4 results on '"Wojdyla, Daniel"'
Search Results
2. Comparison of safety of sotalol versus amiodarone in patients with atrial fibrillation and coronary artery disease.
- Author
-
Piccini JP, Al-Khatib SM, Wojdyla DM, Shaw LK, Horton JR, Lokhnygina Y, Anstrom KJ, DeWald T, Allen-LaPointe N, Steinberg BA, Thomas K, Daubert JP, and Peterson ED
- Subjects
- Aged, Anti-Arrhythmia Agents therapeutic use, Atrial Fibrillation mortality, Atrial Fibrillation physiopathology, Cause of Death trends, Coronary Artery Disease mortality, Coronary Artery Disease physiopathology, Electrocardiography, Female, Follow-Up Studies, Humans, Male, Middle Aged, North Carolina epidemiology, Retrospective Studies, Survival Rate trends, Treatment Outcome, Amiodarone therapeutic use, Atrial Fibrillation drug therapy, Coronary Artery Disease drug therapy, Sotalol therapeutic use
- Abstract
Sotalol is a commonly prescribed antiarrhythmic drug (AAD) used for maintaining sinus rhythm in patients with atrial fibrillation (AF). Although randomized studies have found that sotalol can significantly delay time to AF recurrence, its association with mortality is less clear, particularly among those with coronary artery disease. We examined outcomes of 2,838 patients with coronary artery disease and AF. Using Cox proportional hazards modeling, landmark analysis, and time-dependent covariates for drug therapy, we compared cumulative survival among patients treated with sotalol (n = 226), amiodarone (n = 856), or no AAD (n = 1,756). Median follow-up was 4.2 years (interquartile range [IQR] 2.0-7.4). The median age was 68 years (IQR 60-75). Compared with those treated with amiodarone or no AAD, patients treated with sotalol were less likely to be black (6% vs 13% vs 13%) and have a previous myocardial infarction (35% vs 51% vs 48%) or a left ventricular ejection fraction <40% (13% vs 26% vs 21%). In follow-up, persistence of sotalol was limited; 97% of patients treated with sotalol were treated for <25% of the follow-up period. In adjusted analysis accounting for time on therapy, sotalol use was associated with an increased risk of all-cause death compared with no drug (hazard ratio 1.53, 95% confidence interval 1.19 to 1.96, p = 0.0009), but a decreased risk of death compared with amiodarone (hazard ratio 0.72, 95% confidence interval 0.55 to 0.91, p = 0.0141). In conclusion, sotalol therapy was more frequently used in patients with fewer co-morbidities, often discontinued early in follow-up, and was associated with increased mortality compared with no AAD but decreased mortality relative to amiodarone., (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
3. Evaluating the impact of public health notification: Duke clopidogrel experience.
- Author
-
Eisenstein EL, Wojdyla D, Anstrom KJ, Brennan JM, Califf RM, Peterson ED, and Douglas PS
- Subjects
- Aged, Clopidogrel, Coronary Artery Disease mortality, Drug Administration Schedule, Drug-Eluting Stents, Evidence-Based Medicine, Female, Humans, Logistic Models, Male, Metals, Middle Aged, North Carolina, Platelet Aggregation Inhibitors adverse effects, Proportional Hazards Models, Prosthesis Design, Registries, Stents, Ticlopidine administration & dosage, Ticlopidine adverse effects, Time Factors, Treatment Outcome, Access to Information, Coronary Artery Disease therapy, Drug Information Services trends, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention instrumentation, Percutaneous Coronary Intervention mortality, Platelet Aggregation Inhibitors administration & dosage, Public Health Informatics trends, Ticlopidine analogs & derivatives
- Abstract
Background: Provider and public health interventions in the late 2006 sought to change the duration of clopidogrel use after drug-eluting stent (DES) implantation. We evaluated whether public health interventions were associated with changes in patient-reported clopidogrel use among DES patients., Methods and Results: We used interrupted time analyses to evaluate trends in duration of patient-reported clopidogrel use before, during, and after public and provider interventions. We included patients with significant coronary artery disease receiving an intracoronary stent between April 2004 and December 2007 at a single tertiary care center. The center supplemented national and regulatory messaging regarding the role of clopidogrel after DES implantation with direct-to-patient and to-their-provider notifications in December 2006. The combination of public and provider direct notification was associated with significant changes in the percent of DES patients reporting clopidogrel use at 6 months (16.55% increase, P=0.010) and 12 months (15.33% increase, P=0.004), but no change at 24-month follow-up (4.64, P=0.295). During the same period, there was no change in the percent of bare-metal stent patients reporting clopidogrel use at 6-month (-3.73%, 0.654), 12-month (-5.98%, P=0.389), and 24-month follow-up (-5.16, P=0.708). Although mortality rates through 24 months seemed to decrease between the pre- and postintervention periods, these changes were not significant (DES, P=0.086; bare-metal stent, P=0.296)., Conclusions: The combination of national scientific and regulatory messaging supplemented by local, personal communications to DES patients and their primary healthcare providers was associated with a significant increase in patient-reported clopidogrel use.
- Published
- 2012
- Full Text
- View/download PDF
4. Hyponatremia and long-term outcomes in chronic heart failure--an observational study from the Duke Databank for Cardiovascular Diseases.
- Author
-
Bettari L, Fiuzat M, Shaw LK, Wojdyla DM, Metra M, Felker GM, and O'Connor CM
- Subjects
- Aged, Cardiac Catheterization, Chronic Disease, Cohort Studies, Databases, Factual, Female, Heart Failure complications, Heart Failure physiopathology, Hospitalization, Humans, Hyponatremia physiopathology, Male, Middle Aged, North Carolina, Proportional Hazards Models, Severity of Illness Index, Survival Analysis, Ventricular Dysfunction, Left physiopathology, Heart Failure mortality, Hyponatremia complications
- Abstract
Background: Hyponatremia is a well known predictor of short-term outcomes in heart failure (HF); however, its impact on long-term survival in HF patients with systolic dysfunction is not well established., Methods and Results: Using the Duke Databank for Cardiovascular Diseases, we identified 1,045 patients with HF and systolic dysfunction undergoing cardiac catheterization from January 2000 through December 2008. The effect of hyponatremia as independent predictor of all-cause death and cardiovascular death/rehospitalization was examined using a multivariable Cox proportional regression model. Hyponatremia was present in 107/1,045 patients (10.2%). Hyponatremic patients were older, more likely to be anemic, with higher heart rate and levels of blood urea nitrogen, lower blood pressure, and more severe HF. Using an unadjusted analysis, hyponatremia was associated with higher risk of all-cause death (hazard ratio [HR] 1.89, 95% confidence interval [CI] 1.44-2.49; P < .0001) and of cardiovascular death/rehospitalization (HR 1.40, 95% CI 1.11-1.77; P = .005) at 4.5 years. When entered into a multivariable Cox model, hyponatremia remained significant for all-cause death (HR 1.42, 95% CI 1.07-1.88) and for cardiovascular death/rehospitalization (HR 1.45, 95% CI 1.14-1.86)., Conclusions: Hyponatremia is relatively common in HF patients with LV dysfunction and is independently associated with increased risk of all-cause mortality and cardiovascular mortality/rehospitalization., (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Published
- 2012
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.