20 results on '"Kindzelski, Andrei"'
Search Results
2. Clinically stable covid-19 patients presenting to acute unscheduled episodic care venues have increased risk of hospitalization: secondary analysis of a randomized control trial
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Bledsoe, Joseph, Woller, Scott C., Brooks, Maria, Sciurba, Frank C., Krishnan, Jerry A., Martin, Deborah, Hou, Peter, Lin, Janet Y., Kindzelski, Andrei, Handberg, Eileen, Kirwan, Bridget-Anne, Zaharris, Elaine, Castro, Lauren, Shapiro, Nancy L., Pepine, Carl J., Majercik, Sarah, Fu, Zhuxuan, Zhong, Yongqi, Venugopal, Vidya, Lai, Yu-Hsuan, Ridker, Paul M., and Connors, Jean M.
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- 2023
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3. Effect of therapeutic-dose heparin on severe acute kidney injury and death in noncritically ill patients hospitalized for COVID-19: a prespecified secondary analysis of the ACTIV4a and ATTACC randomized trial
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Smilowitz, Nathaniel R., Hade, Erinn M., Kornblith, Lucy Z., Castellucci, Lana A., Cushman, Mary, Farkouh, Michael, Gong, Michelle N., Heath, Anna, Hunt, Beverly J., Kim, Keri S., Kindzelski, Andrei, Lawler, Patrick, Leaf, David E., Goligher, Ewan, Leifer, Eric S., McVerry, Bryan J., Reynolds, Harmony R., Zarychanski, Ryan, Hochman, Judith S., Neal, Matthew D., and Berger, Jeffrey S.
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- 2023
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4. Effect of the P-Selectin Inhibitor Crizanlizumab on Survival Free of Organ Support in Patients Hospitalized for COVID-19: A Randomized Controlled Trial
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Solomon, Scott D., Lowenstein, Charles J., Bhatt, Ankeet S., Peikert, Alexander, Vardeny, Orly, Kosiborod, Mikhail N., Berger, Jeffrey S., Reynolds, Harmony R., Mavromichalis, Stephanie, Barytol, Anya, Althouse, Andrew D., Luther, James F., Leifer, Eric S., Kindzelski, Andrei L., Cushman, Mary, Gong, Michelle N., Kornblith, Lucy Z., Khatri, Pooja, Kim, Keri S., Baumann Kreuziger, Lisa, Wahid, Lana, Kirwan, Bridget-Anne, Geraci, Mark W., Neal, Matthew D., and Hochman, Judith S.
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- 2023
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5. Quality of life after pharmacomechanical catheter-directed thrombolysis for proximal deep venous thrombosis
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Sichlau, Michael, Vlahos, Athanasios, Smith, Steven, Thalheimer, Quinn, Singh, Nisha, Harting, Rekha, Gocke, John, Guth, Scott, Shah, Neel, Brady, Paul, Schatz, Marvin, Horrow, Mindy, Markazi, Peyman, Forouzan, Leli, Matalon, Terence A.S., Hertzog, David, Goday, Swapna, Kennedy, Margaret, Kaplan, Robert, Campbell, Thomas, Hartman, Jamie, Nahum, Elmer, Venkat, Arvind, Krishnamurthy, Venkataramu, Rectenwald, John, Henke, Peter, Eliason, Jonathan, Willatt, Jonathon, Escobar, Guillermo, Samuels, Shaun, Katzen, Barry, Benenati, James, Powell, Alex, Pena, Constantino, Wallach, Howard, Gandhi, Ripal, Schneider, Joseph, Kim, Stanley, Hashemi, Farrah, Boyle, Joseph, Patel, Nilesh, Verta, Michael, Leung, Daniel, Garcia, Marc, Blatt, Phillip, Khatri, Jamil, Epstein, Dave, Ryan, Randall, Sweeny, Tom, Stillabower, Michael, Kimbiris, George, Raman, Tuhina, Sierzenski, Paul, Getto, Lelia, Dignazio, Michael, Horvath, Mark, Gornik, Heather, Bartholomew, John, Shishehbor, Mehdi, Peacock, Frank, Joseph, Douglas, Kim, Soo Hyum, Mahlay, Natalia Fendrikova, Clair, Daniel, Lyden, Sean, Kapoor, Baljendra, McLennon, Gordon, Pierce, Gregory, Newman, James, Spain, James, Gill, Amanjiit, Hamilton, Aaron, Rizzo, Anthony, Park, Woosup, Dietzek, Alan, Galin, Ira, Plummer, Dahlia, Hsu, Richard, Broderick, Patrick, Keller, Andrew, Sayeed, Sameer, Slater, Dennis, Lustberg, Herb, Akus, Jan, Sidman, Robert, Dhami, Mandeep, Kohanski, Phillip, Bulgaru, Anca, Dulala, Renuka, Burch, James, Kapur, Dinesh, Yang, Jie, Ranson, Mark, Wladis, Alan, Varnagy, David, Mekhail, Tarek, Winter, Robert, Perez-Izquierdo, Manuel, Motew, Stephen, Royd-Kranis, Robin, Workman, Raymond, Kribbs, Scott, Hogsette, Gerald, Moore, Phillip, Thomason, Bradley, Means, William, Bonsall, Richard, Stewart, John, Golwya, Daniel, Azene, Ezana, Bottner, Wayne, Bishop, William, Clayton, Dave, Gundersen, Lincoln, Riherd, Jody, Shakhnovich, Irina, Ziegelbein, Kurt, Chang, Thomas, Sharma, Karun, Allison, Sandra, Banovac, Fil, Cohen, Emil, Furlong, Brendan, Kessler, Craig, McCullough, Mike, Spies, Jim, Lin, Judith, Kaatz, Scott, Getzen, Todd, Miller, Joseph, Schwartz, Scott, Kabbani, Loay, McVinnie, David, Rundback, John, Manno, Joseph, Schwab, Richard, Cole, Randolph, Herman, Kevin, Singh, David, Barkama, Ravit, Patel, Amish, Comerota, Anthony, Pigott, John, Seiwert, Andrew, Whalen, Ralph, Russell, Todd, Assi, Zakaria, Kazanjian, Sahira, Yobbagy, Jonathan, Kaminski, Brian, Kaufman, Allan, Begeman, Garett, DiSalle, Robert, Thakur, Subash, Kim, Paul, Jacquet, Marc, Dykes, Thomas, Gerding, Joseph, Baker, Christopher, Debiasto, Mark, Mittleider, Derek, Higgins, George, III, Amberson, Steven, Pezzuti, Roger, Gallagher, Thomas, Schainfeld, Robert, Wicky, Stephan, Kalva, Sanjeeva, Walker, Gregory, Salazar, Gloria, Pomerantz, Benjamin, Patel, Virenda, Kabrhel, Christopher, Iqbal, Shams, Gangull, Suvranu, Oklu, Rahmi, Brannan, Scott, Misra, Sanjay, Bjarnason, Haraldur, Ashrani, Aneel, Caccavale, Michael, Fleming, Chad, Friese, Jeremy, Heit, John, Kalra, Manju, Macedo, Thanila, McBane, Robert, McKusick, Michael, Stockland, Andrew, Woodrum, David, Wysokinski, Waldemar, Verma, Adarsh, Davis, Andrew, Chung, Jerry, Nicker, David, Anderson, Brian, Stein, Robert, Weiss, Michael, Patel, Parag, Rilling, William, Tutton, Sean, Hieb, Robert, Hohenwalter, Eric, Colella, M. Riccardo, Gosset, James, White, Sarah, Lewis, Brian, Brown, Kellie, Rossi, Peter, Seabrook, Gary, Guimaraes, Marcelo, Selby, J. Bayne, McGary, William, Hannegan, Christopher, Robison, Jacob, Brothers, Thomas, Elliott, Bruce, Garg, Nitin, Anderson, M. Bret, Uflacker, Renan, Schonholz, Claudio, Raney, Laurence, Greenberg, Charles, Kaufman, John, Keller, Frederick, Kolbeck, Kenneth, Landry, Gregory, Mitchell, Erica, Barton, Robert, DeLoughery, Thomas, Kalbfleisch, Norman, Minjarez, Renee, Lakin, Paul, Liem, Timothy, Moneta, Gregory, Farsad, Khashayar, Fleischman, Ross, French, Loren, Marques, Vasco, Al−Hassani, Yasir, Sawar, Asad, Taylor, Frank, Patel, Rajul, Malhotra, Rahul, Hashemi, Farah, Padnick, Marvin, Gurley, Melissa, Cucher, Fred, Sterrenberg, Ronald, Deepthi, G. Reshmaal, Cumaranatunge, Gomes, Bhatla, Sumit, Jacobs, Darick, Dolen, Eric, Gamboa, Pablo, Dean, L. Mark, Davis, Thomas, Lippert, John, Khanna, Sanjeev, Schirf, Brian, Silber, Jeffrey, Wood, Donald, McGraw, J. Kevin, LaPerna, Lucy, Willette, Paul, Murphy, Timothy, Cerezo, Joselyn, Dhangana, Rajoo, Ahn, Sun Ho, Dubel, Gregory, Haas, Richard, Jay, Bryan, Prince, Ethan, Soares, Gregory, Klinger, James, Lambiase, Robert, Jay, Gregory, Tubbs, Robert, Beland, Michael, Hampson, Chris, O'Hara, Ryan, Thompson, Chad, Frodsham, Aaron, Gardiner, Fenwick, Jaffan, Abdel, Keating, Lawrence, Zafar, Abdul, Alicic, Radica, Raabe, Rodney, Brower, Jayson, McClellan, David, Pellow, Thomas, Zylak, Christopher, Davis, Joseph, Reilly, M. Kathleen, Symington, Kenneth, Seibold, Camerson, Nachreiner, Ryan, Murray, Daniel, Murray, Stephen, Saha, Sandeep, Luna, Gregory, Hodgson, Kim, McLafferty, Robert, Hood, Douglas, Moore, Colleen, Griffen, David, Hurst, Darren, Lubbers, David, Kim, Daniel, Warren, Brent, Engel, Jeremy, Suresh, D.P., VanderWoude, Eric, Razdan, Rahul, Hutchins, Mark, Rounsborg, Terry, Midathada, Madhu, Moravec, Daniel, Tilford, Joni, Beckman, Joni, Razavi, Mahmood, Openshaw, Kurt, Flanigan, D. Preston, Loh, Christopher, Dorne, Howard, Chan, Michael, Thomas, Jamie, Psaila, Justin, Ringold, Michael, Fisher, Jay, Lipcomb, Any, Oskin, Timothy, Wible, Brandt, Coleman, Brendan, Elliott, David, Gaddis, Gary, Cochran, C. Doug, Natarajan, Kannan, Bick, Stewart, Cooke, Jeffrey, Hedderman, Ann, Greist, Anne, Miller, Lorrie, Martinez, Brandon, Flanders, Vincent, Underhill, Mark, Hofmann, Lawrence, Sze, Daniel, Kuo, William, Louie, John, Hwang, Gloria, Hovsepian, David, Kothary, Nishita, Berube, Caroline, Schreiber, Donald, Jeffrey, Brooke, Schor, Jonathan, Deitch, Jonathan, Singh, Kuldeep, Hahn, Barry, Ardolic, Brahim, Gupta, Shilip, Bashir, Riyaz, Rao, Angara Koneti, Garg, Manish, Patil, Pravin, Zack, Chad, Cohen, Gary, Schmieder, Frank, Lakhter, Valdimir, Sacks, David, Guay, Robert, Scott, Mark, Cunningham, Karekin, Sigal, Adam, Cescon, Terrence, Leasure, Nick, Dhurairaj, Thiruvenkatasamy, Muck, Patrick, Knochel, Kurt, Lohr, Joann, Barreau, Jose, Recht, Matthew, Bhaskaran, Jayapandia, Brahmamdam, Ranga, Draper, David, Mehta, Apurva, Maher, James, Sharafuddin, Melhem, Lentz, Steven, Nugent, Andrew, Sharp, William, Kresowik, Timothy, Nicholson, Rachel, Sun, Shiliang, Youness, Fadi, Pascarella, Luigi, Ray, Charles, Knuttinen, Martha-Gracia, Bui, James, Gaba, Ron, Dobiesz, Valerie, Shamim, Ejaz, Nimmagadda, Sangeetha, Peace, David, Zain, Aarti, Palumto, Alison, Haskal, Ziv, Hirshon, Jon Mark, Richard, Howard, Verceles, Avelino, Wong-You-Chong, Jade, Othee, Bertrand, Patel, Rahul, Iliescu, Bogdan, Williams, David, Gemmete, Joseph, Cwikiel, Wojciech, Cho, Kyung, Schields, James, Vellody, Ranjith, Novelli, Paula, Dasika, Narasimham, Wakefield, Thomas, Desmond, Jeffrey, Froehlich, James, Khaja, Minhajuddin, Hunter, David, Golzarian, Jafar, Cressman, Erik, Dotta, Yvonne, Schmiechen, Nate, Marek, John, Garcia, David, Tawil, Isaac, Langsfeld, Mark, Moll, Stephan, Mauro, Matthew, Stavas, Joseph, Burke, Charles, Dixon, Robert, Yu, Hyeon, Keagy, Blair, Kim, Kyuny, Kasthuri, Raj, Key, Nigel, Chaer, Rabih, Makaroun, Michael, Rhee, Robert, Cho, Jae−Sung, Baril, Donald, Marone, Luke, Hseih, Margaret, Feterik, Kristian, Smith, Roy, Jeyabalan, Geetha, Rogers, Jennifer, Vinik, Russel, Kinikini, Dan, Kraiss, Larry, Mueller, Michelle, Pendleton, Robert, Rondina, Matthew, Sarfati, Mark, Wanner, Nathan, Johnson, Stacy, Hopkins, Christy, Ihnat, Daniel, Angle, John, Matsumoto, Alan, Harthun, Nancy, Turba, Ulku, Saad, Wael, Uthlaut, Brian, Nannapaneni, Srikant, Ling, David, Sabri, Saher, Kern, John, Macik, B. Gail, Hoke, George, Park, Auh Wahn, Stone, James, Sneed, Benjamin, Syverud, Scott, Davidson, Kelly, Sharma, Aditya, Wilkins, Luke, Black, Carl, Asay, Mark, Hatch, Daniel, Smilanich, Robert, Patten, Craig, Brown, S. Douglas, Nielsen, Ryan, Alward, William, Collins, John, Nokes, Matthew, Geary, Randolph, Edwards, Matthew, Godshall, Christopher, Levy, Pavel, Winokur, Ronald, Sista, Akhilesh, Madoff, David, Lee, Kyungmouk, Pua, Bradley, DeSancho, Maria, Milizia, Raffaele, Gao, Jing, McLean, Gordon, Khalid, Sanualah, Vedantham, Suresh, Lewis, Larry, Saad, Nael, Thoelke, Mark, Pallow, Robert, Klein, Seth, Sicard, Gregorio, Cohen, David J., Comerota, Anthony J., Gornik, Heather L., Jaff, Michael R., Julian, Jim, Kahn, Susan R., Kearon, Clive, Kee, Stephen, Kindzelski, Andrei L., Lewis, Lawrence, Magnuson, Elizabeth, Razavi, Mahmood K., Murphy, Timothy P., Julian, Jim A., Gu, Chu-Shu, Magnuson, Elizabeth A., Goldhaber, Samuel Z., Schneider, Joseph R., Sista, Akhilesh K., McLafferty, Robert B., Kaufman, John A., Wible, Brandt C., and Blinder, Morey
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- 2020
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6. TACTIC: Trans‐Agency Consortium for Trauma‐Induced Coagulopathy
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Mann, K.G., Freeman, K., Mann, Kenneth G., Esmon, Charles T., Wisnewski, Stephen, Tracy, Russell P., Kindzelski, Andrei L., Pusateri, Anthony, Banerjee, Anirban, Brass, Lawrence F., Brummel‐Ziedins, Kathleen E., Butenas, Saulius, Cohen, Mitchell J., Diamond, Scott L., Freeman, Kalev, Moore, Ernest E., Morrissey, James H., Nelson, Mark T., Park, Myung S., Ruf, Wolfram, Shupp, Jeffrey W., Sperry, Jason L., Spiess, Bruce D., Stalker, Timothy J., and Zuckerbraun, Brian S.
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- 2015
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7. Effect of P2Y12 Inhibitors on Survival Free of Organ Support Among Non-Critically Ill Hospitalized Patients With COVID-19: A Randomized Clinical Trial.
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Berger, Jeffrey S., Kornblith, Lucy Z., Gong, Michelle N., Reynolds, Harmony R., Cushman, Mary, Cheng, Yu, McVerry, Bryan J., Kim, Keri S., Lopes, Renato D., Atassi, Bassel, Berry, Scott, Bochicchio, Grant, de Oliveira Antunes, Murillo, Farkouh, Michael E., Greenstein, Yonatan, Hade, Erinn M., Hudock, Kristin, Hyzy, Robert, Khatri, Pooja, and Kindzelski, Andrei
- Abstract
Importance: Platelets represent a potential therapeutic target for improved clinical outcomes in patients with COVID-19.Objective: To evaluate the benefits and risks of adding a P2Y12 inhibitor to anticoagulant therapy among non-critically ill patients hospitalized for COVID-19.Design, Setting, and Participants: An open-label, bayesian, adaptive randomized clinical trial including 562 non-critically ill patients hospitalized for COVID-19 was conducted between February 2021 and June 2021 at 60 hospitals in Brazil, Italy, Spain, and the US. The date of final 90-day follow-up was September 15, 2021.Interventions: Patients were randomized to a therapeutic dose of heparin plus a P2Y12 inhibitor (n = 293) or a therapeutic dose of heparin only (usual care) (n = 269) in a 1:1 ratio for 14 days or until hospital discharge, whichever was sooner. Ticagrelor was the preferred P2Y12 inhibitor.Main Outcomes and Measures: The composite primary outcome was organ support-free days evaluated on an ordinal scale that combined in-hospital death (assigned a value of -1) and, for those who survived to hospital discharge, the number of days free of respiratory or cardiovascular organ support up to day 21 of the index hospitalization (range, -1 to 21 days; higher scores indicate less organ support and better outcomes). The primary safety outcome was major bleeding by 28 days as defined by the International Society on Thrombosis and Hemostasis.Results: Enrollment of non-critically ill patients was discontinued when the prespecified criterion for futility was met. All 562 patients who were randomized (mean age, 52.7 [SD, 13.5] years; 41.5% women) completed the trial and 87% received a therapeutic dose of heparin by the end of study day 1. In the P2Y12 inhibitor group, ticagrelor was used in 63% of patients and clopidogrel in 37%. The median number of organ support-free days was 21 days (IQR, 20-21 days) among patients in the P2Y12 inhibitor group and was 21 days (IQR, 21-21 days) in the usual care group (adjusted odds ratio, 0.83 [95% credible interval, 0.55-1.25]; posterior probability of futility [defined as an odds ratio <1.2], 96%). Major bleeding occurred in 6 patients (2.0%) in the P2Y12 inhibitor group and in 2 patients (0.7%) in the usual care group (adjusted odds ratio, 3.31 [95% CI, 0.64-17.2]; P = .15).Conclusions and Relevance: Among non-critically ill patients hospitalized for COVID-19, the use of a P2Y12 inhibitor in addition to a therapeutic dose of heparin, compared with a therapeutic dose of heparin only, did not result in an increased odds of improvement in organ support-free days within 21 days during hospitalization.Trial Registration: ClinicalTrials.gov Identifier: NCT04505774. [ABSTRACT FROM AUTHOR]- Published
- 2022
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8. Effect of Antithrombotic Therapy on Clinical Outcomes in Outpatients With Clinically Stable Symptomatic COVID-19: The ACTIV-4B Randomized Clinical Trial.
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Connors, Jean M., Brooks, Maria M., Sciurba, Frank C., Krishnan, Jerry A., Bledsoe, Joseph R., Kindzelski, Andrei, Baucom, Amanda L., Kirwan, Bridget-Anne, Eng, Heather, Martin, Deborah, Zaharris, Elaine, Everett, Brendan, Castro, Lauren, Shapiro, Nancy L., Lin, Janet Y., Hou, Peter C., Pepine, Carl J., Handberg, Eileen, Haight, Daniel O., and Wilson, Jason W.
- Abstract
Importance: Acutely ill inpatients with COVID-19 typically receive antithrombotic therapy, although the risks and benefits of this intervention among outpatients with COVID-19 have not been established.Objective: To assess whether anticoagulant or antiplatelet therapy can safely reduce major adverse cardiopulmonary outcomes among symptomatic but clinically stable outpatients with COVID-19.Design, Setting, and Participants: The ACTIV-4B Outpatient Thrombosis Prevention Trial was designed as a minimal-contact, adaptive, randomized, double-blind, placebo-controlled trial to compare anticoagulant and antiplatelet therapy among 7000 symptomatic but clinically stable outpatients with COVID-19. The trial was conducted at 52 US sites between September 2020 and June 2021; final follow-up was August 5, 2021. Prior to initiating treatment, participants were required to have platelet count greater than 100 000/mm3 and estimated glomerular filtration rate greater than 30 mL/min/1.73 m2.Interventions: Random allocation in a 1:1:1:1 ratio to aspirin (81 mg orally once daily; n = 164), prophylactic-dose apixaban (2.5 mg orally twice daily; n = 165), therapeutic-dose apixaban (5 mg orally twice daily; n = 164), or placebo (n = 164) for 45 days.Main Outcomes and Measures: The primary end point was a composite of all-cause mortality, symptomatic venous or arterial thromboembolism, myocardial infarction, stroke, or hospitalization for cardiovascular or pulmonary cause. The primary analyses for efficacy and bleeding events were limited to participants who took at least 1 dose of trial medication.Results: On June 18, 2021, the trial data and safety monitoring board recommended early termination because of lower than anticipated event rates; at that time, 657 symptomatic outpatients with COVID-19 had been randomized (median age, 54 years [IQR, 46-59]; 59% women). The median times from diagnosis to randomization and from randomization to initiation of study treatment were 7 days and 3 days, respectively. Twenty-two randomized participants (3.3%) were hospitalized for COVID-19 prior to initiating treatment. Among the 558 patients who initiated treatment, the adjudicated primary composite end point occurred in 1 patient (0.7%) in the aspirin group, 1 patient (0.7%) in the 2.5-mg apixaban group, 2 patients (1.4%) in the 5-mg apixaban group, and 1 patient (0.7%) in the placebo group. The risk differences compared with placebo for the primary end point were 0.0% (95% CI not calculable) in the aspirin group, 0.7% (95% CI, -2.1% to 4.1%) in the 2.5-mg apixaban group, and 1.4% (95% CI, -1.5% to 5.0%) in the 5-mg apixaban group. Risk differences compared with placebo for bleeding events were 2.0% (95% CI, -2.7% to 6.8%), 4.5% (95% CI, -0.7% to 10.2%), and 6.9% (95% CI, 1.4% to 12.9%) among participants who initiated therapy in the aspirin, prophylactic apixaban, and therapeutic apixaban groups, respectively, although none were major. Findings inclusive of all randomized patients were similar.Conclusions and Relevance: Among symptomatic clinically stable outpatients with COVID-19, treatment with aspirin or apixaban compared with placebo did not reduce the rate of a composite clinical outcome. However, the study was terminated after enrollment of 9% of participants because of an event rate lower than anticipated.Trial Registration: ClinicalTrials.gov Identifier: NCT04498273. [ABSTRACT FROM AUTHOR]- Published
- 2021
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9. Recommended primary outcomes for clinical trials evaluating hemostatic blood products and agents in patients with bleeding: Proceedings of a National Heart Lung and Blood Institute and US Department of Defense Consensus Conference.
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Spinella, Philip C., El Kassar, Nahed, Cap, Andrew P., Kindzelski, Andrei L., Almond, Christopher S., Barkun, Alan, Gernsheimer, Terry B., Goldstein, Joshua N., Holcomb, John B., Iorio, Alfonso, Jensen, Dennis M., Key, Nigel S., Levy, Jerrold H., Mayer, Stephan A., Moore, Ernest E., Stanworth, Simon J., Lewis, Roger J., Steiner, Marie E., and Hemostasis Trials Outcomes Working Group
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- 2021
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10. Imaging inflammation and its resolution in health and disease: current status, clinical needs, challenges, and opportunities.
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Liu, Christina H., Abrams, Natalie D., Carrick, Danielle M., Chander, Preethi, Dwyer, Johanna, Hamlet, Michelle R. J., Kindzelski, Andrei L., PrabhuDas, Mercy, Shang-Yi Anne Tsai, Vedamony, Merriline M., Chiayeng Wang, and Tandon, Pushpa
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- 2019
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11. Relationships between the use of pharmacomechanical catheter-directed thrombolysis, sonographic findings, and clinical outcomes in patients with acute proximal DVT: Results from the ATTRACT Multicenter Randomized Trial.
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Weinberg, Ido, Vedantham, Suresh, Salter, Amber, Hadley, Gail, Al-Hammadi, Noor, Kearon, Clive, Julian, Jim A, Razavi, Mahmood K, Gornik, Heather L, Goldhaber, Samuel Z, Comerota, Anthony J, Kindzelski, Andrei L, Schainfeld, Robert M, Angle, John F, Misra, Sanjay, Schor, Jonathan A, Hurst, Darren, and Jaff, Michael R
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VENOUS thrombosis ,FEMORAL vein ,THROMBOLYTIC therapy ,DUPLEX ultrasonography ,THROMBOSIS ,VENOUS insufficiency ,VEIN diseases - Abstract
Few studies have documented relationships between endovascular therapy, duplex ultrasonography (DUS), post-thrombotic syndrome (PTS), and quality of life (QOL). The Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis (ATTRACT) trial randomized 692 patients with acute proximal deep vein thrombosis (DVT) to receive anticoagulation or anticoagulation plus pharmacomechanical catheter-directed thrombolysis (PCDT). Compression DUS was obtained at baseline, 1 month and 12 months. Reflux DUS was obtained at 12 months in a subset of 126 patients. Clinical outcomes were collected over 24 months. At 1 month, patients who received PCDT had less residual thrombus compared to Control patients, evidenced by non-compressible common femoral vein (CFV) (21% vs 35%, p < 0.0001), femoral vein (51% vs 70%, p < 0.0001), and popliteal vein (61% vs 74%, p < 0.0001). At 12 months, in the ultrasound substudy, valvular reflux prevalence was similar between groups (85% vs 91%, p = 0.35). CFV non-compressibility at 1 month was associated with higher rates of any PTS (61% vs 46%, p < 0.001), a higher incidence of moderate-or-severe PTS (30% vs 19%, p = 0.003), and worse QOL (difference 8.2 VEINES-QOL (VEnous INsufficiency Epidemiological and Economic Study on Quality of Life) points; p = 0.004) at 24 months. Valvular reflux at 12 months was associated with moderate-or-severe PTS at 24 months (30% vs 0%, p = 0.01). In summary, PCDT results in less residual thrombus but does not reduce venous valvular reflux. CFV non-compressibility at 1 month is associated with more PTS, more severe PTS, and worse QOL at 24 months. Valvular reflux may predispose to moderate-or-severe PTS. ClinicalTrials.gov Identifier NCT00790335. [ABSTRACT FROM AUTHOR]
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- 2019
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12. Pharmacomechanical Catheter-Directed Thrombolysis in Acute Femoral-Popliteal Deep Vein Thrombosis: Analysis from a Stratified Randomized Trial.
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Kearon, Clive, Chu-Shu Gu, Julian, Jim A., Goldhaber, Samuel Z., Comerota, Anthony J., Gornik, Heather L., Murphy, Timothy P., Lewis, Laurence, Kahn, Susan R., Kindzelski, Andrei L., Slater, Dennis, Geary, Randolph, Winokur, Ronald, Natarajan, Kannan, Dietzek, Alan, Leung, Daniel A., Kim, Stanley, and Vedantham, Suresh
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- 2019
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13. Endovascular Thrombus Removal for Acute Iliofemoral Deep Vein Thrombosis: Analysis From a Stratified Multicenter Randomized Trial.
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Comerota, Anthony J., Kearon, Clive, Gu, Chu-Shu, Julian, Jim A., Goldhaber, Samuel Z., Kahn, Susan R., Jaff, Michael R., Razavi, Mahmood K., Kindzelski, Andrei L., Bashir, Riyaz, Patel, Parag, Sharafuddin, Mel, Sichlau, Michael J., Saad, Wael E., Assi, Zakaria, Hofmann, Lawrence V., Kennedy, Margaret, and Vedantham, Suresh
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- 2019
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14. Predictors of perioperative major bleeding in patients who interrupt warfarin for an elective surgery or procedure: Analysis of the BRIDGE trial.
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Clark, Nathan P., Douketis, James D., Hasselblad, Vic, Schulman, Sam, Kindzelski, Andrei L., Ortel, Thomas L., and BRIDGE Investigators
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Background: The use of low-molecular weight heparin bridge therapy during warfarin interruption for elective surgery/procedures increases bleeding. Other predictors of bleeding in this setting are not well described.Methods: BRIDGE was a randomized, double-blind, placebo-controlled trial of bridge therapy with dalteparin 100 IU/kg twice daily in patients with atrial fibrillation requiring warfarin interruption. Bleeding outcomes were documented from the time of warfarin interruption until up to 37 days postprocedure. Multiple logistic regression and time-dependent hazard models were used to identify major bleeding predictors.Results: We analyzed 1,813 patients of whom 895 received bridging and 918 received placebo. Median patient age was 72.6 years, and 73.3% were male. Forty-one major bleeding events occurred at a median time of 7.0 days (interquartile range, 4.0-18.0 days) postprocedure. Bridge therapy was a baseline predictor of major bleeding (odds ratio [OR]=2.4, 95% CI: 1.2-4.8), as were a history of renal disease (OR=2.9, 95% CI: 1.4-6.0), and high-bleeding risk procedures (vs low-bleeding risk procedures) (OR=2.9, 95% CI: 1.4-5.9). Perioperative aspirin use (OR=3.6, 95% CI: 1.1-11.9) and postprocedure international normalized ratio >3.0 (OR=2.1, 95% CI: 1.5-3.1) were time-dependent predictors of major bleeding. Major bleeding was most common in the first 10 days compared with 11-37 days postprocedure (OR=3.5, 95% CI: 1.8-6.9).Conclusions: In addition to bridge therapy, perioperative aspirin use, postprocedure international normalized ratio >3.0, a history of renal failure, and having a high-bleeding risk procedure increase the risk of major bleeding around the time of an elective surgery/procedure requiring warfarin interruption. [ABSTRACT FROM AUTHOR]- Published
- 2018
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15. NIH workshop report on the trans-agency blood-brain interface workshop 2016: exploring key challenges and opportunities associated with the blood, brain and their interface.
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Ochocinska, Margaret J., Zlokovic, Berislav V., Searson, Peter C., Crowder, A. Tamara, Kraig, Richard P., Ljubimova, Julia Y., Mainprize, Todd G., Banks, William A., Warren, Ronald Q., Kindzelski, Andrei, Timmer, William, and Liu, Christina H.
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BLOOD-brain barrier - Abstract
A trans-agency workshop on the blood-brain interface (BBI), sponsored by the National Heart, Lung and Blood Institute, the National Cancer Institute and the Combat Casualty Care Research Program at the Department of Defense, was conducted in Bethesda MD on June 7-8, 2016. The workshop was structured into four sessions: (1) blood sciences; (2) exosome therapeutics; (3) next generation in vitro blood-brain barrier (BBB) models; and (4) BBB delivery and targeting. The first day of the workshop focused on the physiology of the blood and neuro-vascular unit, blood or biofluid-based molecular markers, extracellular vesicles associated with brain injury, and how these entities can be employed to better evaluate injury states and/or deliver therapeutics. The second day of the workshop focused on technical advances in in vitro models, BBB manipulations and nanoparticle-based drug carrier designs, with the goal of improving drug delivery to the central nervous system. The presentations and discussions underscored the role of the BBI in brain injury, as well as the role of the BBB as both a limiting factor and a potential conduit for drug delivery to the brain. At the conclusion of the meeting, the participants discussed challenges and opportunities confronting BBI translational researchers. In particular, the participants recommended using BBI translational research to stimulate advances in diagnostics, as well as targeted delivery approaches for detection and therapy of both brain injury and disease. [ABSTRACT FROM AUTHOR]
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- 2017
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16. Hypothermia and hemostasis in severe trauma: A new crossroads workshop report.
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Alam, Hasan B., Pusateri, Anthony E., Kindzelski, Andrei, Egan, Debra, Hoots, Keith, Andrews, Matthew T., Rhee, Peter, Tisherman, Samuel, Mann, Kenneth, Vostal, Jaroslav, Kochanek, Patrick M., Scalea, Thomas, Deal, Virgil, Sheppard, Forest, and Sopko, George
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- 2012
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17. Apparent role of traveling metabolic waves in oxidant release by living neutrophils.
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Kindzelski, Andrei L. and Petty, Howard R.
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NAD (Coenzyme) , *NEUTROPHILS , *REACTIVE oxygen species , *CELL metabolism - Abstract
Examines the proposed association of the traveling nicotinamide adenine dinucleotide phosphate (NADPH) waves within neutrophils with the release of reactive oxygen metabolites. Types of dissipative structures of cell metabolism; Use of high-speed optical microscopy; Properties of NADPH.
- Published
- 2002
18. Cost-Effectiveness of Pharmacomechanical Catheter-Directed Thrombolysis Versus Standard Anticoagulation in Patients With Proximal Deep Vein Thrombosis: Results From the ATTRACT Trial.
- Author
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Magnuson, Elizabeth A., Chinnakondepalli, Khaja, Vilain, Katherine, Kearon, Clive, Julian, Jim A., Kahn, Susan R., Goldhaber, Samuel Z., Jaff, Michael R., Kindzelski, Andrei L., Herman, Kevin, Brady, Paul S., Sharma, Karun, Black, Carl M., Vedantham, Suresh, and Cohen, David J.
- Abstract
Background: In patients with acute deep vein thrombosis (DVT), pharmacomechanical catheter-directed thrombolysis (PCDT) in conjunction with anticoagulation therapy is increasingly used with the goal of preventing postthrombotic syndrome. Long-term costs and cost-effectiveness of these 2 treatment strategies from the perspective of the US healthcare system have not been compared.Methods and Results: Between 2009 and 2014, the ATTRACT trial (Acute Venous Thrombosis: Thrombus Removal With Adjunctive Catheter-Directed Thrombolysis) randomized 692 patients with acute proximal DVT to PCDT plus anticoagulation (n=337) or standard treatment with anticoagulation alone (n=355). Costs (2017 US dollars) were assessed over a 24-month follow-up period using a combination of resource-based costing, hospital bills, Medicare reimbursement rates, and the Drug Topics Red Book. Health state utilities were obtained from the Short Form-36. In-trial results and US life tables were used to develop a Markov cohort model to evaluate lifetime cost-effectiveness. For the PCDT group, mean costs of the initial procedure were $13 600; per-patient costs associated with the index hospitalization were $21 509 for PCDT and $3877 for standard care (difference=$17 632; 95% CI, $16 117-$19 243). The 24-month difference in costs was $20 045 (95% CI, $16 093-$24 120). Utility scores increased significantly between baseline and 6 months for both groups, with no significant differences between groups at any follow-up time point. Projected differences in lifetime costs of $16 740 and quality-adjusted life years (QALYs) of 0.08, yield an incremental cost-effectiveness ratio for PCDT of $222 041/QALY gained. In probabilistic sensitivity analysis, the probability that PCDT would achieve a lifetime incremental cost-effectiveness ratio <$50 000/QALY or <$150 000/QALY was 1% and 25%, respectively. For iliofemoral DVT, QALY gains with PCDT were greater, yielding an incremental cost-effectiveness ratio of $137 526/QALY; for femoral-popliteal DVT, standard therapy was an economically dominant strategy.Conclusions: With an incremental cost-effectiveness ratio >$200 000/QALY gained, PCDT is not an economically attractive treatment for proximal DVT. PCDT may be of intermediate value in patients with iliofemoral DVT. Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT00790335. [ABSTRACT FROM AUTHOR]- Published
- 2019
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19. Endovascular Thrombus Removal for Acute Iliofemoral Deep Vein Thrombosis.
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Comerota, Anthony J, Kearon, Clive, Gu, Chu-Shu, Julian, Jim A, Goldhaber, Samuel Z, Kahn, Susan R, Jaff, Michael R, Razavi, Mahmood K, Kindzelski, Andrei L, Bashir, Riyaz, Patel, Parag, Sharafuddin, Mel, Sichlau, Michael J, Saad, Wael E, Assi, Zakaria, Hofmann, Lawrence V, Kennedy, Margaret, Vedantham, Suresh, and ATTRACT Trial Investigators
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- 2018
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20. CRT-500.12 The VITA Program: Promoting Vascular Translational Innovation at NHLBI.
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Charette, Marc, McDonald, Cheryl, Moore, Tim, Xiao, Lei, Kindzelski, Andrei, Gao, Yunling, Sasiela, Chris, Mattson, Janet, Malkin, Kelli, Swift, Jennifer, Joyce, Charles, Tolunay, Eser, and Galis, Zorina
- Published
- 2016
- Full Text
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