676 results on '"Dunning, Allison"'
Search Results
2. Superior Risk Stratification With Coronary Computed Tomography Angiography Using a Comprehensive Atherosclerotic Risk Score
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van Rosendael, Alexander R, Shaw, Leslee J, Xie, Joe X, Dimitriu-Leen, Aukelien C, Smit, Jeff M, Scholte, Arthur J, van Werkhoven, Jacob M, Callister, Tracy Q, DeLago, Augustin, Berman, Daniel S, Hadamitzky, Martin, Hausleiter, Jeorg, Al-Mallah, Mouaz H, Budoff, Matthew J, Kaufmann, Philipp A, Raff, Gilbert, Chinnaiyan, Kavitha, Cademartiri, Filippo, Maffei, Erica, Villines, Todd C, Kim, Yong-Jin, Feuchtner, Gudrun, Lin, Fay Y, Jones, Erica C, Pontone, Gianluca, Andreini, Daniele, Marques, Hugo, Rubinshtein, Ronen, Achenbach, Stephan, Dunning, Allison, Gomez, Millie, Hindoyan, Niree, Gransar, Heidi, Leipsic, Jonathon, Narula, Jagat, Min, James K, and Bax, Jeroen J
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Biomedical and Clinical Sciences ,Clinical Sciences ,Heart Disease ,Atherosclerosis ,Biomedical Imaging ,Prevention ,Patient Safety ,Cardiovascular ,Clinical Research ,Heart Disease - Coronary Heart Disease ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Adult ,Aged ,Computed Tomography Angiography ,Coronary Angiography ,Coronary Artery Disease ,Coronary Stenosis ,Coronary Vessels ,Female ,Humans ,Male ,Middle Aged ,Multidetector Computed Tomography ,Myocardial Infarction ,Plaque ,Atherosclerotic ,Predictive Value of Tests ,Progression-Free Survival ,Reproducibility of Results ,Risk Assessment ,Risk Factors ,Severity of Illness Index ,coronary computed tomography angiography ,risk stratification ,stable coronary artery disease ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
ObjectivesThis study was designed to assess the prognostic value of a new comprehensive coronary computed tomography angiography (CTA) score compared with the stenosis severity component of the Coronary Artery Disease-Reporting and Data System (CAD-RADS).BackgroundCurrent risk assessment with coronary CTA is mainly focused on maximal stenosis severity. Integration of plaque extent, location, and composition in a comprehensive model may improve risk stratification.MethodsA total of 2,134 patients with suspected but without known CAD were included. The predictive value of the comprehensive CTA score (ranging from 0 to 42 and divided into 3 groups: 0 to 5, 6 to 20, and >20) was compared with the CAD-RADS combined into 3 groups (0% to 30%, 30% to 70% and ≥70% stenosis). Its predictive performance was internally and externally validated (using the 5-year follow-up dataset of the CONFIRM [Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry], n = 1,971).ResultsThe mean age of patients was 55 ± 13 years, mean follow-up 3.6 ± 2.8 years, and 130 events (myocardial infarction or death) occurred. The new, comprehensive CTA score showed strong and independent predictive value using the Cox proportional hazard analysis. A model including clinical variables plus comprehensive CTA score showed better discrimination of events compared with a model consisting of clinical variables plus CAD-RADS (0.768 vs. 0.742, p = 0.001). Also, the comprehensive CTA score correctly reclassified a significant proportion of patients compared with the CAD-RADS (net reclassification improvement 12.4%, p < 0.001). Good predictive accuracy was reproduced in the external validation cohort.ConclusionsThe new comprehensive CTA score provides better discrimination and reclassification of events compared with the CAD-RADS score based on stenosis severity only. The score retained similar prognostic accuracy when externally validated. Anatomic risk scores can be improved with the addition of extent, location, and compositional measures of atherosclerotic plaque. (Comprehensive CTA risk score calculator is available at: http://18.224.14.19/calcApp/).
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- 2019
3. Biomechanical characterization of isolated epineurial and perineurial membranes of rabbit sciatic nerve
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Koppaka, Smruta, Hess-Dunning, Allison, and Tyler, Dustin J.
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- 2022
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4. Prognostic value of age adjusted segment involvement score as measured by coronary computed tomography: a potential marker of vascular age
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Ayoub, Chadi, Kritharides, Leonard, Yam, Yeung, Chen, Li, Hossain, Alomgir, Achenbach, Stephan, Al-Mallah, Mouaz H, Andreini, Daniele, Berman, Daniel S, Budoff, Matthew J, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Chinnaiyan, Kavitha, Cury, Ricardo C, Delago, Augustin, Dunning, Allison, Feuchtner, Gudrun, Gomez, Millie, Gransar, Heidi, Hadamitzky, Martin, Hausleiter, Joerg, Hindoyan, Niree, Kaufmann, Philipp A, Kim, Yong-Jin, Leipsic, Jonathon, Maffei, Erica, Marques, Hugo, Pontone, Gianluca, Raff, Gilbert, Rubinshtein, Ronen, Shaw, Leslee J, Villines, Todd C, Min, James K, and Chow, Benjamin JW
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Biomedical and Clinical Sciences ,Clinical Sciences ,Heart Disease ,Clinical Research ,Biomedical Imaging ,Cardiovascular ,Atherosclerosis ,Aging ,Heart Disease - Coronary Heart Disease ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Good Health and Well Being ,Age Factors ,Aged ,Computed Tomography Angiography ,Coronary Angiography ,Coronary Artery Disease ,Coronary Vessels ,Female ,Follow-Up Studies ,Humans ,Male ,Middle Aged ,Plaque ,Atherosclerotic ,Predictive Value of Tests ,Prognosis ,Prospective Studies ,Registries ,Risk Factors ,Time Factors ,Coronary ,Computed tomography ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology - Abstract
Extent of coronary atherosclerotic disease (CAD) burden on coronary computed tomography angiography (CCTA) as measured by segment involvement score (SIS) has a prognostic value. We sought to investigate the incremental prognostic value of 'age adjusted SIS' (aSIS), which may be a marker of premature atherosclerosis and vascular age. Consecutive patients were prospectively enrolled into the CONFIRM (Coronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicentre) multinational observational study. Patients were followed for the outcome of all-cause death. aSIS was calculated on CCTA for each patient, and its incremental prognostic value was evaluated. A total of 22,211 patients [mean age 58.5 ± 12.7 years, 55.8% male) with a median follow-up of 27.3 months (IQR 17.8, 35.4)] were identified. After adjustment for clinical factors and presence of obstructive CAD, higher aSIS was associated with increased death on multivariable analysis, with hazard ratio (HR) 2.40 (1.83-3.16, p
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- 2018
5. Incremental prognostic value of coronary computed tomography angiography over coronary calcium scoring for major adverse cardiac events in elderly asymptomatic individuals
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Han, Donghee, Hartaigh, Bríain Ó, Gransar, Heidi, Lee, Ji Hyun, Rizvi, Asim, Baskaran, Lohendran, Schulman-Marcus, Joshua, Dunning, Allison, Achenbach, Stephan, Al-Mallah, Mouaz H, Berman, Daniel S, Budoff, Matthew J, Cademartiri, Filippo, Maffei, Erica, Callister, Tracy Q, Chinnaiyan, Kavitha, Chow, Benjamin JW, DeLago, Augustin, Hadamitzky, Martin, Hausleiter, Joerg, Kaufmann, Philipp A, Raff, Gilbert, Shaw, Leslee J, Villines, Todd C, Kim, Yong-Jin, Leipsic, Jonathon, Feuchtner, Gudrun, Cury, Ricardo C, Pontone, Gianluca, Andreini, Daniele, Marques, Hugo, Rubinshtein, Ronen, Hindoyan, Niree, Jones, Erica C, Gomez, Millie, Lin, Fay Y, Chang, Hyuk-Jae, and Min, James K
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Heart Disease - Coronary Heart Disease ,Atherosclerosis ,Cardiovascular ,Heart Disease ,Biomedical Imaging ,Aging ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Age Factors ,Aged ,Analysis of Variance ,Asymptomatic Diseases ,Cohort Studies ,Computed Tomography Angiography ,Coronary Angiography ,Coronary Artery Disease ,Critical Illness ,Female ,Geriatric Assessment ,Humans ,Internationality ,Kaplan-Meier Estimate ,Male ,Middle Aged ,Myocardial Infarction ,Prognosis ,Registries ,Risk Assessment ,Sex Factors ,Survival Analysis ,Vascular Calcification ,elderly ,risk assessment ,coronary computed tomography angiography ,coronary artery calcium score ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology - Abstract
AimsCoronary computed tomography angiography (CCTA) and coronary artery calcium score (CACS) have prognostic value for coronary artery disease (CAD) events beyond traditional risk assessment. Age is a risk factor with very high weight and little is known regarding the incremental value of CCTA over CAC for predicting cardiac events in older adults.Methods and resultsOf 27 125 individuals undergoing CCTA, a total of 3145 asymptomatic adults were identified. This study sample was categorized according to tertiles of age (cut-off points: 52 and 62 years). CAD severity was classified as 0, 1-49, and ≥50% maximal stenosis in CCTA, and further categorized according to number of vessels ≥50% stenosis. The Framingham 10-year risk score (FRS) and CACS were employed as major covariates. Major adverse cardiovascular events (MACE) were defined as a composite of all-cause death or non-fatal MI. During a median follow-up of 26 months (interquartile range: 18-41 months), 59 (1.9%) MACE occurred. For patients in the top age tertile, CCTA improved discrimination beyond a model included FRS and CACS (C-statistic: 0.75 vs. 0.70, P-value = 0.015). Likewise, the addition of CCTA improved category-free net reclassification (cNRI) of MACE in patients within the highest age tertile (e.g. cNRI = 0.75; proportion of events/non-events reclassified were 50 and 25%, respectively; P-value
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- 2018
6. The Coronary Artery Disease–Reporting and Data System (CAD-RADS) Prognostic and Clinical Implications Associated With Standardized Coronary Computed Tomography Angiography Reporting
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Xie, Joe X, Cury, Ricardo C, Leipsic, Jonathon, Crim, Matthew T, Berman, Daniel S, Gransar, Heidi, Budoff, Matthew J, Achenbach, Stephan, Hartaigh, Bríain Ó, Callister, Tracy Q, Marques, Hugo, Rubinshtein, Ronen, Al-Mallah, Mouaz H, Andreini, Daniele, Pontone, Gianluca, Cademartiri, Filippo, Maffei, Erica, Chinnaiyan, Kavitha, Raff, Gilbert, Hadamitzky, Martin, Hausleiter, Joerg, Feuchtner, Gudrun, Dunning, Allison, DeLago, Augustin, Kim, Yong-Jin, Kaufmann, Philipp A, Villines, Todd C, Chow, Benjamin JW, Hindoyan, Niree, Gomez, Millie, Lin, Fay Y, Jones, Erica, Min, James K, and Shaw, Leslee J
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Clinical Sciences ,Atherosclerosis ,Heart Disease ,Clinical Research ,Patient Safety ,Cardiovascular ,Biomedical Imaging ,Prevention ,Heart Disease - Coronary Heart Disease ,Detection ,screening and diagnosis ,4.2 Evaluation of markers and technologies ,Good Health and Well Being ,Adult ,Aged ,Computed Tomography Angiography ,Coronary Angiography ,Coronary Artery Disease ,Coronary Stenosis ,Coronary Vessels ,Decision Support Systems ,Clinical ,Decision Support Techniques ,Female ,Humans ,Male ,Middle Aged ,Predictive Value of Tests ,Prognosis ,Prospective Studies ,Radiology Information Systems ,Registries ,Risk Assessment ,Risk Factors ,Severity of Illness Index ,appropriate use ,clinical decision support ,coronary computed tomography angiography ,prognosis ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
ObjectivesThis study sought to assess clinical outcomes associated with the novel Coronary Artery Disease-Reporting and Data System (CAD-RADS) scores used to standardize coronary computed tomography angiography (CTA) reporting and their potential utility in guiding post-coronary CTA care.BackgroundClinical decision support is a major focus of health care policies aimed at improving guideline-directed care. Recently, CAD-RADS was developed to standardize coronary CTA reporting and includes clinical recommendations to facilitate patient management after coronary CTA.MethodsIn the multinational CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) registry, 5,039 patients without known coronary artery disease (CAD) underwent coronary CTA and were stratified by CAD-RADS scores, which rank CAD stenosis severity as 0 (0%), 1 (1% to 24%), 2 (25% to 49%), 3 (50% to 69%), 4A (70% to 99% in 1 to 2 vessels), 4B (70% to 99% in 3 vessels or ≥50% left main), or 5 (100%). Kaplan-Meier and multivariable Cox models were used to estimate all-cause mortality or myocardial infarction (MI). Receiver-operating characteristic (ROC) curves were used to compare CAD-RADS to the Duke CAD Index and traditional CAD classification. Referrals to invasive coronary angiography (ICA) after coronary CTA were also assessed.ResultsCumulative 5-year event-free survival ranged from 95.2% to 69.3% for CAD-RADS 0 to 5 (p < 0.0001). Higher scores were associated with elevations in event risk (hazard ratio: 2.46 to 6.09; p < 0.0001). The ROC curve for prediction of death or MI was 0.7052 for CAD-RADS, which was noninferior to the Duke Index (0.7073; p = 0.893) and traditional CAD classification (0.7095; p = 0.783). ICA rates were 13% for CAD-RADS 0 to 2, 66% for CAD-RADS 3, and 84% for CAD-RADS ≥4A. For CAD-RADS 3, 58% of all catheterizations occurred within the first 30 days of follow-up. In a patient subset with available medication data, 57% of CAD-RADS 3 patients who received 30-day ICA were either asymptomatic or not receiving antianginal therapy at baseline, whereas only 32% had angina and were receiving medical therapy.ConclusionsCAD-RADS effectively identified patients at risk for adverse events. Frequent ICA use was observed among patients without severe CAD, many of whom were asymptomatic or not taking antianginal drugs. Incorporating CAD-RADS into coronary CTA reports may provide a novel opportunity to promote evidence-based care post-coronary CTA.
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- 2018
7. Impact of age and sex on left ventricular function determined by coronary computed tomographic angiography: results from the prospective multicentre CONFIRM study
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Gebhard, Catherine, Buechel, Ronny R, Stähli, Barbara E, Gransar, Heidi, Achenbach, Stephan, Berman, Daniel S, Budoff, Matthew J, Callister, Tracy Q, Chow, Benjamin, Dunning, Allison, Al-Mallah, Mouaz H, Cademartiri, Filippo, Chinnaiyan, Kavitha, Rubinshtein, Ronen, Marques, Hugo, DeLago, Augustin, Villines, Todd C, Hadamitzky, Martin, Hausleiter, Joerg, Shaw, Leslee J, Cury, Ricardo C, Feuchtner, Gudrun, Kim, Yong-Jin, Maffei, Erica, Raff, Gilbert, Pontone, Gianluca, Andreini, Daniele, Chang, Hyuk-Jae, Leipsic, Jonathon, Min, James K, and Kaufmann, Philipp A
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Clinical Sciences ,Heart Disease - Coronary Heart Disease ,Prevention ,Clinical Research ,Biomedical Imaging ,Cardiovascular ,Heart Disease ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Adult ,Age Factors ,Aged ,Analysis of Variance ,Cohort Studies ,Computed Tomography Angiography ,Coronary Angiography ,Coronary Artery Disease ,Female ,Humans ,Male ,Middle Aged ,Prognosis ,Prospective Studies ,Registries ,Risk Assessment ,Severity of Illness Index ,Sex Factors ,Statistics ,Nonparametric ,Survival Rate ,Ventricular Dysfunction ,Left ,cardiac computed tomography ,left ventricular ejection fraction ,Cardiovascular medicine and haematology - Abstract
BackgroundLeft ventricular (LV) volumetric and functional parameters measured with cardiac computed tomography (cardiac CT) augment risk prediction and discrimination for future mortality. Gender- and age-specific standard values for LV dimensions and systolic function obtained by 64-slice cardiac CT are lacking.Methods and results1155 patients from the Coronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter registry (54.5% males, mean age 53.1 ± 12.4 years, range: 18-92 years) without known coronary artery disease (CAD), structural heart disease, diabetes, or hypertension who underwent cardiac CT for various indications were categorized according to age and sex. A cardiac CT data acquisition protocol was used that allowed volumetric measuring of LV function. Image interpretation was performed at each site. Patients with significant CAD (>50% stenosis) on cardiac CT were excluded from the analysis. Overall, mean left ventricular ejection fraction (LVEF) was higher in women when compared with men (66.6 ± 7.7% vs. 64.6 ± 8.1%, P < 0.001). This gender-difference in overall LVEF was caused by a significantly higher LVEF in women ≥70 years when compared with men ≥70 years (69.95 ± 8.89% vs. 65.50 ± 9.42%, P = 0.004). Accordingly, a significant increase in LVEF was observed with age (P = 0.005 for males and P < 0.001 for females), which was more pronounced in females (5.21%) than in males (2.6%). LV end-diastolic volume decreased in females from 122.48 ± 27.87 (70 years; P < 0.001) and in males from 155.22 ± 35.07 (70 years; P < 0.001).ConclusionOur findings indicate that the LV undergoes a lifelong remodelling and highlight the need for age and gender adjusted reference values.
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- 2017
8. Coronary revascularization vs. medical therapy following coronary-computed tomographic angiography in patients with low-, intermediate- and high-risk coronary artery disease: results from the CONFIRM long-term registry
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Schulman-Marcus, Joshua, Lin, Fay Y, Gransar, Heidi, Berman, Daniel, Callister, Tracy, DeLago, Augustin, Hadamitzky, Martin, Hausleiter, Joerg, Al-Mallah, Mouaz, Budoff, Matthew, Kaufmann, Philipp, Achenbach, Stephan, Raff, Gilbert, Chinnaiyan, Kavitha, Cademartiri, Filippo, Maffei, Erica, Villines, Todd, Kim, Yong-Jin, Leipsic, Jonathon, Feuchtner, Gudrun, Rubinshtein, Ronen, Pontone, Gianluca, Andreini, Daniele, Marques, Hugo, Chang, Hyuk-Jae, Chow, Benjamin JW, Cury, Ricardo C, Dunning, Allison, Shaw, Leslee, and Min, James K
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Heart Disease ,Biomedical Imaging ,Clinical Research ,Cardiovascular ,Heart Disease - Coronary Heart Disease ,Atherosclerosis ,Good Health and Well Being ,Age Factors ,Aged ,Analysis of Variance ,Cardiotonic Agents ,Cause of Death ,Computed Tomography Angiography ,Coronary Angiography ,Coronary Artery Disease ,Female ,Humans ,Internationality ,Kaplan-Meier Estimate ,Male ,Middle Aged ,Multivariate Analysis ,Myocardial Revascularization ,Odds Ratio ,Percutaneous Coronary Intervention ,Prognosis ,Proportional Hazards Models ,Registries ,Risk Assessment ,Severity of Illness Index ,Sex Factors ,Survival Analysis ,Treatment Outcome ,coronary-computed tomographic angiography ,CAD ,revascularization ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology - Abstract
AimsTo identify the effect of early revascularization on 5-year survival in patients with CAD diagnosed by coronary-computed tomographic angiography (CCTA).Methods and resultsWe examined 5544 stable patients with suspected CAD undergoing CCTA who were followed a median of 5.5 years in a large international registry. Patients were categorized as having low-, intermediate-, or high-risk CAD based on CCTA findings. Two treatment groups were defined: early revascularization within 90 days of CCTA (n = 1171) and medical therapy (n = 4373). To account for the non-randomized referral to revascularization, we developed a propensity score by logistic regression. This score was incorporated into Cox proportional hazard models to calculate the effect of revascularization on all-cause mortality. Death occurred in 363 (6.6%) patients and was more frequent in medical therapy. In multivariable models, when compared with medical therapy, the mortality benefit of revascularization varied significantly over time and by CAD risk (P for interaction 0.04). In high-risk CAD, revascularization was significantly associated with lower mortality at 1 year (hazard ratio [HR] 0.22, 95% confidence interval [CI] 0.11-0.47) and 5 years (HR 0.31, 95% CI 0.18-0.54). For intermediate-risk CAD, revascularization was associated with reduced mortality at 1 year (HR 0.45, 95% CI 0.22-0.93) but not 5 years (HR 0.63, 95% CI 0.33-1.20). For low-risk CAD, there was no survival benefit at either time point.ConclusionsEarly revascularization was associated with reduced 1-year mortality in intermediate- and high-risk CAD detected by CCTA, but this association only persisted for 5-year mortality in high-risk CAD.
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- 2017
9. Relationship of Hypertension to Coronary Atherosclerosis and Cardiac Events in Patients With Coronary Computed Tomographic Angiography
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Nakanishi, Rine, Baskaran, Lohendran, Gransar, Heidi, Budoff, Matthew J, Achenbach, Stephan, Al-Mallah, Mouaz, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Chinnaiyan, Kavitha, Chow, Benjamin JW, DeLago, Augustin, Hadamitzky, Martin, Hausleiter, Joerg, Cury, Ricardo, Feuchtner, Gudrun, Kim, Yong-Jin, Leipsic, Jonathon, Kaufmann, Philipp A, Maffei, Erica, Raff, Gilbert, Shaw, Leslee J, Villines, Todd C, Dunning, Allison, Marques, Hugo, Pontone, Gianluca, Andreini, Daniele, Rubinshtein, Ronen, Bax, Jeroen, Jones, Erica, Hindoyan, Niree, Gomez, Millie, Lin, Fay Y, Min, James K, and Berman, Daniel S
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Biomedical Imaging ,Atherosclerosis ,Heart Disease - Coronary Heart Disease ,Heart Disease ,Hypertension ,Cardiovascular ,Clinical Research ,4.1 Discovery and preclinical testing of markers and technologies ,2.1 Biological and endogenous factors ,Detection ,screening and diagnosis ,Aetiology ,Aged ,Computed Tomography Angiography ,Coronary Angiography ,Coronary Artery Disease ,Female ,Humans ,International Cooperation ,Male ,Middle Aged ,Myocardial Ischemia ,Outcome and Process Assessment ,Health Care ,Prognosis ,Proportional Hazards Models ,Prospective Studies ,Registries ,Risk Assessment ,Risk Factors ,Severity of Illness Index ,angiography ,atherosclerosis ,coronary artery disease ,hypertension ,risk factors ,Cardiorespiratory Medicine and Haematology ,Clinical Sciences ,Public Health and Health Services ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
Hypertension is an atherosclerosis factor and is associated with cardiovascular risk. We investigated the relationship between hypertension and the presence, extent, and severity of coronary atherosclerosis in coronary computed tomographic angiography and cardiac events risk. Of 17 181 patients enrolled in the CONFIRM registry (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) who underwent ≥64-detector row coronary computed tomographic angiography, we identified 14 803 patients without known coronary artery disease. Of these, 1434 hypertensive patients were matched to 1434 patients without hypertension. Major adverse cardiac events risk of hypertension and non-hypertensive patients was evaluated with Cox proportional hazards models. The prognostic associations between hypertension and no-hypertension with increasing degree of coronary stenosis severity (nonobstructive or obstructive ≥50%) and extent of coronary artery disease (segment involvement score of 1-5, >5) was also assessed. Hypertension patients less commonly had no coronary atherosclerosis and more commonly had nonobstructive and 1-, 2-, and 3-vessel disease than the no-hypertension group. During a mean follow-up of 5.2±1.2 years, 180 patients experienced cardiac events, with 104 (2.0%) occurring in the hypertension group and 76 (1.5%) occurring in the no-hypertension group (hazard ratios, 1.4; 95% confidence intervals, 1.0-1.9). Compared with no-hypertension patients without coronary atherosclerosis, hypertension patients with no coronary atherosclerosis and obstructive coronary disease tended to have higher risk of cardiac events. Similar trends were observed with respect to extent of coronary artery disease. Compared with no-hypertension patients, hypertensive patients have increased presence, extent, and severity of coronary atherosclerosis and tend to have an increase in major adverse cardiac events.
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- 2017
10. Prognostic implications of coronary artery calcium in the absence of coronary artery luminal narrowing
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Cho, Iksung, Hartaigh, Bríain Ó, Gransar, Heidi, Valenti, Valentina, Lin, Fay Y, Achenbach, Stephan, Berman, Daniel S, Budoff, Matthew J, Callister, Tracy Q, Al-Mallah, Mouaz H, Cademartiri, Filippo, Chinnaiyan, Kavitha, Chow, Benjamin JW, Dunning, Allison M, DeLago, Augustin, Villines, Todd C, Hadamitzky, Martin, Hausleiter, Joerg, Leipsic, Jonathon, Shaw, Leslee J, Kaufmann, Philipp A, Cury, Ricardo C, Feuchtner, Gudrun, Kim, Yong-Jin, Maffei, Erica, Raff, Gilbert, Pontone, Gianluca, Andreini, Daniele, Chang, Hyuk-Jae, and Min, James K
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Heart Disease - Coronary Heart Disease ,Heart Disease ,Prevention ,Clinical Research ,Atherosclerosis ,Cardiovascular ,Detection ,screening and diagnosis ,4.2 Evaluation of markers and technologies ,Good Health and Well Being ,Adult ,Aged ,Asymptomatic Diseases ,Computed Tomography Angiography ,Coronary Angiography ,Coronary Artery Disease ,Coronary Stenosis ,Coronary Vessels ,Europe ,Female ,Humans ,Israel ,Kaplan-Meier Estimate ,Male ,Middle Aged ,North America ,Predictive Value of Tests ,Prevalence ,Prognosis ,Proportional Hazards Models ,Prospective Studies ,Registries ,Risk Factors ,Time Factors ,Vascular Calcification ,Coronary computed tomographic ,angiography ,Coronary artery calcium scoring ,Coronary artery disease ,Coronary computed tomographic angiography ,Cardiorespiratory Medicine and Haematology ,Clinical Sciences ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
Background and aimsCoronary artery calcium (CAC) scoring is a predictor of future adverse clinical events, and a surrogate measure of overall coronary artery plaque burden. Coronary computed tomographic angiography (CCTA) is a contrast-enhanced method that allows for visualization of plaque as well as whether that plaque causes luminal narrowing. To date, the prognosis of individuals with CAC but without stenosis has not been reported. We explored the prevalence of CAC>0 and its prognostic utility for future mortality for patients without luminal narrowing by CCTA.MethodsFrom 17 sites in 9 countries, we identified patients without known coronary artery disease, who underwent CAC scoring and CCTA, and were followed for >3 years. CCTA was graded for % stenosis according to a modified American Heart Association 16-segment model. We calculated hazard ratios (HR) with 95% confidence intervals (95% CI) for incident mortality and compared risk of death for patients as a function of presence or absence of CAC and presence or absence of luminal narrowing by CCTA.ResultsAmong 6656 patients who underwent CCTA and CAC scoring, 399 patients (6.0%) had no coronary luminal narrowing but CAC>0. During a median follow-up of 5.1 years (IQR: 3.9-5.9 years), 456 deaths occurred. Compared to individuals without luminal narrowing or CAC, individuals without luminal narrowing but CAC>0 were older, more likely to be male and had higher rates of diabetes, hypertension, and dyslipidemia. Individuals without luminal narrowing but CAC experienced a 2-fold increased risk of mortality, with increasing risk of mortality with higher CAC score. Following adjustment, incident death persisted (HR, 1.8; 95% CI, 1.1-2.9, p = 0.02) among patients without luminal narrowing but with CAC>0 compared with patients whose CACS = 0. Individuals without luminal narrowing but CAC ≥100 had mortality risks similar to individuals with non-obstructive CAD (0
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- 2017
11. Improved 5-year prediction of all-cause mortality by coronary CT angiography applying the CONFIRM score
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Deseive, Simon, Shaw, Leslee J, Min, James K, Achenbach, Stephan, Andreini, Daniele, Al-Mallah, Mouaz H, Berman, Daniel S, Budoff, Matthew J, Callister, Tracy Q, Cademartiri, Filippo, Chang, Hyuk-Jae, Chinnaiyan, Kavitha, Chow, Benjamin JW, Cury, Ricardo C, DeLago, Augustin, Dunning, Allison M, Feuchtner, Gudrun, Kaufmann, Philipp A, Kim, Yong-Jin, Leipsic, Jonathon, Marques, Hugo, Maffei, Erica, Pontone, Gianluca, Raff, Gilbert, Rubinshtein, Ronin, Villines, Todd C, Hausleiter, Jörg, and Hadamitzky, Martin
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Cardiovascular ,Heart Disease ,Clinical Research ,Patient Safety ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Good Health and Well Being ,Aged ,Analysis of Variance ,Cause of Death ,Cohort Studies ,Computed Tomography Angiography ,Coronary Angiography ,Coronary Artery Disease ,Disease-Free Survival ,Female ,Humans ,Internationality ,Kaplan-Meier Estimate ,Male ,Middle Aged ,Multivariate Analysis ,Predictive Value of Tests ,Proportional Hazards Models ,Quality Improvement ,ROC Curve ,Registries ,Risk Assessment ,Severity of Illness Index ,Survival Analysis ,Time Factors ,Cardiac computer tomographic angiography ,Prognosis ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology - Abstract
AimsTo investigate the long-term performance of the CONFIRM score for prediction of all-cause mortality in a large patient cohort undergoing coronary computed tomography angiography (CCTA).Methods and resultsPatients with a 5-year follow-up from the international multicentre CONFIRM registry were included. The primary endpoint was all-cause mortality. The predictive value of the CONFIRM score over clinical risk scores (Morise, Framingham, and NCEP ATP III score) was studied in the entire patient population as well as in subgroups. Improvement in risk prediction and patient reclassification were assessed using categorical net reclassification index (NRI) and integrated discrimination improvement (IDI). During a median follow-up period of 5.3 years, 982 (6.5%) of 15 219 patients died. The CONFIRM score outperformed the prognostic value of the studied three clinical risk scores (c-indices: CONFIRM score 0.696, NCEP ATP III score 0.675, Framingham score 0.610, Morise score 0.606; c-index for improvement CONFIRM score vs. NCEP ATP III score 0.650, P < 0.0001). Application of the CONFIRM score allowed reclassification of 34% of patients when compared with the NCEP ATP III score, which was the best clinical risk score. Reclassification was significant as revealed by categorical NRI (0.06 with 95% CI 0.02 and 0.10, P = 0.005) and IDI (0.013 with 95% CI 0.01 and 0.015, P < 0.001). Subgroup analysis revealed a comparable performance in a variety of patient subgroups.ConclusionsThe CONFIRM score permits a significantly improved prediction of mortality over clinical risk scores for >5 years after CCTA. These findings are consistent in a large variety of patient subgroups.
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- 2017
12. Predictive Value of Age- and Sex-Specific Nomograms of Global Plaque Burden on Coronary Computed Tomography Angiography for Major Cardiac Events
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Naoum, Christopher, Berman, Daniel S, Ahmadi, Amir, Blanke, Philipp, Gransar, Heidi, Narula, Jagat, Shaw, Leslee J, Kritharides, Leonard, Achenbach, Stephan, Al-Mallah, Mouaz H, Andreini, Daniele, Budoff, Matthew J, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Chinnaiyan, Kavitha, Chow, Benjamin, Cury, Ricardo C, DeLago, Augustin, Dunning, Allison, Feuchtner, Gudrun, Hadamitzky, Martin, Hausleiter, Joerg, Kaufmann, Philipp A, Kim, Yong-Jin, Maffei, Erica, Marquez, Hugo, Pontone, Gianluca, Raff, Gilbert, Rubinshtein, Ronen, Villines, Todd C, Min, James, and Leipsic, Jonathon
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Biomedical and Clinical Sciences ,Clinical Sciences ,Heart Disease - Coronary Heart Disease ,Heart Disease ,Atherosclerosis ,Biomedical Imaging ,Cardiovascular ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Good Health and Well Being ,Adult ,Age Factors ,Aged ,Canada ,Computed Tomography Angiography ,Coronary Angiography ,Coronary Artery Disease ,Coronary Vessels ,Europe ,Female ,Humans ,Male ,Middle Aged ,Multidetector Computed Tomography ,Nomograms ,Plaque ,Atherosclerotic ,Predictive Value of Tests ,Prevalence ,Prognosis ,Prospective Studies ,Registries ,Reproducibility of Results ,Republic of Korea ,Risk Factors ,Severity of Illness Index ,Sex Factors ,United States ,computed tomography angiography ,coronary artery disease ,coronary angiography ,epidemiology ,nomograms ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
Age-adjusted coronary artery disease (CAD) burden identified on coronary computed tomography angiography predicts major adverse cardiovascular event (MACE) risk; however, it seldom contributes to clinical decision making because of a lack of nomographic data. We aimed to develop clinically pragmatic age- and sex-specific nomograms of CAD burden using coronary computed tomography angiography and to validate their prognostic use. Patients prospectively enrolled in phase I of the CONFIRM registry (Coronary CT Angiography Evaluation for Clinical Outcomes) were included (derivation cohort: n=21,132; 46% female) to develop CAD nomograms based on age-sex percentiles of segment involvement score (SIS) at each year of life (40-79 years). The relationship between SIS age-sex percentiles (SIS%) and MACE (all-cause death, myocardial infarction, unstable angina, and late revascularization) was tested in a nonoverlapping validation cohort (phase II, CONFIRM registry; n=3030, 44% female) by stratifying patients into 3 SIS% groups (≤50th, 51-75th, and >75th) and comparing annualized MACE rates and time to MACE using multivariable Cox proportional hazards models adjusting for Framingham risk and chest pain typicality. Age-sex percentiles were well fitted to second-order polynomial curves (men: R2=0.86±0.12; women: R2=0.86±0.14). Using the nomograms, there were 1576, 965, and 489 patients, respectively, in the ≤50th, 51-75th, and >75th SIS% groups. Annualized event rates were higher among patients with greater CAD burden (2.1% [95% confidence interval: 1.7%-2.7%], 3.9% [95% confidence interval: 3.0%-5.1%], and 7.2% [95% confidence interval: 5.4%-9.6%] in ≤50th, 51-75th, and >75th SIS% groups, respectively; P75th SIS% group; P
- Published
- 2017
13. Machine learning for prediction of all-cause mortality in patients with suspected coronary artery disease: a 5-year multicentre prospective registry analysis
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Motwani, Manish, Dey, Damini, Berman, Daniel S, Germano, Guido, Achenbach, Stephan, Al-Mallah, Mouaz H, Andreini, Daniele, Budoff, Matthew J, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Chinnaiyan, Kavitha, Chow, Benjamin JW, Cury, Ricardo C, Delago, Augustin, Gomez, Millie, Gransar, Heidi, Hadamitzky, Martin, Hausleiter, Joerg, Hindoyan, Niree, Feuchtner, Gudrun, Kaufmann, Philipp A, Kim, Yong-Jin, Leipsic, Jonathon, Lin, Fay Y, Maffei, Erica, Marques, Hugo, Pontone, Gianluca, Raff, Gilbert, Rubinshtein, Ronen, Shaw, Leslee J, Stehli, Julia, Villines, Todd C, Dunning, Allison, Min, James K, and Slomka, Piotr J
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Biomedical and Clinical Sciences ,Clinical Sciences ,Heart Disease ,Heart Disease - Coronary Heart Disease ,Cardiovascular ,Clinical Research ,Prevention ,Biomedical Imaging ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Good Health and Well Being ,Cause of Death ,Computed Tomography Angiography ,Coronary Artery Disease ,Feasibility Studies ,Female ,Humans ,Machine Learning ,Male ,Middle Aged ,Prospective Studies ,Registries ,Risk Factors ,Coronary artery disease ,Coronary CT angiography ,Prognosis ,Machine learning ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
AimsTraditional prognostic risk assessment in patients undergoing non-invasive imaging is based upon a limited selection of clinical and imaging findings. Machine learning (ML) can consider a greater number and complexity of variables. Therefore, we investigated the feasibility and accuracy of ML to predict 5-year all-cause mortality (ACM) in patients undergoing coronary computed tomographic angiography (CCTA), and compared the performance to existing clinical or CCTA metrics.Methods and resultsThe analysis included 10 030 patients with suspected coronary artery disease and 5-year follow-up from the COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter registry. All patients underwent CCTA as their standard of care. Twenty-five clinical and 44 CCTA parameters were evaluated, including segment stenosis score (SSS), segment involvement score (SIS), modified Duke index (DI), number of segments with non-calcified, mixed or calcified plaques, age, sex, gender, standard cardiovascular risk factors, and Framingham risk score (FRS). Machine learning involved automated feature selection by information gain ranking, model building with a boosted ensemble algorithm, and 10-fold stratified cross-validation. Seven hundred and forty-five patients died during 5-year follow-up. Machine learning exhibited a higher area-under-curve compared with the FRS or CCTA severity scores alone (SSS, SIS, DI) for predicting all-cause mortality (ML: 0.79 vs. FRS: 0.61, SSS: 0.64, SIS: 0.64, DI: 0.62; P< 0.001).ConclusionsMachine learning combining clinical and CCTA data was found to predict 5-year ACM significantly better than existing clinical or CCTA metrics alone.
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- 2017
14. Effects of micromachining on anti-oxidant elution from a mechanically-adaptive polymer
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Mueller, Natalie N, primary, Kim, Youjoung, additional, Ocoko, Mali Ya Mungu, additional, Dernelle, Peter, additional, Kale, Ishani, additional, Patwa, Simran, additional, Hermoso, Anna Clarissa, additional, Chirra, Deeksha, additional, Capadona, Jeffrey R, additional, and Hess-Dunning, Allison, additional
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- 2024
- Full Text
- View/download PDF
15. In Vivo Characterization of Intracortical Probes with Focused Ion Beam-Etched Nanopatterned Topographies
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Duncan, Jonathan L., primary, Wang, Jaime J., additional, Glusauskas, Gabriele, additional, Weagraff, Gwendolyn R., additional, Gao, Yue, additional, Hoeferlin, George F., additional, Hunter, Allen H., additional, Hess-Dunning, Allison, additional, Ereifej, Evon S., additional, and Capadona, Jeffrey R., additional
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- 2024
- Full Text
- View/download PDF
16. In Vivo Characterization of Focus Ion Beam Etched Nanopatterned Microelectrodes to Improve Acute Recording Performance
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Duncan, Jonathan, primary, Wang, Jaime, additional, Glusauskas, Gabriele, additional, Weagraff, Gwendolyn R., additional, Gao, Yue, additional, Hoeferlin, George F, additional, Hunter, Allen H., additional, Hess-Dunning, Allison, additional, Ereifej, Evon S, additional, and Capadona, Jeffrey R, additional
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- 2024
- Full Text
- View/download PDF
17. Genetically Predicted Body Mass Index and Breast Cancer Risk: Mendelian Randomization Analyses of Data from 145,000 Women of European Descent.
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Guo, Yan, Warren Andersen, Shaneda, Shu, Xiao-Ou, Michailidou, Kyriaki, Bolla, Manjeet K, Wang, Qin, Garcia-Closas, Montserrat, Milne, Roger L, Schmidt, Marjanka K, Chang-Claude, Jenny, Dunning, Allison, Bojesen, Stig E, Ahsan, Habibul, Aittomäki, Kristiina, Andrulis, Irene L, Anton-Culver, Hoda, Arndt, Volker, Beckmann, Matthias W, Beeghly-Fadiel, Alicia, Benitez, Javier, Bogdanova, Natalia V, Bonanni, Bernardo, Børresen-Dale, Anne-Lise, Brand, Judith, Brauch, Hiltrud, Brenner, Hermann, Brüning, Thomas, Burwinkel, Barbara, Casey, Graham, Chenevix-Trench, Georgia, Couch, Fergus J, Cox, Angela, Cross, Simon S, Czene, Kamila, Devilee, Peter, Dörk, Thilo, Dumont, Martine, Fasching, Peter A, Figueroa, Jonine, Flesch-Janys, Dieter, Fletcher, Olivia, Flyger, Henrik, Fostira, Florentia, Gammon, Marilie, Giles, Graham G, Guénel, Pascal, Haiman, Christopher A, Hamann, Ute, Hooning, Maartje J, Hopper, John L, Jakubowska, Anna, Jasmine, Farzana, Jenkins, Mark, John, Esther M, Johnson, Nichola, Jones, Michael E, Kabisch, Maria, Kibriya, Muhammad, Knight, Julia A, Koppert, Linetta B, Kosma, Veli-Matti, Kristensen, Vessela, Le Marchand, Loic, Lee, Eunjung, Li, Jingmei, Lindblom, Annika, Luben, Robert, Lubinski, Jan, Malone, Kathi E, Mannermaa, Arto, Margolin, Sara, Marme, Frederik, McLean, Catriona, Meijers-Heijboer, Hanne, Meindl, Alfons, Neuhausen, Susan L, Nevanlinna, Heli, Neven, Patrick, Olson, Janet E, Perez, Jose IA, Perkins, Barbara, Peterlongo, Paolo, Phillips, Kelly-Anne, Pylkäs, Katri, Rudolph, Anja, Santella, Regina, Sawyer, Elinor J, Schmutzler, Rita K, Seynaeve, Caroline, Shah, Mitul, Shrubsole, Martha J, Southey, Melissa C, Swerdlow, Anthony J, Toland, Amanda E, Tomlinson, Ian, Torres, Diana, Truong, Thérèse, Ursin, Giske, Van Der Luijt, Rob B, and Verhoef, Senno
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Humans ,Breast Neoplasms ,Genetic Predisposition to Disease ,Body Mass Index ,Models ,Statistical ,Risk Factors ,Menopause ,Polymorphism ,Single Nucleotide ,Middle Aged ,European Continental Ancestry Group ,Female ,Mendelian Randomization Analysis ,Models ,Statistical ,Polymorphism ,Single Nucleotide ,Genetics ,Prevention ,Breast Cancer ,Nutrition ,Clinical Research ,Cancer ,Aging ,Human Genome ,2.1 Biological and endogenous factors ,General & Internal Medicine ,Medical and Health Sciences - Abstract
BackgroundObservational epidemiological studies have shown that high body mass index (BMI) is associated with a reduced risk of breast cancer in premenopausal women but an increased risk in postmenopausal women. It is unclear whether this association is mediated through shared genetic or environmental factors.MethodsWe applied Mendelian randomization to evaluate the association between BMI and risk of breast cancer occurrence using data from two large breast cancer consortia. We created a weighted BMI genetic score comprising 84 BMI-associated genetic variants to predicted BMI. We evaluated genetically predicted BMI in association with breast cancer risk using individual-level data from the Breast Cancer Association Consortium (BCAC) (cases = 46,325, controls = 42,482). We further evaluated the association between genetically predicted BMI and breast cancer risk using summary statistics from 16,003 cases and 41,335 controls from the Discovery, Biology, and Risk of Inherited Variants in Breast Cancer (DRIVE) Project. Because most studies measured BMI after cancer diagnosis, we could not conduct a parallel analysis to adequately evaluate the association of measured BMI with breast cancer risk prospectively.ResultsIn the BCAC data, genetically predicted BMI was found to be inversely associated with breast cancer risk (odds ratio [OR] = 0.65 per 5 kg/m2 increase, 95% confidence interval [CI]: 0.56-0.75, p = 3.32 × 10-10). The associations were similar for both premenopausal (OR = 0.44, 95% CI:0.31-0.62, p = 9.91 × 10-8) and postmenopausal breast cancer (OR = 0.57, 95% CI: 0.46-0.71, p = 1.88 × 10-8). This association was replicated in the data from the DRIVE consortium (OR = 0.72, 95% CI: 0.60-0.84, p = 1.64 × 10-7). Single marker analyses identified 17 of the 84 BMI-associated single nucleotide polymorphisms (SNPs) in association with breast cancer risk at p
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- 2016
18. Coronary dominance and prognosis in patients undergoing coronary computed tomographic angiography: results from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) registry
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Gebhard, Catherine, Fuchs, Tobias A, Stehli, Julia, Gransar, Heidi, Berman, Daniel S, Budoff, Matthew J, Achenbach, Stephan, Al-Mallah, Mouaz, Andreini, Daniele, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Chinnaiyan, Kavitha M, Chow, Benjamin JW, Cury, Ricardo C, Delago, Augustin, Gomez, Millie J, Hadamitzky, Martin, Hausleiter, Joerg, Hindoyan, Niree, Feuchtner, Gudrun, Kim, Yong-Jin, Leipsic, Jonathon, Lin, Fay Y, Maffei, Erica, Pontone, Gianluca, Raff, Gilbert, Shaw, Leslee J, Villines, Todd C, Dunning, Allison M, Min, James K, and Kaufmann, Philipp A
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Atherosclerosis ,Heart Disease ,Heart Disease - Coronary Heart Disease ,Biomedical Imaging ,Clinical Research ,Cardiovascular ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Coronary Angiography ,Coronary Artery Disease ,Female ,Humans ,Male ,Middle Aged ,Prognosis ,Prospective Studies ,Radiographic Image Interpretation ,Computer-Assisted ,Registries ,Risk Factors ,Tomography ,X-Ray Computed ,Coronary dominance ,Coronary computed tomographic angiography ,Predictive value ,Cardiovascular medicine and haematology - Abstract
AimsCoronary computed tomographic angiography (CCTA) has become an important tool for non-invasive diagnosis of coronary artery disease (CAD). Coronary dominance can be assessed by CCTA; however, the predictive value of coronary dominance is controversially discussed. The aim of this study was to evaluate the prevalence and prognosis of coronary dominance in a large prospective, international multicentre cohort of patients undergoing CCTA.Methods and resultsThe study population consisted of 6382 patients with or without CAD (47% females, 53% males, mean age 56.9 ± 12.3 years) who underwent CCTA and were followed over a period of 60 months. Right or left coronary dominance was determined. Right dominance was present in 91% (n = 5817) and left in 9% (n = 565) of the study population. At the end of follow-up, outcome in patients with obstructive CAD (>50% luminal stenosis) and right dominance was similar compared with patients with left dominance [hazard ratio (HR) 0.46, 95% CI 0.16-1.32, P = 0.15]. Furthermore, no differences were observed for the type of coronary dominance in patients with non-obstructive CAD (HR 0.95, 95% CI 0.41-2.21, P = 0.8962) or normal coronary arteries (HR 1.04, 95% CI 0.68-1.59, P = 0.9). Subgroup analysis in patients with left main disease revealed an elevated hazard of the combined endpoint for left dominance (HR 6.45, 95% CI 1.66-25.0, P = 0.007), but not for right dominance.ConclusionIn our study population, survival after 5 years of follow-up did not differ significantly between patients with left or right coronary dominance. Thus, assessment of coronary vessel dominance by CCTA may not enhance risk stratification in patients with normal coronary arteries or obstructive CAD, but may add prognostic information for specific subpopulations.
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- 2015
19. Medical History for Prognostic Risk Assessment and Diagnosis of Stable Patients with Suspected Coronary Artery Disease
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Min, James K, Dunning, Allison, Gransar, Heidi, Achenbach, Stephan, Lin, Fay Y, Al-Mallah, Mouaz, Budoff, Matthew J, Callister, Tracy Q, Chang, Hyuk-Jae, Cademartiri, Filippo, Maffei, Erica, Chinnaiyan, Kavitha, Chow, Benjamin JW, D'Agostino, Ralph, DeLago, Augustin, Friedman, John, Hadamitzky, Martin, Hausleiter, Joerg, Hayes, Sean W, Kaufmann, Philipp, Raff, Gilbert L, Shaw, Leslee J, Thomson, Louise, Villines, Todd, Cury, Ricardo C, Feuchtner, Gudrun, Kim, Yong-Jin, Leipsic, Jonathon, Marques, Hugo, Berman, Daniel S, and Pencina, Michael
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Health Sciences ,Biomedical Imaging ,Heart Disease ,Cardiovascular ,Atherosclerosis ,Clinical Research ,Heart Disease - Coronary Heart Disease ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Adolescent ,Adult ,Algorithms ,Coronary Angiography ,Coronary Artery Disease ,Female ,Humans ,Male ,Medical History Taking ,Middle Aged ,Myocardial Infarction ,Prognosis ,Proportional Hazards Models ,Reproducibility of Results ,Risk Assessment ,Risk Factors ,Tomography ,X-Ray Computed ,Young Adult ,Coronary artery disease ,Diagnosis ,Medical and Health Sciences ,General & Internal Medicine ,Biomedical and clinical sciences ,Health sciences - Abstract
ObjectiveTo develop a clinical cardiac risk algorithm for stable patients with suspected coronary artery disease based upon angina typicality and coronary artery disease risk factors.MethodsBetween 2004 and 2011, 14,004 adults with suspected coronary artery disease referred for cardiac imaging were followed: 1) 9093 patients for coronary computed tomography angiography (CCTA) followed for 2.0 years (CCTA-1); 2) 2132 patients for CCTA followed for 1.6 years (CCTA-2); and 3) 2779 patients for exercise myocardial perfusion scintigraphy (MPS) followed for 5.0 years. A best-fit model from CCTA-1 for prediction of death or myocardial infarction was developed, with integer values proportional to regression coefficients. Discrimination was assessed using C-statistic. The validated model was tested for estimation of the likelihood of obstructive coronary artery disease, defined as ≥50% stenosis, as compared with the method of Diamond and Forrester. Primary outcomes included all-cause mortality and nonfatal myocardial infarction. Secondary outcomes included prevalent angiographically obstructive coronary artery disease.ResultsIn CCTA-1, best-fit model discriminated individuals at risk of death or myocardial infarction (C-statistic 0.76). The integer model ranged from 3 to 13, corresponding to 3-year death risk or myocardial infarction of 0.25% to 53.8%. When applied to CCTA-2 and MPS cohorts, the model demonstrated C-statistics of 0.71 and 0.77, respectively. Both best-fit (C = 0.76; 95% confidence interval [CI], 0.746-0.771) and integer models (C = 0.71; 95% CI, 0.693-0.719) performed better than Diamond and Forrester (C = 0.64; 95% CI, 0.628-0.659) for estimating obstructive coronary artery disease.ConclusionsFor stable symptomatic patients with suspected coronary artery disease, we developed a history-based method for prediction of death and obstructive coronary artery disease.
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- 2015
20. Gender differences in the prevalence, severity, and composition of coronary artery disease in the young: a study of 1635 individuals undergoing coronary CT angiography from the prospective, multinational confirm registry.
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Otaki, Yuka, Gransar, Heidi, Cheng, Victor Y, Dey, Damini, Labounty, Troy, Lin, Fay Y, Achenbach, Stephan, Al-Mallah, Mouaz, Budoff, Matthew J, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Chinnaiyan, Kavitha, Chow, Benjamin JW, Delago, Augustin, Hadamitzky, Martin, Hausleiter, Joerg, Kaufmann, Philipp, Maffei, Erica, Raff, Gilbert, Shaw, Leslee J, Villines, Todd C, Dunning, Allison, Cury, Ricardo C, Feuchtner, Gudrun, Kim, Yong-Jin, Leipsic, Jonathon, Berman, Daniel S, and Min, James K
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Humans ,Genetic Predisposition to Disease ,Tomography ,X-Ray Computed ,Coronary Angiography ,Severity of Illness Index ,Registries ,Prevalence ,Risk Factors ,Prospective Studies ,Sex Factors ,Adult ,Female ,Male ,Coronary Artery Disease ,coronary CT angiography ,coronary artery disease ,coronary risk factors ,young adults ,Heart Disease ,Clinical Research ,Clinical Trials and Supportive Activities ,Cardiovascular ,Heart Disease - Coronary Heart Disease ,Atherosclerosis ,2.1 Biological and endogenous factors ,Aetiology ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology - Abstract
ObjectivePrior studies examining coronary atherosclerosis in the young have been limited by retrospective analyses in small cohorts. We examined the relationship between cardiovascular risk factors (RFs) and prevalence and severity of coronary atherosclerosis in a large, prospective, multinational registry of consecutive young individuals undergoing coronary computerized tomographic angiography (CCTA).Method and resultsOf 27 125 patients undergoing CCTA, 1635 young (
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- 2015
21. Current but not past smoking increases the risk of cardiac events: insights from coronary computed tomographic angiography
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Nakanishi, Rine, Berman, Daniel S, Budoff, Matthew J, Gransar, Heidi, Achenbach, Stephan, Al-Mallah, Mouaz, Andreini, Daniele, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Cheng, Victor Y, Chinnaiyan, Kavitha, Chow, Benjamin JW, Cury, Ricardo, Delago, Augustin, Hadamitzky, Martin, Hausleiter, Jörg, Feuchtner, Gudrun, Kim, Yong-Jin, Kaufmann, Philipp A, Leipsic, Jonathon, Lin, Fay Y, Maffei, Erica, Pontone, Gianluca, Raff, Gilbert, Shaw, Leslee J, Villines, Todd C, Dunning, Allison, and Min, James K
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Biomedical and Clinical Sciences ,Clinical Sciences ,Atherosclerosis ,Heart Disease ,Clinical Research ,Biomedical Imaging ,Cardiovascular ,Heart Disease - Coronary Heart Disease ,Prevention ,Respiratory ,Coronary Angiography ,Coronary Artery Disease ,Epidemiologic Methods ,Female ,Humans ,Male ,Middle Aged ,Myocardial Infarction ,Plaque ,Atherosclerotic ,Prognosis ,Smoking ,Tomography ,X-Ray Computed ,Smoking risk ,Coronary atherosclerosis ,Coronary computed tomographic angiography ,Major adverse cardiovascular risk ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
AimsWe evaluated coronary artery disease (CAD) extent, severity, and major adverse cardiac events (MACEs) in never, past, and current smokers undergoing coronary CT angiography (CCTA).Methods and resultsWe evaluated 9456 patients (57.1 ± 12.3 years, 55.5% male) without known CAD (1588 current smokers; 2183 past smokers who quit ≥3 months before CCTA; and 5685 never smokers). By risk-adjusted Cox proportional-hazards models, we related smoking status to MACE (all-cause death or non-fatal myocardial infarction). We further performed 1:1:1 propensity matching for 1000 in each group evaluate event risk among individuals with similar age, gender, CAD risk factors, and symptom presentation. During a mean follow-up of 2.8 ± 1.9 years, 297 MACE occurred. Compared with never smokers, current and past smokers had greater atherosclerotic burden including extent of plaque defined as segments with any plaque (2.1 ± 2.8 vs. 2.6 ± 3.2 vs. 3.1 ± 3.3, P < 0.0001) and prevalence of obstructive CAD [1-vessel disease (VD): 10.6% vs. 14.9% vs. 15.2%, P < 0.001; 2-VD: 4.4% vs. 6.1% vs. 6.2%, P = 0.001; 3-VD: 3.1% vs. 5.2% vs. 4.3%, P < 0.001]. Compared with never smokers, current smokers experienced higher MACE risk [hazard ratio (HR) 1.9, 95% confidence interval (CI) 1.4-2.6, P < 0.001], while past smokers did not (HR 1.2, 95% CI 0.8-1.6, P = 0.35). Among matched individuals, current smokers had higher MACE risk (HR 2.6, 95% CI 1.6-4.2, P < 0.001), while past smokers did not (HR 1.3, 95% CI 0.7-2.4, P = 0.39). Similar findings were observed for risk of all-cause death.ConclusionAmong patients without known CAD undergoing CCTA, current and past smokers had increased burden of atherosclerosis compared with never smokers; however, risk of MACE was heightened only in current smokers.
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- 2015
22. A Clinical Model to Identify Patients With High-Risk Coronary Artery Disease
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Yang, Yelin, Chen, Li, Yam, Yeung, Achenbach, Stephan, Al-Mallah, Mouaz, Berman, Daniel S, Budoff, Matthew J, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Cheng, Victor Y, Chinnaiyan, Kavitha, Cury, Ricardo, Delago, Augustin, Dunning, Allison, Feuchtner, Gudrun, Hadamitzky, Martin, Hausleiter, Jörg, Karlsberg, Ronald P, Kaufmann, Philipp A, Kim, Yong-Jin, Leipsic, Jonathon, LaBounty, Troy, Lin, Fay, Maffei, Erica, Raff, Gilbert L, Shaw, Leslee J, Villines, Todd C, Min, James K, and Chow, Benjamin JW
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Clinical Sciences ,Clinical Research ,Heart Disease - Coronary Heart Disease ,Cardiovascular ,Atherosclerosis ,Prevention ,Heart Disease ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Aged ,Coronary Angiography ,Coronary Artery Disease ,Female ,Humans ,Male ,Middle Aged ,Predictive Value of Tests ,Registries ,Retrospective Studies ,Risk Assessment ,Risk Factors ,Tomography ,X-Ray Computed ,computed tomographic coronary angiography ,high-risk coronary artery disease ,risk factors ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
ObjectivesThis study sought to develop a clinical model that identifies patients with and without high-risk coronary artery disease (CAD).BackgroundAlthough current clinical models help to estimate a patient's pre-test probability of obstructive CAD, they do not accurately identify those patients with and without high-risk coronary anatomy.MethodsRetrospective analysis of a prospectively collected multinational coronary computed tomographic angiography (CTA) cohort was conducted. High-risk anatomy was defined as left main diameter stenosis ≥50%, 3-vessel disease with diameter stenosis ≥70%, or 2-vessel disease involving the proximal left anterior descending artery. Using a cohort of 27,125, patients with a history of CAD, cardiac transplantation, and congenital heart disease were excluded. The model was derived from 24,251 consecutive patients in the derivation cohort and an additional 7,333 nonoverlapping patients in the validation cohort.ResultsThe risk score consisted of 9 variables: age, sex, diabetes, hypertension, current smoking, hyperlipidemia, family history of CAD, history of peripheral vascular disease, and chest pain symptoms. Patients were divided into 3 risk categories: low (≤7 points), intermediate (8 to 17 points) and high (≥18 points). The model was statistically robust with area under the curve of 0.76 (95% confidence interval [CI]: 0.75 to 0.78) in the derivation cohort and 0.71 (95% CI: 0.69 to 0.74) in the validation cohort. Patients who scored ≤7 points had a low negative likelihood ratio (
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- 2015
23. Prognostic and Therapeutic Implications of Statin and Aspirin Therapy in Individuals With Nonobstructive Coronary Artery Disease
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Chow, Benjamin JW, Small, Gary, Yam, Yeung, Chen, Li, McPherson, Ruth, Achenbach, Stephan, Al-Mallah, Mouaz, Berman, Daniel S, Budoff, Matthew J, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Cheng, Victor Y, Chinnaiyan, Kavitha, Cury, Ricardo, Delago, Augustin, Dunning, Allison, Feuchtner, Gundrun, Hadamitzky, Martin, Hausleiter, Jörg, Karlsberg, Ronald P, Kaufmann, Philipp A, Kim, Yong-Jin, Leipsic, Jonathon, LaBounty, Troy, Lin, Fay, Maffei, Erica, Raff, Gilbert L, Shaw, Leslee J, Villines, Todd C, and Min, James K
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Patient Safety ,Cardiovascular ,Heart Disease ,Atherosclerosis ,Clinical Research ,Heart Disease - Coronary Heart Disease ,Evaluation of treatments and therapeutic interventions ,Detection ,screening and diagnosis ,6.1 Pharmaceuticals ,4.2 Evaluation of markers and technologies ,Good Health and Well Being ,Adult ,Aged ,Asia ,Aspirin ,Canada ,Coronary Angiography ,Coronary Artery Disease ,Coronary Stenosis ,Europe ,Female ,Humans ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Kaplan-Meier Estimate ,Male ,Middle Aged ,Multivariate Analysis ,Odds Ratio ,Platelet Aggregation Inhibitors ,Predictive Value of Tests ,Primary Prevention ,Proportional Hazards Models ,Prospective Studies ,Protective Factors ,Registries ,Risk Factors ,Severity of Illness Index ,Time Factors ,Tomography ,X-Ray Computed ,Treatment Outcome ,United States ,aspirin ,coronary angiography ,coronary atherosclerosis ,mortality ,prognosis ,statin ,CONFIRM Investigators ,Cardiorespiratory Medicine and Haematology ,Clinical Sciences ,Cardiovascular System & Hematology - Abstract
ObjectiveWe sought to examine the risk of mortality associated with nonobstructive coronary artery disease (CAD) and to determine the impact of baseline statin and aspirin use on mortality.Approach and resultsCoronary computed tomographic angiography permits direct visualization of nonobstructive CAD. To date, the prognostic implications of nonobstructive CAD and the potential benefit of directing therapy based on nonobstructive CAD have not been carefully examined. A total of 27 125 consecutive patients who underwent computed tomographic angiography (12 enrolling centers and 6 countries) were prospectively entered into the COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter (CONFIRM) registry. Patients, without history of previous CAD or obstructive CAD, for whom baseline statin and aspirin use was available were analyzed. Each coronary segment was classified as normal or nonobstructive CAD (1%-49% stenosis). Patients were followed up for a median of 27.2 months for all-cause mortality. The study comprised 10 418 patients (5712 normal and 4706 with nonobstructive CAD). In multivariable analyses, patients with nonobstructive CAD had a 6% (95% confidence interval, 1%-12%) higher risk of mortality for each additional segment with nonobstructive plaque (P=0.021). Baseline statin use was associated with a reduced risk of mortality (hazard ratio, 0.44; 95% confidence interval, 0.28-0.68; P=0.0003), a benefit that was present for individuals with nonobstructive CAD (hazard ratio, 0.32; 95% confidence interval, 0.19-0.55; P
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- 2015
24. Incremental prognostic utility of coronary CT angiography for asymptomatic patients based upon extent and severity of coronary artery calcium: results from the COronary CT Angiography EvaluatioN For Clinical Outcomes InteRnational Multicenter (CONFIRM) Study
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Cho, Iksung, Chang, Hyuk-Jae, Hartaigh, Bríain Ó, Shin, Sanghoon, Sung, Ji Min, Lin, Fay Y, Achenbach, Stephan, Heo, Ran, Berman, Daniel S, Budoff, Matthew J, Callister, Tracy Q, Al-Mallah, Mouaz H, Cademartiri, Filippo, Chinnaiyan, Kavitha, Chow, Benjamin JW, Dunning, Allison M, DeLago, Augustin, Villines, Todd C, Hadamitzky, Martin, Hausleiter, Joerg, Leipsic, Jonathon, Shaw, Leslee J, Kaufmann, Philipp A, Cury, Ricardo C, Feuchtner, Gudrun, Kim, Yong-Jin, Maffei, Erica, Raff, Gilbert, Pontone, Gianluca, Andreini, Daniele, and Min, James K
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Biomedical and Clinical Sciences ,Clinical Sciences ,Heart Disease - Coronary Heart Disease ,Atherosclerosis ,Cardiovascular ,Patient Safety ,Heart Disease ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Coronary Angiography ,Coronary Stenosis ,Female ,Humans ,Kaplan-Meier Estimate ,Male ,Middle Aged ,Myocardial Infarction ,Prognosis ,Risk Assessment ,Tomography ,X-Ray Computed ,Vascular Calcification ,Coronary computed tomographic angiography ,Coronary artery calcium scoring ,Framingham risk score ,Asymptomatic ,Prognostic ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
AimPrior evidence observed no predictive utility of coronary CT angiography (CCTA) over the coronary artery calcium score (CACS) and the Framingham risk score (FRS), among asymptomatic individuals. Whether the prognostic value of CCTA differs for asymptomatic patients, when stratified by CACS severity, remains unknown.Methods and resultsFrom a 12-centre, 6-country observational registry, 3217 asymptomatic individuals without known coronary artery disease (CAD) underwent CACS and CCTA. Individuals were categorized by CACS as: 0-10, 11-100, 101-400, 401-1000, >1000. For CCTA analysis, the number of obstructive vessels-as defined by the per-patient presence of a ≥50% luminal stenosis-was used to grade the extent and severity of CAD. The incremental prognostic value of CCTA over and above FRS was measured by the likelihood ratio (LR) χ(2), C-statistic, and continuous net reclassification improvement (NRI) for prediction, discrimination, and reclassification of all-cause mortality and non-fatal myocardial infarction. During a median follow-up of 24 months (25th-75th percentile, 17-30 months), there were 58 composite end-points. The incremental value of CCTA over FRS was demonstrated in individuals with CACS >100 (LRχ(2), 25.34; increment in C-statistic, 0.24; NRI, 0.62, all P < 0.001), but not among those with CACS ≤100 (all P > 0.05). For subgroups with CACS >100, the utility of CCTA for predicting the study end-point was evident among individuals whose CACS ranged from 101 to 400; the observed predictive benefit attenuated with increasing CACS.ConclusionCoronary CT angiography provides incremental prognostic utility for prediction of mortality and non-fatal myocardial infarction for asymptomatic individuals with moderately high CACS, but not for lower or higher CACS.
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- 2015
25. Effects of cardiac medications for patients with obstructive coronary artery disease by coronary computed tomographic angiography: Results from the multicenter CONFIRM registry
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Schulman-Marcus, Joshua, Hartaigh, Bríain Ó, Giambrone, Ashley E, Gransar, Heidi, Valenti, Valentina, Berman, Daniel S, Budoff, Matthew J, Achenbach, Stephan, Al-Mallah, Mouaz, Andreini, Daniele, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Chinnaiyan, Kavitha, Chow, Benjamin JW, Cury, Ricardo, Delago, Augustin, Hadamitzky, Martin, Hausleiter, Joerg, Feuchtner, Gudrun, Kim, Yong-Jin, Kaufmann, Philipp A, Leipsic, Jonathon, Lin, Fay Y, Maffei, Erica, Pontone, Gianluca, Raff, Gilbert, Shaw, Leslee J, Villines, Todd C, Dunning, Allison, and Min, James K
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Atherosclerosis ,Biomedical Imaging ,Cardiovascular ,Heart Disease - Coronary Heart Disease ,Clinical Research ,Heart Disease ,Aged ,Algorithms ,Cohort Studies ,Coronary Angiography ,Coronary Artery Disease ,Female ,Heart ,Humans ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Male ,Middle Aged ,Proportional Hazards Models ,Registries ,Tomography ,X-Ray Computed ,Treatment Outcome ,Coronary artery disease ,Coronary computed tomographic ,angiography ,Major adverse cardiac events ,Medication therapy ,Statins ,Coronary computed tomographic angiography ,Cardiorespiratory Medicine and Haematology ,Clinical Sciences ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
ObjectiveThis study sought to determine the correlation between baseline cardiac medications and cardiovascular outcomes in patients with obstructive coronary artery disease (CAD) diagnosed by coronary computed tomographic angiography (CCTA).Methods1637 patients (mean age 64.8 ± 10.2 years, 69.6% male) with obstructive CAD from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) registry were followed over the course of three years. Obstructive CAD was defined as a ≥50% stenosis in an epicardial vessel. Medications analyzed included statins, aspirin, beta-blockers, angiotensin converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs). Using Cox proportional-hazards models, we calculated the hazard ratio (HR) with 95% confidence intervals (95% CIs) for incident major adverse cardiovascular events (MACE), defined as death, acute coronary syndrome, or myocardial infarction.ResultsAt the time of CCTA, 59%, 54%, 40%, and 46% of patients were using statins, aspirin, beta-blockers, and ACE inhibitors or ARBs, respectively. Statins were associated with a 43% (95% CI = 0.38-0.87, p = 0.008) lower adjusted risk of MACE. Following adjustment, aspirin, beta-blockers, ACE inhibitors and ARBs did not attenuate the risk of MACE. When restricted to patients with multivessel obstructive CAD, only statins were associated with lower risk of MACE.ConclusionIn patients with obstructive CAD by CCTA, the baseline use of statins was associated with improved clinical outcomes. Other cardiac medications-including aspirin, beta-blockers, ACE inhibitors, and ARBs-were not associated with reduced risk of MACE.
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- 2015
26. Is metabolic syndrome predictive of prevalence, extent, and risk of coronary artery disease beyond its components? Results from the multinational coronary CT angiography evaluation for clinical outcome: an international multicenter registry (CONFIRM).
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Ahmadi, Amir, Leipsic, Jonathon, Feuchtner, Gudrun, Gransar, Heidi, Kalra, Dan, Heo, Ran, Achenbach, Stephan, Andreini, Daniele, Al-Mallah, Mouaz, Berman, Daniel S, Budoff, Matthew, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Chinnaiyan, Kavitha, Chow, Benjamin, Cury, Ricardo C, Delago, Augustin, Gomez, Millie J, Hadamitzky, Martin, Hausleiter, Joerg, Hindoyan, Niree, Kaufmann, Philipp A, Kim, Yong-Jin, Lin, Fay, Maffei, Erica, Pontone, Gianluca, Raff, Gilbert L, Shaw, Leslee J, Villines, Todd C, Dunning, Allison, and Min, James K
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Humans ,Myocardial Infarction ,Tomography ,X-Ray Computed ,Coronary Angiography ,Prognosis ,Angioplasty ,Severity of Illness Index ,Registries ,Prevalence ,Risk Assessment ,Risk Factors ,Survival Analysis ,Cohort Studies ,International Cooperation ,Aged ,Middle Aged ,Female ,Male ,Coronary Artery Disease ,Acute Coronary Syndrome ,Metabolic Syndrome ,Tomography ,X-Ray Computed ,General Science & Technology - Abstract
Although metabolic syndrome is associated with increased risk of cardiovascular disease and events, its added prognostic value beyond its components remains unknown. This study compared the prevalence, severity of coronary artery disease (CAD), and prognosis of patients with metabolic syndrome to those with individual metabolic syndrome components. The study cohort consisted of 27125 consecutive individuals who underwent ≥ 64-detector row coronary CT angiography (CCTA) at 12 centers from 2003 to 2009. Metabolic syndrome was defined as per NCEP/ATP III criteria. Metabolic syndrome patients (n = 690) were matched 1:1:1 to those with 1 component (n = 690) and 2 components (n = 690) of metabolic syndrome for age, sex, smoking status, and family history of premature CAD using propensity scoring. Major adverse cardiac events (MACE) were defined by a composite of myocardial infarction (MI), acute coronary syndrome, mortality and late target vessel revascularization. Patients with 1 component of metabolic syndrome manifested lower rates of obstructive 1-, 2-, and 3-vessel/left main disease compared to metabolic syndrome patients (9.4% vs 13.8%, 2.6% vs 4.5%, and 1.0% vs 2.3%, respectively; p < 0.05), while those with 2 components did not (10.5% vs 13.8%, 2.8% vs 4.5% and 1.3% vs 2.3%, respectively; p > 0.05). At 2.5 years, metabolic syndrome patients experienced a higher rate of MACE compared to patients with 1 component (4.4% vs 1.6%; p = 0.002), while no difference observed compared to individuals with 2 components (4.4% vs 3.2% p = 0.25) of metabolic syndrome. In conclusion, Metabolic syndrome patients have significantly greater prevalence, severity, and prognosis of CAD compared to patients with 1 but not 2 components of metabolic syndrome.
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- 2015
27. Global Longitudinal Strain and Immune Status in Patients Living With Human Immunodeficiency Virus
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Alenezi, Fawaz, Bloomfield, Gerald S., Okeke, Nwora Lance, Velagapudi, Poonam, Abudaqa, Loai, Ijioma, Nkechinyere, Dunning, Allison, Alajmi, Hasan, Clement, Meredith E., Shah, Svati H., Naggie, Susanna, and Velazquez, Eric J.
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- 2019
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28. Predictors and Changes in Cardiac Hemodynamics and Geometry With Transcatheter Aortic Valve Implantation
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Alenezi, Fawaz, Fudim, Marat, Rymer, Jennifer, Dunning, Allison, Chiswell, Karen, Swaminathan, Madhav, Bottiger, Brandi, Velagapudi, Poonam, Nicoara, Alina, Kisslo, Joseph, Velazquez, Eric, Vemulapalli, Sreekanth, Bloomfield, Gerald S., and Samad, Zainab
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- 2019
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29. Sex-based Prognostic Implications of Nonobstructive Coronary Artery Disease: Results from the International Multicenter CONFIRM Study
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Leipsic, Jonathon, Taylor, Carolyn M, Gransar, Heidi, Shaw, Leslee J, Ahmadi, Amir, Thompson, Angus, Humphries, Karin, Berman, Daniel S, Hausleiter, Jörg, Achenbach, Stephan, Al-Mallah, Mouaz, Budoff, Matthew J, Cademartiri, Fillippo, Callister, Tracy Q, Chang, Hyuk-Jae, Chow, Benjamin JW, Cury, Ricardo C, Delago, Augustin J, Dunning, Allison L, Feuchtner, Gudrun M, Hadamitzky, Martin, Kaufmann, Philipp A, Lin, Fay Y, Chinnaiyan, Kavitha M, Maffei, Erica, Raff, Gilbert L, Villines, Todd C, Gomez, Millie J, and Min, James K
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Patient Safety ,Cardiovascular ,Clinical Research ,Heart Disease - Coronary Heart Disease ,Heart Disease ,Aging ,Atherosclerosis ,6.1 Pharmaceuticals ,Detection ,screening and diagnosis ,Evaluation of treatments and therapeutic interventions ,4.2 Evaluation of markers and technologies ,Good Health and Well Being ,Cardiac-Gated Imaging Techniques ,Contrast Media ,Coronary Angiography ,Coronary Artery Disease ,Female ,Humans ,Male ,Middle Aged ,Prognosis ,Prospective Studies ,Registries ,Risk Assessment ,Risk Factors ,Severity of Illness Index ,Sex Factors ,Surveys and Questionnaires ,Tomography ,X-Ray Computed ,Medical and Health Sciences ,Nuclear Medicine & Medical Imaging - Abstract
PurposeTo determine the clinical outcomes of women and men with nonobstructive coronary artery disease ( CAD coronary artery disease ) with coronary computed tomographic (CT) angiography data in patients who were similar in terms of CAD coronary artery disease risk factors, angina typicality, and CAD coronary artery disease extent and distribution.Materials and methodsInstitutional review board approval was obtained for all participating sites, with either informed consent or waiver of informed consent. In a prospective international multicenter cohort study of 27 125 patients undergoing coronary CT angiography at 12 centers, 18 158 patients with no CAD coronary artery disease or nonobstructive (
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- 2014
30. Prognostic significance of calcified plaque among symptomatic patients with nonobstructive coronary artery disease
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Shah, Sana, Bellam, Naveen, Leipsic, Jonathon, Berman, Daniel S, Quyyumi, Arshed, Hausleiter, Jörg, Achenbach, Stephan, Al-Mallah, Mouaz, Budoff, Matthew J, Cademartiri, Fillippo, Callister, Tracy Q, Chang, Hyuk-Jae, Chow, Benjamin JW, Cury, Ricardo C, Delago, Augustin J, Dunning, Allison L, Feuchtner, Gudrun M, Hadamitzky, Martin, Karlsberg, Ronald P, Kaufmann, Philipp A, Lin, Fay Y, Chinnaiyan, Kavitha M, Maffei, Erica, Raff, Gilbert L, Villines, Todd C, Gomez, Millie J, Min, James K, Shaw, Leslee J, and for the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter Registry) Investigators
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Cardiovascular ,Clinical Research ,Heart Disease ,Heart Disease - Coronary Heart Disease ,Atherosclerosis ,Prevention ,Detection ,screening and diagnosis ,4.2 Evaluation of markers and technologies ,Good Health and Well Being ,Adult ,Age Distribution ,Aged ,Aged ,80 and over ,Animals ,Cats ,Causality ,Comorbidity ,Coronary Stenosis ,Female ,Humans ,Internationality ,Male ,Middle Aged ,Prevalence ,Prognosis ,Proportional Hazards Models ,Radionuclide Imaging ,Registries ,Reproducibility of Results ,Risk Assessment ,Sensitivity and Specificity ,Sex Distribution ,Survival Rate ,Symptom Assessment ,Vascular Calcification ,Coronary calcification ,prognosis ,nonobstructive coronary artery disease ,CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter Registry) Investigators ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology - Abstract
BackgroundCoronary artery calcium (CAC) is a well-established predictor of clinical outcomes for population screening. Limited evidence is available as to its predictive value in symptomatic patients without obstructive coronary artery disease (CAD). The aim of the current study was to assess the prognostic value of CAC scores among symptomatic patients with nonobstructive CAD.MethodsFrom the COronary Computed Tomographic Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter (CONFIRM) registry, 7,200 symptomatic patients with nonobstructive CAD (0% but
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- 2014
31. Age-related risk of major adverse cardiac event risk and coronary artery disease extent and severity by coronary CT angiography: results from 15 187 patients from the International Multisite CONFIRM Study
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Nakazato, Ryo, Arsanjani, Reza, Achenbach, Stephan, Gransar, Heidi, Cheng, Victor Y, Dunning, Allison, Lin, Fay Y, Al-Mallah, Mouaz, Budoff, Matthew J, Callister, Tracy Q, Chang, Hyuk-Jae, Cademartiri, Filippo, Chinnaiyan, Kavitha, Chow, Benjamin JW, DeLago, Augustin, Hadamitzky, Martin, Hausleiter, Joerg, Kaufmann, Philipp, Raff, Gilbert, Shaw, Leslee J, Villines, Todd, Cury, Ricardo C, Feuchtner, Gudrun, Kim, Yong-Jin, Leipsic, Jonathon, Berman, Daniel S, and Min, James K
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Clinical Sciences ,Clinical Research ,Heart Disease - Coronary Heart Disease ,Biomedical Imaging ,Patient Safety ,Heart Disease ,Atherosclerosis ,Cardiovascular ,Detection ,screening and diagnosis ,4.2 Evaluation of markers and technologies ,Age Factors ,Coronary Angiography ,Coronary Artery Disease ,Female ,Humans ,Male ,Middle Aged ,Predictive Value of Tests ,Prognosis ,Prospective Studies ,Radiographic Image Interpretation ,Computer-Assisted ,Risk Assessment ,Risk Factors ,Severity of Illness Index ,Tomography ,X-Ray Computed ,Age ,Major adverse cardiac events ,Coronary artery disease ,coronary CT angiography ,Cardiovascular medicine and haematology - Abstract
AimsPrior studies evaluating the prognostic utility of cardiac CT angiography (CCTA) have been largely constrained to an all-cause mortality endpoint, with other cardiac endpoints generally not reported. To this end, we sought to determine the relationship of extent and severity of coronary artery disease (CAD) by CCTA to risk of incident major adverse cardiac events (MACEs) (defined as death, myocardial infarction, and late revascularization).Methods and resultsWe identified subjects without prior known CAD who underwent CCTA and were followed for MACE. CAD by CCTA was defined as none (0% luminal stenosis), mild (1-49% luminal stenosis), moderate (50-69% luminal stenosis), or severe (≥70% luminal stenosis), and ≥50% luminal stenosis was considered as obstructive. CAD severity was judged on per-patient, per-vessel, and per-segment basis. Time to MACE was estimated using univariable and multivariable Cox proportional hazards models. Among 15 187 patients (57 ± 12 years, 55% male), 595 MACE events (3.9%) occurred at a 2.4 ± 1.2 year follow-up. In multivariable analyses, an increased risk of MACE was observed for both non-obstructive [hazard ratio (HR) 2.43, P < 0.001] and obstructive CAD (HR: 11.21, P < 0.001) when compared with patients with normal CCTA. Risk-adjusted MACE increased in a dose-response relationship based on the number of vessels with obstructive CAD ≥50%, with increasing hazards observed for non-obstructive (HR: 2.54, P < 0.001), obstructive one-vessel (HR: 9.15, P < 0.001), two-vessel (HR: 15.00, P < 0.001), or three-vessel or left main (HR: 24.53, P < 0.001) CAD. Among patients stratified by age
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- 2014
32. Incremental prognostic value of coronary computed tomographic angiography over coronary artery calcium score for risk prediction of major adverse cardiac events in asymptomatic diabetic individuals
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Min, James K, Labounty, Troy M, Gomez, Millie J, Achenbach, Stephan, Al-Mallah, Mouaz, Budoff, Matthew J, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Cheng, Victor, Chinnaiyan, Kavitha M, Chow, Benjamin, Cury, Ricardo, Delago, Augustin, Dunning, Allison, Feuchtner, Gudrun, Hadamitzky, Martin, Hausleiter, Jorg, Kaufmann, Philipp, Kim, Yong-Jin, Leipsic, Jonathon, Lin, Fay Y, Maffei, Erica, Raff, Gilbert, Shaw, Leslee J, Villines, Todd C, and Berman, Daniel S
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Biomedical and Clinical Sciences ,Clinical Sciences ,Biomedical Imaging ,Atherosclerosis ,Heart Disease ,Cardiovascular ,Prevention ,Heart Disease - Coronary Heart Disease ,Clinical Research ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Aged ,Calcium ,Constriction ,Pathologic ,Coronary Angiography ,Coronary Vessels ,Diabetes Complications ,Female ,Humans ,Image Processing ,Computer-Assisted ,Male ,Middle Aged ,Myocardial Infarction ,Myocardial Revascularization ,Predictive Value of Tests ,Prognosis ,Proportional Hazards Models ,Prospective Studies ,Registries ,Risk Factors ,Surveys and Questionnaires ,Tomography ,X-Ray Computed ,Coronary artery disease ,Major adverse cardiac events ,Coronary CT angiography ,Coronary artery calcium score ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
BackgroundCoronary artery disease (CAD) diagnosis by coronary computed tomographic angiography (CCTA) is useful for identification of symptomatic diabetic individuals at heightened risk for death. Whether CCTA-detected CAD enables improved risk assessment of asymptomatic diabetic individuals beyond clinical risk factors and coronary artery calcium scoring (CACS) remains unexplored.MethodsFrom a prospective 12-center international registry of 27,125 individuals undergoing CCTA, we identified 400 asymptomatic diabetic individuals without known CAD. Coronary stenosis by CCTA was graded as 0%, 1-49%, 50-69%, and ≥70%. CAD was judged on a per-patient, per-vessel and per-segment basis as maximal stenosis severity, number of vessels with ≥50% stenosis, and coronary segments weighted for stenosis severity (segment stenosis score), respectively. We assessed major adverse cardiovascular events (MACE) - inclusive of mortality, nonfatal myocardial infarction (MI), and late target vessel revascularization ≥90 days (REV) - and evaluated the incremental utility of CCTA for risk prediction, discrimination and reclassification.ResultsMean age was 60.4 ± 9.9 years; 65.0% were male. At a mean follow-up 2.4 ± 1.1 years, 33 MACE occurred (13 deaths, 8 MI, 12 REV) [8.25%; annualized rate 3.4%]. By univariate analysis, per-patient maximal stenosis [hazards ratio (HR) 2.24 per stenosis grade, 95% confidence interval (CI) 1.61-3.10, p < 0.001], increasing numbers of obstructive vessels (HR 2.30 per vessel, 95% CI 1.75-3.03, p < 0.001) and segment stenosis score (HR 1.14 per segment, 95% CI 1.09-1.19, p < 0.001) were associated with increased MACE. After adjustment for CAD risk factors and CACS, maximal stenosis (HR 1.80 per grade, 95% CI 1.18-2.75, p = 0.006), number of obstructive vessels (HR 1.85 per vessel, 95% CI 1.29-2.65, p < 0.001) and segment stenosis score (HR 1.11 per segment, 95% CI 1.05-1.18, p < 0.001) were associated with increased risk of MACE. Beyond age, gender and CACS (C-index 0.64), CCTA improved discrimination by maximal stenosis, number of obstructive vessels and segment stenosis score (C-index 0.77, 0.77 and 0.78, respectively). Similarly, CCTA findings improved risk reclassification by per-patient maximal stenosis [integrated discrimination improvement (IDI) index 0.03, p = 0.03] and number of obstructive vessels (IDI index 0.06, p = 0.002), and by trend for segment stenosis score (IDI 0.03, p = 0.06).ConclusionFor asymptomatic diabetic individuals, CCTA measures of CAD severity confer incremental risk prediction, discrimination and reclassification on a per-patient, per-vessel and per-segment basis.
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- 2014
33. Flexible multifunctional titania nanotube array platform for biological interfacing
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Amani Hamedani, Hoda, primary, Stegall, Thomas, additional, Yang, Yi, additional, Wang, Haochen, additional, Menon, Ashwin, additional, Bhalotia, Anubhuti, additional, Karathanasis, Efstathios, additional, Capadona, Jeffrey R., additional, and Hess-Dunning, Allison, additional
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- 2023
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34. In vivo validation of a mechanically adaptive microfluidic intracortical device as a platform for sustained local drug delivery
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Kim, Youjoung, primary, Druschel, Lindsey N., additional, Mueller, Natalie, additional, Sarno, Danielle, additional, Gisser, Kaela, additional, Hess-Dunning, Allison, additional, and Capadona, Jeffrey R., additional
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- 2023
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35. Relation of Volume Overload to Clinical Outcomes in Acute Heart Failure (From ASCEND-HF)
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Fudim, Marat, Parikh, Kishan S., Dunning, Allison, DeVore, Adam D., Mentz, Robert J., Schulte, Phillip J., Armstrong, Paul W., Ezekowitz, Justin A., Tang, W.H. Wilson, McMurray, John J.V., Voors, Adriaan A., Drazner, Mark H., O'Connor, Christopher M., Hernandez, Adrian F., and Patel, Chetan B.
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- 2018
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36. Transcatheter Aortic Valve Replacement versus Medical Management among Patients with Aortic Stenosis and Left Ventricular Systolic Dysfunction
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Lowenstern, Angela, Vora, Amit N., Dunning, Allison, Schulte, Phillip J., Vemulapalli, Sreekanth, Hughes, G. Chad, Velazquez, Eric J., Harrison, J. Kevin, and Samad, Zainab
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- 2018
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37. Determinants of Left Ventricular Hypertrophy and Diastolic Dysfunction in an HIV Clinical Cohort
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OKEKE, NWORA LANCE, ALENEZI, FAWAZ, BLOOMFIELD, GERALD S., DUNNING, ALLISON, CLEMENT, MEREDITH E., SHAH, SVATI H., NAGGIE, SUSANNA, and VELAZQUEZ, ERIC J.
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- 2018
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38. Impaired Recovery of Left Ventricular Function in Patients With Cardiomyopathy and Left Bundle Branch Block
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Sze, Edward, Samad, Zainab, Dunning, Allison, Campbell, Kristen Bova, Loring, Zak, Atwater, Brett D., Chiswell, Karen, Kisslo, Joseph A., Velazquez, Eric J., and Daubert, James P.
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- 2018
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39. Differences in Prevalence, Extent, Severity, and Prognosis of Coronary Artery Disease Among Patients With and Without Diabetes Undergoing Coronary Computed Tomography Angiography Results from 10,110 individuals from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes): an InteRnational Multicenter Registry
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Rana, Jamal S, Dunning, Allison, Achenbach, Stephan, Al-Mallah, Mouaz, Budoff, Matthew J, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Cheng, Victor Y, Chinnaiyan, Kavitha, Chow, Benjamin JW, Cury, Ricardo, Delago, Augustin, Feuchtner, Gudrun, Hadamitzky, Martin, Hausleiter, Jörg, Kaufmann, Philipp, Karlsberg, Ronald P, Kim, Yong-Jin, Leipsic, Jonathon, Labounty, Troy M, Lin, Fay Y, Maffei, Erica, Raff, Gilbert, Villines, Todd C, Shaw, Leslee J, Berman, Daniel S, and Min, James K
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Cardiovascular ,Clinical Research ,Heart Disease ,Heart Disease - Coronary Heart Disease ,Biomedical Imaging ,Atherosclerosis ,Prevention ,Diabetes ,Detection ,screening and diagnosis ,4.2 Evaluation of markers and technologies ,Good Health and Well Being ,Aged ,Coronary Angiography ,Coronary Artery Disease ,Diabetes Mellitus ,Female ,Humans ,Male ,Middle Aged ,Prevalence ,Prognosis ,Medical and Health Sciences ,Endocrinology & Metabolism ,Biomedical and clinical sciences ,Health sciences - Abstract
ObjectiveWe examined the prevalence, extent, severity, and prognosis of coronary artery disease (CAD) in individuals with and without diabetes (DM) who are similar in CAD risk factors.Research design and methodsWe identified 23,643 consecutive individuals without known CAD undergoing coronary computed tomography angiography. A total of 3,370 DM individuals were propensity matched in a 1-to-2 fashion to 6,740 unique non-DM individuals. CAD was defined as none, nonobstructive (1-49% stenosis), or obstructive (≥ 50% stenosis). All-cause mortality was assessed by risk-adjusted Cox proportional hazards models.ResultsAt a 2.2-year follow-up, 108 (3.2%) and 115 (1.7%) deaths occurred among DM and non-DM individuals, respectively. Compared with non-DM individuals, DM individuals possessed higher rates of obstructive CAD (37 vs. 27%) and lower rates of having normal arteries (28 vs. 36%) (P < 0.0001). CAD extent was higher for DM versus non-DM individuals for obstructive one-vessel disease (19 vs. 14%), two-vessel disease (9 vs. 7%), and three-vessel disease (9 vs. 5%) (P < 0.0001 for comparison), with higher per-segment stenosis in the proximal and mid-segments of every coronary artery (P < 0.001 for all). Compared with non-DM individuals with no CAD, risk of mortality for DM individuals was higher for those with no CAD (hazard ratio 3.63 [95% CI 1.67-7.91]; P = 0.001), nonobstructive CAD (5.25 [2.56-10.8]; P < 0.001), one-vessel disease (6.39 [2.98-13.7]; P < 0.0001), two-vessel disease (12.33 [5.622-27.1]; P < 0.0001), and three-vessel disease (13.25 [6.15-28.6]; P < 0.0001).ConclusionsCompared with matched non-DM individuals, DM individuals possess higher prevalence, extent, and severity of CAD. At comparable levels of CAD, DM individuals experience higher risk of mortality compared with non-DM individuals.
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- 2012
40. Efficacy and Safety of Apixaban Versus Warfarin in Patients with Atrial Fibrillation and a History of Cancer: Insights from the ARISTOTLE Trial
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Melloni, Chiara, Dunning, Allison, Granger, Christopher B., Thomas, Laine, Khouri, Michel G., Garcia, David A., Hylek, Elaine M., Hanna, Michael, Wallentin, Lars, Gersh, Bernard J., Douglas, Pamela S., Alexander, John H., and Lopes, Renato D.
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- 2017
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41. Comparison of Incidence of Left Ventricular Systolic Dysfunction Among Patients With Left Bundle Branch Block Versus Those With Normal QRS Duration
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Sze, Edward, Dunning, Allison, Loring, Zak, Atwater, Brett D., Chiswell, Karen, Daubert, James P., Kisslo, Joseph A., Mark, Daniel B., Velazquez, Eric J., and Samad, Zainab
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- 2017
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42. Long-term prognostic impact of CT-Leaman score in patients with non-obstructive CAD: Results from the COronary CT Angiography EvaluatioN For Clinical Outcomes InteRnational Multicenter (CONFIRM) study
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Andreini, Daniele, Pontone, Gianluca, Mushtaq, Saima, Gransar, Heidi, Conte, Edoardo, Bartorelli, Antonio L., Pepi, Mauro, Opolski, Maksymilian P., ó Hartaigh, Bríain, Berman, Daniel S., Budoff, Matthew J., Achenbach, Stephan, Al-Mallah, Mouaz, Cademartiri, Filippo, Callister, Tracy Q., Chang, Hyuk-Jae, Chinnaiyan, Kavitha, Chow, Benjamin J.W., Cury, Ricardo, Delago, Augustin, Hadamitzky, Martin, Hausleiter, Joerg, Feuchtner, Gudrun, Kim, Yong-Jin, Kaufmann, Philipp A., Leipsic, Jonathon, Lin, Fay Y., Maffei, Erica, Raff, Gilbert, Shaw, Leslee J., Villines, Todd C., Dunning, Allison, Marques, Hugo, Rubinshtein, Ronen, Hindoyan, Niree, Gomez, Millie, and Min, James K
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- 2017
- Full Text
- View/download PDF
43. Fabrication Methods and Chronic In Vivo Validation of Mechanically Adaptive Microfluidic Intracortical Devices
- Author
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Kim, Youjoung, primary, Mueller, Natalie N., additional, Schwartzman, William E., additional, Sarno, Danielle, additional, Wynder, Reagan, additional, Hoeferlin, George F., additional, Gisser, Kaela, additional, Capadona, Jeffrey R., additional, and Hess-Dunning, Allison, additional
- Published
- 2023
- Full Text
- View/download PDF
44. Pulmonary function and adverse cardiovascular outcomes: Can cardiac function explain the link?
- Author
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Burroughs Peña, Melissa S., Dunning, Allison, Schulte, Phillip J., Durheim, Michael T., Kussin, Peter, Checkley, William, and Velazquez, Eric J.
- Published
- 2016
- Full Text
- View/download PDF
45. Statins and Exercise Training Response in Heart Failure Patients: Insights From HF-ACTION
- Author
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Kelly, Jacob P., Dunning, Allison, Schulte, Phillip J., Fiuzat, Mona, Leifer, Eric S., Fleg, Jerome L., Cooper, Lawton S., Keteyian, Steven J., Kitzman, Dalane W., Pina, Ileana L., Kraus, William E., Whellan, David J., O'Connor, Christopher M., and Mentz, Robert J.
- Published
- 2016
- Full Text
- View/download PDF
46. Effectiveness of a low contrast load CT angiography protocol in octogenarians and nonagenarians being evaluated for transcatheter aortic valve replacement
- Author
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Zemedkun, Micheas, LaBounty, Troy M., Bergman, Geoffrey, Wong, Shing-Chiu, Lin, Fay Y., Reynolds, Dolores, Gomez, Millie, Dunning, Allison M., Leipsic, Jonathon, and Min, James K.
- Published
- 2015
- Full Text
- View/download PDF
47. Comparison of the prognostic value of regadenoson and adenosine myocardial perfusion imaging
- Author
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Farzaneh-Far, Afshin, Shaw, Linda K., Dunning, Allison, Oldan, Jorge D., O’Connor, Christopher M., and Borges-Neto, Salvador
- Published
- 2015
- Full Text
- View/download PDF
48. Do Surgeon Expectations Predict Clinically Important Improvements in WOMAC Scores After THA and TKA?
- Author
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Ghomrawi, Hassan M. K., Mancuso, Carol A., Dunning, Allison, Gonzalez Della Valle, Alejandro, Alexiades, Michael, Cornell, Charles, Sculco, Thomas, Bostrom, Matthias, Mayman, David, Marx, Robert G., Westrich, Geoffrey, O’Dell, Michael, and Mushlin, Alvin I.
- Published
- 2017
- Full Text
- View/download PDF
49. Calcium score, coronary artery disease extent and severity, and clinical outcomes among low Framingham risk patients with low vs high lifetime risk: Results from the CONFIRM registry
- Author
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Hulten, Edward, Villines, Todd C., Cheezum, Michael K., Berman, Daniel S., Dunning, Allison, Achenbach, Stephan, Al-Mallah, Mouaz, Budoff, Matthew J., Cademartiri, Filippo, Callister, Tracy Q., Chang, Hyuk-Jae, Cheng, Victor Y., Chinnaiyan, Kavitha, Chow, Benjamin J.W., Cury, Ricardo C., Delago, Augustin, Feuchtner, Gudrun, Hadamitzky, Martin, Hausleiter, Jörg, Kaufmann, Philipp A., Kim, Yong-Jin, Leipsic, Jonathon, Lin, Fay Y., Maffei, Erica, Plank, Fabian, Raff, Gilbert L., Shaw, Leslee J., and Min, James K.
- Published
- 2014
- Full Text
- View/download PDF
50. Aetiology, timing and clinical predictors of early vs. late readmission following index hospitalization for acute heart failure: insights from ASCEND‐HF
- Author
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Fudim, Marat, OʼConnor, Christopher M., Dunning, Allison, Ambrosy, Andrew P., Armstrong, Paul W., Coles, Adrian, Ezekowitz, Justin A., Greene, Stephen J., Metra, Marco, Starling, Randall C., Voors, Adriaan A., Hernandez, Adrian F., Michael Felker, G., and Mentz, Robert J.
- Published
- 2018
- Full Text
- View/download PDF
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