahms, Cardiorentis, Lilly, Novartis, Pfizer, Roche, and Siemens.; V.P.H. received speaker's fee: Bayer, Orion, Resmed, Roche Diagnostics, Ratiopharm; consultation fees: Bayer, BMS, Boehringer-Ingelheim, Novartis, Pfizer, Roche Diagnostics, Servier. H.A.T. received speaker's honoraria from Daiichi Sankyo, Lilly, Medicines Company, AstraZeneca, Boehinger Ingelheim. Advisory board for Maquet Cardiovascular. Institutional research support by Maquet Cardiovascular, Teleflex, Terumo, Lilly, The Medicine Company.; G.F. has received research grants and/or has served as Committee member or Cochair of studies sponsored by Bayer, Novartis, Cardiorentis, Vifor Pharma, and the European Union.
- Published
- 2014
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