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539 results on '"Westerhout, Cynthia M."'

2. Comparing Analytical Methods for Composite End Points in Clinical Trials: Insights from the Vericiguat Global Study in Subjects with Heart Failure With Reduced Ejection Fraction Trial

Author

WESTERHOUT, CYNTHIA M., RATHWELL, SARAH, ANSTROM, KEVIN J., HERNANDEZ, ADRIAN F., PONIKOWSKI, PIOTR, EZEKOWITZ, JUSTIN A., VOORS, ADRIAAN A., FELKER, G. MICHAEL, BAKAL, JEFFREY A., BLAUSTEIN, ROBERT O., NKULIKIYINKA, RICHARD, O'CONNOR, CHRISTOPHER M., and ARMSTRONG, PAUL W.

Published
2024
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6. Assessment of Biomarkers of Myocardial injury, Inflammation, and Renal Function in Heart Failure With Reduced Ejection Fraction: The VICTORIA Biomarker Substudy

Author

DEFILIPPI, CHRISTOPHER R., ALEMAYEHU, WENDIMAGEGN G., VOORS, ADRIAAN A., KAYE, DAVID, BLAUSTEIN, ROBERT O., BUTLER, JAVED, EZEKOWITZ, JUSTIN A., HERNANDEZ, ADRIAN F., LAM, CAROLYN S.P., ROESSIG, LOTHAR, SELIGER, STEPHEN, SHAH, PALAK, WESTERHOUT, CYNTHIA M., ARMSTRONG, PAUL W., and O'CONNOR, CHRISTOPHER M.

Published
2023
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9. Background Medical Therapy and Clinical Outcomes From the VICTORIA Trial

Author

Ezekowitz, Justin A., McMullan, Ciaran J., Westerhout, Cynthia M., Piña, Ileana L., Lopez-Sendon, Jose, Anstrom, Kevin J., Hernandez, Adrian F., Lam, Carolyn S.P., O’Connor, Christopher M., Pieske, Burkert, Ponikowski, Piotr, Roessig, Lothar, Voors, Adriaan A., Koglin, Joerg, Armstrong, Paul W., and Butler, Javed

Published
2023
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10. STREAM-2: Half-Dose Tenecteplase or Primary Percutaneous Coronary Intervention in Older Patients With ST-Segment–Elevation Myocardial Infarction: A Randomized, Open-Label Trial

Author

Van de Werf, Frans, Ristić, Arsen D., Averkov, Oleg V., Arias-Mendoza, Alexandra, Lambert, Yves, Kerr Saraiva, José F., Sepulveda, Pablo, Rosell-Ortiz, Fernando, French, John K., Musić, Ljilja B., Vandenberghe, Katleen, Bogaerts, Kris, Westerhout, Cynthia M., Pagès, Alain, Danays, Thierry, Bainey, Kevin R., Sinnaeve, Peter, Goldstein, Patrick, Welsh, Robert C., and Armstrong, Paul W.

Published
2023
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13. Proteomics Identify Clinical Phenotypes and Predict Functional Outcomes in Heart Failure With Preserved Ejection Fraction: Insights From VITALITY-HFpEF.

Author

deFilippi, Christopher R., Shah, Palak, Shah, Sanjiv J., Alemayehu, Wendimagegn, Lam, Carolyn S. P., Butler, Javed, Roessig, Lothar, O’Connor, Christopher M., Westerhout, Cynthia M., and Armstrong, Paul W.

Abstract

BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome that may emerge from overlapping systemic processes associated with comorbidities. We assessed whether unique clusters of circulating proteins are associated with specific clinical characteristics and functional status at baseline and follow-up in a well-phenotyped cohort of patients with HFpEF. METHODS: We evaluated 368 proteins associated with cardiovascular disease and inflammation in prerandomization blood samples from 763 VITALITY-HFpEF (Vericiguat to Improve Physical Functioning in Daily Living Activities of Patients With HFpEF) participants who had a left ventricular ejection fraction ≥45% and a heart failure decompensation event within 6 months. Proteins were clustered, and their associations with clinical characteristics, baseline, and 24-week functional outcomes (Kansas City Cardiomyopathy Questionnaire Physical Limitation Score, 6-minute walk distance [6MWD], and Fried frailty phenotype) were estimated with linear regression. Elastic net regression was used to derive a proteomic summary composite to predict changes in 24-week functional outcomes. RESULTS: Four unique protein clusters were identified, containing 24, 66, 197, and 81 proteins. At baseline, 2 protein clusters with the hub proteins caspase-3 and Dickkopf-related protein 1 were associated with increased frailty, whereas the cluster with tumor necrosis factor receptor 1 as a hub protein was associated with lower Kansas City Cardiomyopathy Questionnaire Physical Limitation Score and shorter 6MWD. By contrast, the cluster with protein C as a hub protein was associated with less frailty and longer a 6MWD. The 24-week increase in 6MWD was negatively correlated with the protein cluster with caspase-3; the protein C cluster was correlated with less frailty at 24 weeks. The baseline proteomic summary composite predicted observed changes in Kansas City Cardiomyopathy Questionnaire Physical Limitation Score and 6MWD at 24 weeks (r=0.42 and 0.30; P<0.001 for both). CONCLUSIONS: Proteomics differentiate specific baseline functional traits associated with HFpEF and may facilitate phenotyping in a heterogeneous disease. These proteins also provide insights into the diverse pathophysiology of HFpEF and which patients may improve functional status during follow-up. [ABSTRACT FROM AUTHOR]

Published
2024
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15. Abstract 11574: Relationship Between Baseline Electrocardiographic Parameters and Outcomes in Patients With High-Risk Heart Failure With Reduced Ejection Fraction: Insights From the Vericiguat Global Study in Patients With Heart Failure With Reduced Ejection Fraction (VICTORIA) Trial

Author

Yogasundaram, Haran, Zheng, Yinggan, Ly, Eric, Ezekowitz, Justin A, OConnor, Christopher M, Blaustein, Robert O, ROESSIG, Lothar, Temple, Tracy C, Westerhout, Cynthia M, Armstrong, Paul W, and Sandhu, Roopinder

Published
2022
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19. Hemoglobin and Clinical Outcomes in the Vericiguat Global Study in Patients With Heart Failure and Reduced Ejection Fraction (VICTORIA)

Author

Ezekowitz, Justin A., Zheng, Yinggan, Cohen-Solal, Alain, Melenovský, Vojtěch, Escobedo, Jorge, Butler, Javed, Hernandez, Adrian F., Lam, Carolyn S.P., O’Connor, Christopher M., Pieske, Burkert, Ponikowski, Piotr, Voors, Adriaan A., deFilippi, Christopher, Westerhout, Cynthia M., McMullan, Ciaran, Roessig, Lothar, and Armstrong, Paul W.

Published
2021
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20. Diuretic use and outcomes in patients with heart failure with reduced ejection fraction: Insights from the VICTORIA trial.

Author

Ezekowitz, Justin, Alemayehu, Wendimagegn, Edelmann, Frank, Ponikowski, Piotr, Lam, Carolyn S.P., O'Connor, Christopher M., Butler, Javed, Corda, Stefano, McMullan, Ciaran J., Westerhout, Cynthia M., Voors, Adriaan A., Mentz, Robert J., and Armstrong, Paul W.

Subjects
HEART failure patients, VENTRICULAR ejection fraction, DIURETICS, TREATMENT effectiveness, HEART failure
Abstract

Aims: In VICTORIA, vericiguat compared with placebo reduced the risk of cardiovascular death (CVD) and heart failure hospitalization (HFH) in patients enrolled after a worsening heart failure (WHF) event. We examined clinical outcomes and efficacy of vericiguat as it relates to background use of loop diuretics in patients with WHF. Methods and results: We calculated the total daily loop diuretic dose equivalent to furosemide dosing at randomization and categorized these as: no loop diuretic, 1–39, 41–80, 40, and >80 mg total daily dose (TDD). The primary composite outcome of CVD/HFH and its components were evaluated based on TDD loop diuretic and expressed as adjusted hazard ratios with 95% confidence intervals. Post‐randomization rates of change in TDD were also examined. Of 4974 patients (98% of the trial) with diuretic dose information available at randomization, 540 (10.8%) were on no loop diuretic, 647 (13.0%) were on 1–39, 1633 (32.8%) were on 40, 1185 (23.8%) were on 41–80, and 969 (19.4%) were on >80 mg TDD. Patients with higher TDD had a higher rate of primary and secondary clinical outcomes. There were no significant interactions with TDD at randomization and efficacy of vericiguat versus placebo for any outcome (all pinteraction > 0.5). Post‐randomization diuretic dose changes for vericiguat and placebo showed similar rates of up‐titration (19.6 and 20.2/100 person‐years), down‐titration (16.8 and 18.1/100 person‐years), and stopping diuretics (22.9 and 24.2/100 person‐years). Conclusions: Loop diuretic TDD at randomization was independently associated with worse outcomes in this high‐risk population. The efficacy of vericiguat was consistent across the range of diuretic doses. [ABSTRACT FROM AUTHOR]

Published
2024
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25. NT-PROBNP DURING SCREENING IN THE STUDY OF VERICIGUAT IN PARTICIPANTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION (VICTORIA) TRIAL: INSIGHTS INTO OUTCOMES AND VERICIGUAT

Author

Westerhout, Cynthia M., primary, Zheng, Yinggan, additional, Lund, Lars, additional, Butler, Javed, additional, Troughton, Richard W., additional, Emdin, Michele, additional, Lam, Carolyn S.P., additional, Ponikowski, Piotr, additional, Blaustein, Robert, additional, O'Connor, Christopher M., additional, Roessig, Lothar, additional, Voors, Adriaan, additional, Ezekowitz, Justin A., additional, and Armstrong, Paul Wayne, additional

Published
2023
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27. Relationship between baseline electrocardiographic measurements and outcomes in patients with high‐risk heart failure: Insights from the VerICiguaT Global Study in Subjects with Heart Failure with Reduced Ejection Fraction (VICTORIA) trial.

Author

Yogasundaram, Haran, Zheng, Yinggan, Ly, Eric, Ezekowitz, Justin, Ponikowski, Piotr, Lam, Carolyn S.P., O'Connor, Christopher, Blaustein, Robert O., Roessig, Lothar, Temple, Tracy, Westerhout, Cynthia M., Armstrong, Paul W., and Sandhu, Roopinder K.

Subjects
BRAIN natriuretic factor, HEART failure, HEART failure patients, VENTRICULAR ejection fraction, RIGHT ventricular hypertrophy
Abstract

Aims: Whether electrocardiographic (ECG) measurements predict mortality in chronic heart failure with reduced ejection fraction (HFrEF) is unknown. Methods and results: We studied 4880 patients from the Vericiguat Global Study in Subjects with Heart Failure with Reduced Ejection Fraction (VICTORIA) trial with a baseline 12‐lead ECG. Associations between ECG measurements and mortality were estimated as hazard ratios (HR) and adjusted for the Meta‐Analysis Global Group in Chronic Heart Failure (MAGGIC) risk score, N‐terminal pro‐B‐type natriuretic peptide, and index event. Select interactions between ECG measurements, patient characteristics and mortality were examined. Over a median of 10.8 months, there were 824 cardiovascular (CV) deaths (214 sudden) and 1005 all‐cause deaths. Median age was 68 years (interquartile range [IQR] 60–76), 24% were women, median ejection fraction was 30% (IQR 23–35), 41% had New York Heart Association class III/IV, and median MAGGIC score was 24 (IQR 19–28). After multivariable adjustment, significant associations existed between heart rate (per 5 bpm: HR 1.02), QRS duration (per 10 ms: HR 1.02), absence of left ventricular hypertrophy (HR 0.64) and CV death, and similarly so with all‐cause death (HR 1.02; HR 1.02; HR 0.61, respectively). Contiguous pathologic Q waves were significantly associated with sudden death (HR 1.46), and right ventricular hypertrophy with all‐cause death (HR 1.44). The only sex‐based interaction observed was for pathologic Q waves on CV (men: HR 1.05; women: HR 1.64, pinteraction = 0.024) and all‐cause death (men: HR 0.99; women: HR 1.57; pinteraction = 0.010). Whereas sudden death doubled in females, it did not differ among males (male: HR 1.25, 95% confidence interval [CI] 0.87–1.79; female: HR 2.50, 95% CI 1.23–5.06; pinteraction = 0.141). Conclusion: Routine ECG measurements provide additional prognostication of mortality in high‐risk HFrEF patients, particularly in women with contiguous pathologic Q waves. [ABSTRACT FROM AUTHOR]

Published
2023
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28. Relationship Between Time to Invasive Assessment and Clinical Outcomes of Patients Undergoing an Early Invasive Strategy After Fibrinolysis for ST-Segment Elevation Myocardial Infarction: A Patient-Level Analysis of the Randomized Early Routine Invasive Clinical Trials

Author

Madan, Mina, Halvorsen, Sigrun, Di Mario, Carlo, Tan, Mary, Westerhout, Cynthia M., Cantor, Warren J., Le May, Michel R., Borgia, Francesco, Piscione, Federico, Scheller, Bruno, Armstrong, Paul W., Fernandez-Aviles, Francisco, Sanchez, Pedro L., Graham, John J., Yan, Andrew T., and Goodman, Shaun G.

Published
2015
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32. Predictors and associated clinical outcomes of low cardiac output syndrome following cardiac surgery: insights from the LEVO-CTS trial

Author

Kochar, Ajar, primary, Zheng, Yinggan, additional, van Diepen, Sean, additional, Mehta, Rajendra H, additional, Westerhout, Cynthia M, additional, Mazer, David Cyril, additional, Duncan, Andra I, additional, Whitlock, Richard, additional, Lopes, Renato D, additional, Argenziano, Michael, additional, de Varennes, Benoit, additional, Alexander, John H, additional, Goodman, Shaun G, additional, and Fremes, Stephen, additional

Published
2022
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33. Outcomes of a Pharmacoinvasive Strategy for Successful Versus Failed Fibrinolysis and Primary Percutaneous Intervention in Acute Myocardial Infarction (from the Strategic Reperfusion Early After Myocardial Infarction [STREAM] Study)

Author

Welsh, Robert C., Van de Werf, Frans, Westerhout, Cynthia M., Goldstein, Patrick, Gershlick, Anthony H., Wilcox, Robert G., Danays, Thierry, Bluhmki, Erich, Lopes, Renato D., Steg, Philippe Gabriel, and Armstrong, Paul W.

Published
2014
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34. Effect of vericiguat on left ventricular structure and function in patients with heart failure with reduced ejection fraction: The VICTORIA echocardiographic substudy.

Author

Pieske, Burkert, Pieske‐Kraigher, Elisabeth, Lam, Carolyn S.P., Melenovský, Vojtěch, Sliwa, Karen, Lopatin, Yuri, Arango, Juan Luis, Bahit, M. Cecilia, O'Connor, Christopher M., Patel, Mahesh J., Roessig, Lothar, Morris, Daniel A., Kropf, Martin, Westerhout, Cynthia M., Zheng, Yinggan, and Armstrong, Paul W.

Subjects
HEART failure patients, VENTRICULAR ejection fraction, ECHOCARDIOGRAPHY, HEART failure, CARDIOVASCULAR disease related mortality
Abstract

Aim: Vericiguat significantly reduced the primary composite outcome of heart failure (HF) hospitalization or cardiovascular death in the VICTORIA trial. It is unknown if these outcome benefits are related to reverse left ventricular (LV) remodelling with vericiguat in patients with HF with reduced ejection fraction (HFrEF). The aim of this study was to compare the effects of vericiguat versus placebo on LV structure and function after 8 months of therapy in patients with HFrEF. Methods and results: Standardized transthoracic echocardiography (TTE) was performed at baseline and after 8 months of therapy in a subset of HFrEF patients in VICTORIA. The co‐primary endpoints were changes in LV end‐systolic volume index (LVESVI) and LV ejection fraction (LVEF). Quality assurance and central reading were performed by an echocardiographic core laboratory blinded to treatment assignment. A total of 419 patients (208 vericiguat, 211 placebo) with high‐quality paired TTE at baseline and 8 months were included. Baseline clinical characteristics were well balanced between treatment groups and echocardiographic characteristics were representative of patients with HFrEF. LVESVI significantly declined (60.7 ± 26.8 to 56.8 ± 30.4 ml/m2; p < 0.01) and LVEF significantly increased (33.0 ± 9.4% to 36.1 ± 10.2%; p < 0.01) in the vericiguat group, but similarly in the placebo group (absolute changes for vericiguat vs. placebo: LVESVI −3.8 ± 15.4 vs. −7.1 ± 20.5 ml/m2; p = 0.07 and LVEF +3.2 ± 8.0% vs. +2.4 ± 7.6%; p = 0.31). The absolute rate per 100 patient‐years of the primary composite endpoint at 8 months tended to be lower in the vericiguat group (19.8) than the placebo group (29.6) (p = 0.07). Conclusions: In this pre‐specified echocardiographic study, significant improvements in LV structure and function occurred over 8 months in both vericiguat and placebo in a high‐risk HFrEF population with recent worsening HF. Further studies are warranted to define the mechanisms of vericiguat's benefit in HFrEF. [ABSTRACT FROM AUTHOR]

Published
2023
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40. DOES FRAILTY MODULATE HEALTH STATUS IN PATIENTS WITH HEART FAILURE AND PRESERVED EJECTION FRACTION?

Author

Kaul, Padma, primary, Rathwell, Sarah, additional, Lam, Carolyn S.P., additional, Westerhout, Cynthia M., additional, Spertus, John A., additional, Anstrom, Kevin J., additional, Blaustein, Robert, additional, Ezekowitz, Justin A., additional, Pieske, Burkert Mathias, additional, Roessig, Lothar, additional, Butler, Javed, additional, and Armstrong, Paul Wayne, additional

Published
2022
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41. EJECTION FRACTION, BIOMARKERS, AND OUTCOMES IN HEART FAILURE WITH REDUCED EJECTION FRACTION AND THE IMPACT OF VERICIGUAT ON OUTCOMES IN THE VICTORIA TRIAL

Author

Butler, Javed, primary, Zheng, Yinggan, additional, Bonderman, Diana, additional, Lund, Lars, additional, DeFilippi, Christopher R., additional, Blaustein, Robert, additional, Ezekowitz, Justin A., additional, Freitas, Cecilia, additional, Hernandez, Adrian F., additional, O’Connor, Christopher M., additional, Voors, Adriaan, additional, Westerhout, Cynthia M., additional, Lam, Carolyn S.P., additional, and Armstrong, Paul Wayne, additional

Published
2022
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