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1. Circulating levels and prognostic cut-offs of sST2, high-sensitivity troponin T, and NT-proBNP in women vs. men with chronic heart failure

Author

Gentile, F, Aimo, A, Jannuzzi, JL, Richards, M, Lam, CS, De Boer, RA, Meems, LM, Latini, R, Staszewsky, L, Anand, IS, Cohn, JN, Ueland, T, Guellestad, L, Aukrust, P, Rocca, HPBL, Bayes-Genis, A, Lupon, J, Yoshihisa, A, Egstrup, M, Gustafsson, I, Gaggin, HK, Eggers, KM, Huber, K, Gamble, GD, Ling, LH, Leong, KTG, Yeo, PSD, Ong, HY, Jaufeerally, F, Ng, TP, Troughton, R, Doughty, RN, Devlin, G, Lund, M, Giannoni, A, Passino, C, Emdin, M, and Vergaro, G

Published
2021

5. Prognostic Value of High-Sensitivity Troponin T in Chronic Heart Failure An Individual Patient Data Meta-Analysis

Author

Aimo, A, Januzzi, JL, Vergaro, G, Ripoli, A, Latini, R, Masson, S, Magnoli, M, Anand, IS, Cohn, JN, Tavazzi, L, Tognoni, G, Gravning, J, Ueland, T, Nymo, SH, Brunner-La Rocca, HP, Genis, AB, Lupon, J, de Boer, RA, Yoshihisa, A, Takeishi, Y, Egstrup, M, Gustafsson, I, Gaggin, HK, Eggers, KM, Huber, K, Tentzeris, I, Tang, WHW, Grodin, J, Passino, C, and Emdin, M

Subjects
meta-analysis, troponin T, heart failure, prognosis, ventricular dysfunction, left
Abstract

BACKGROUND: Most patients with chronic heart failure have detectable troponin concentrations when evaluated by high-sensitivity assays. The prognostic relevance of this finding has not been clearly established so far. We aimed to assess high-sensitivity troponin assay for risk stratification in chronic heart failure through a meta-analysis approach. METHODS: Medline, EMBASE, Cochrane Library, and Scopus were searched in April 2017 by 2 independent authors. The terms were "troponin" AND "heart failure" OR "cardiac failure" OR "cardiac dysfunction" OR "cardiac insufficiency" OR "left ventricular dysfunction." Inclusion criteria were English language, clinical stability, use of a high-sensitivity troponin assay, follow-up studies, and availability of individual patient data after request to authors. Data retrieved from articles and provided by authors were used in agreement with the PRISMA statement. The end points were all-cause death, cardiovascular death, and hospitalization for cardiovascular cause. RESULTS: Ten studies were included, reporting data on 11 cohorts and 9289 patients (age 6612 years, 77% men, 60% ischemic heart failure, 85% with left ventricular ejection fraction

Published
2018

6. Regular Wine Consumption in Chronic Heart Failure: Impact on Outcomes, Quality of Life, and Circulating Biomarkers

Author

Cosmi, Franco, Di Giulio, Paola, Masson, Serge, Finzi, Andrea, Marfisi, Rosa Maria, Cosmi, Deborah, Scarano, Marco, Tognoni, Gianni, Maggioni, Aldo P., Porcu, Maurizio, Boni, Silvana, Cutrupi, Giovanni, Tavazzi, Luigi, Latini, Roberto Tavazzi, L, Tognoni, G, Barlera, S, Franzosi, Mg, Latini, R, Lucci, D, Maggioni, Ap, Marchioli, R, Nicolosi, Gl, Porcu, M, Yusuf, S, Camerini, F, Cohn, Jn, Decarli, A, Pitt, B, Sleight, P, Poole-Wilson, Pa, Geraci, E, Scherillo, M, Fabbri, G, Bartolomei, B, Bertoli, D, Cobelli, F, Fresco, C, Ledda, A, Levantesi, G, Opasich, C, Rusconi, F, Sinagra, G, Turazza, F, Volpi, A, Ceseri, M, Alongi, G, Atzori, A, Bambi, F, Bastarolo, D, Bianchini, F, Cangioli, I, Canu, V, Caporusso, C, Cenni, G, Cintelli, L, Cocchio, M, Confente, A, Fenicia, E, Friso, G, Gianfriddo, M, Grilli, G, Lazzaro, B, Lonardo, G, Luise, A, Nota, R, Orlando, M, Petrolo, R, Pierattini, C, Pierota, V, Provenzani, A, Quartuccio, V, Ragno, A, Serio, C, Spolaor, A, Tafi, A, Tellaroli, E, Ghio, S, Ghizzardi, E, Masson, S, Crociati, L, Rovere, Mt, Corra, U, Di Giulio, P, Finzi, A, Gorini, M, Gonzini, L, Milani, V, Orsini, G, Bianchini, E, Cabiddu, S, Cipressa, L, Cipressa, Ml, Di Bitetto, G, Ferri, B, Galbiati, L, Lorimer, A, Pera, C, Priami, P, Rossi, Mg, Pasotti, E, Vaghi, F, Roncarolo, P, Zunino, Mt, Matta, F, Actis, E, Gaita, F, Azzaro, G, Zanetta, M, Paino, Am, Parravicini, U, Vegis, D, Conte, R, Ferraro, P, De Bernardi, A, Morelloni, S, Fagnani, M, Lucchina, Pg, Montagna, L, Bellone, E, Sappe, D, Ferraro, F, Delucchi, M, Reynaud, Sg, Dore, M, La, A, Massobrio, N, Bo, L, Trinchero, R, Imazio, M, Brocchi, G, Nejrotti, A, Rissone, L, Gabasio, S, Zocchi, C, Randazzo, S, Crenna, A, Giannuzzi, P, Bonanomi, E, Mezzani, A, De Marchi, M, Begliuomini, G, Gianonatti, Ca, Gavazzi, A, Grosu, A, Cas, Ld, Nodari, S, Garyfallidis, P, Bertoletti, A, Bonifazi, C, Arisi, S, Mascaro, F, Fraccarollo, M, Dell, S, Sfolcini, M, Bortolini, F, Raccagni, D, Turelli, A, Santarone, M, Miglierina, E, Sormani, L, Jemoli, R, Tettamanti, F, Pirelli, S, Bianchi, C, Verde, S, Mariani, M, Ziacchi, V, Ferrazza, A, Russo, A, Bortolotti, M, Pasini, Gf, Jones, Kn, Cuzzucrea, D, Gullace, G, Carbone, C, Granata, A, De, S, Del Rosso, G, Inserra, C, Renaldini, E, Zappa, C, Moretti, M, Zanini, R, Ferrari, M, Cei, A, Lissi, C, Dovico, E, Fiorentini, C, Palermo, P, Brusoni, B, Negrini, M, Heyman, J, Danzi, Gb, Frigerio, M, Beretta, L, Sachero, A, Casazza, F, Squadroni, L, Lombardi, F, Marano, L, Margonato, A, Fragasso, G, Febo, Oc, Aiolfi, E, Olmetti, F, Grieco, A, Antonazzo, V, Specchia, G, Mortara, A, Robustelli, F, Songini, Mg, Schweiger, C, Frisinghelli, A, Palvarini, M, Campana, C, Scelsi, L, Marsan, Na, Gualco, A, De Feo, S, Iannone, Ma, Diaco, T, Zaniboni, D, Milanesi, G, Nassiacos, D, Meloni, S, Giani, P, Nicoli, T, Malinverni, C, Gusmini, A, Pozzoni, L, Bisiani, G, Margaroli, P, Schizzarotto, A, Daverio, A, Morelli, E, Occhi, G, Partesana, N, Bandini, P, Rosella, Mg, Giustiniani, S, Cucchi, G, Pedretti, R, Raimondo, R, Vaninetti, R, Fedele, A, Ghezzi, I, Rezzonico, E, Salerno, Ja, Morandi, F, Salvucci, F, Valenti, C, Graziano, G, Romano, M, Cimminiello, C, Mangone, I, Lombardo, M, Quorso, P, Marinoni, G, Breghi, M, Erckert, M, Dienstl, A, Mirante, G, Stefenelli, C, Cioffi, G, Buczkowska, E, Bonanome, A, Bazzanini, F, Parissenti, L, Serafini, C, Catania, G, Tarantini, L, Rigatelli, G, Boni, S, Pasini, A, Masini, E, Zampiero, Aa, Zanchetta, M, Franceschetto, L, Delise, P, Marcon, C, Sacchetta, A, Borgese, L, Artusi, L, Casolino, P, Corbara, F, Banzato, A, Barbiero, M, Aldegheri, Mp, Bazzucco, R, Crivellenti, G, Raviele, A, Zanella, C, Pascotto, P, Sarto, P, Milan, S, Barbieri, E, Girardi, P, Dalla, W, Mule, Jd, Di Sipio ML, Cazzin, R, Milan, D, Zonzin, P, Carraro, M, Rossi, R, Carbonieri, E, Rossi, I, Stritoni, P, Meneghetti, P, Risica, G, Tenderini, Pl, Vassanelli, C, Zanolla, L, Perini, G, Brighetti, G, Chiozza, R, Giuliano, G, Baldin, Mg, Gortan, R, Cesanelli, R, Piazza, R, Mos, L, Vriz, O, Pavan, D, Pascottini, G, Alberti, E, Werren, M, Solinas, L, Longaro, F, Fioretti, P, Albanese, Mc, Miani, D, Gianrossi, R, Pende, A, Rubartelli, P, Magaia, O, Caruso, D, Faraguti, As, Magliani, L, Miccoli, F, Guglielmino, G, Cantarelli, A, Orlandi, S, Vallebona, A, Pozzati, A, Brega, G, Pancaldi, Lg, Vandelli, R, Urbinati, S, Poci, Mg, Zoli, M, Costa, Gm, Guiducci, U, Zobbi, G, Tartagni, F, Tisselli, A, Gentili, A, Pieri, P, Cagnetta, E, Bendinelli, S, Barbieri, A, Conti, R, Ferrari, R, Merlini, F, Fucili, A, Moruzzi, P, Buia, E, Galvani, M, Ferrini, D, Baggioni, G, Yiannacopulu, P, Canè, G, Bonfiglioli, A, Zandomeneghi, R, Brugioni, L, Giannini, A, Di, R, Giuliani, M, Rusconi, L, Del Corso, P, Piovaccari, G, Bologna, F, Venturi, P, Melandri, F, Bagni, E, Bolognese, L, Perticucci, R, Zuppiroli, A, Nannini, M, Consoli, N, Petrone, P, Pipitò, C, Colombi, L, Bernardi, D, Mariani, Pr, Testa, R, Mazzinghi, F, Cosmi, F, Cosmi, D, Zipoli, A, Cecchi, A, Castelli, G, Ciaccheri, M, Mori, F, Pieri, F, Valoti, P, Chiarantini, D, Santoro, Gm, Minneci, C, Marchi, F, Milli, M, Zambaldi, G, Geri, Aa, Cipriani, M, Alessandri, M, Severi, S, Stefanelli, S, Comella, A, Poddighe, R, Digiorgio, A, Carluccio, M, Berti, S, Rizza, A, Bonatti, V, Molendi, V, Brancato, A, D'Aprile, N, Giappichini, G, Del Vecchio, S, Mantini, G, De Tommasi, F, Meucci, G, Cordoni, M, Bechi, S, Barsotti, L, Baldini, P, Romei, M, Scopelliti, G, Lauri, G, Pestelli, F, Furiozzi, F, Cocchieri, M, Severini, D, Patriarchi, F, Chiocchi, P, Buccolieri, M, Martinelli, S, Wee, A, Angelici, F, Bernardinangeli, M, Proietti, G, Biscottini, B, Panciarola, R, Marinacci, L, Perna, Gp, Gabrielli, D, Moraca, A, Moretti, L, Partemi, L, Gregori, G, Amici, R, Patteri, G, Capone, P, Savini, E, Morgagni, Gl, Paccaloni, L, Pezzuoli, F, Carincola, S, Papi, S, De Crescentini, S, Gerardi, P, Midi, P, Gallenzi, E, Pajes, G, Mancone, C, Di, V, Di Gennaro, M, Calcagno, S, Toscano, S, Antonicoli, S, Carta, F, Giorgi, G, Comito, F, Daniele, E, Goretti, Sm, Ciarla, O, Gelfo, Pg, Acquaviva, A, Testa, D, Testa, G, Pagliaro, Fa, Russo, F, Vetta, F, Marchese, I, Di, G, D'Ambrosio, A, Leggio, F, Del Sindaco, D, Lacchè, A, Avallone, A, Risa, Mp, Azzolini, P, Baldo, E, Giovannini, E, Pulignano, G, Tondo, C, Picchio, E, Biffani, E, Tanzi, P, Pozzar, F, Farnetti, F, Azzarito, M, Santini, M, Varveri, A, Ferraiuolo, G, Valtorta, C, Gaspardone, A, Barbato, G, Ceci, V, Aspromonte, N, Bellocci, F, Colizzi, C, Fedele, F, Perez, Fi, Galati, A, Rossetti, A, Mainella, A, Ciuffetta, D, Matteucci, C, Busi, G, De, A, Farina, G, Granatelli, A, Leone, F, Frasca, F, Castellani, G, Massaro, G, Mastrogiuseppe, G, Vacri, A, De Sanctis, F, Cioli, M, Di Luzio, S, Napoletano, C, Piccioni, Ll, De Simone, G, Ottaviano, A, Mazza, V, Spedaliere, C, Staniscia, Td, Calgione, E, De Marco, G, Chiacchio, T, Di, T, Romanzi, S, Salvatore, G, Golino, P, Palermo, A, Mascia, F, Vetrano, A, Vinciguerra, A, Caliendo, L, Longobardi, R, De Caro, G, Di Nola, R, Piemonte, F, Prinzi, D, De Rosa, P, De, V, Riello, F, Capuano, V, Vecchio, G, Landi, M, Amato, S, Garofalo, M, D'Avino, M, Sensale, P, Maiolica, O, Santoro, R, Caso, P, Miceli, D, Maurea, N, Bianchi, U, Crispo, C, Chiariello, M, Filardi, Pp, Russo, L, Capuano, N, Ungaro, G, Vergara, G, Scafuro, F, D'Angelo, G, Campaniello, C, Bottiglieri, P, Volpe, A, Battista, R, De Risi, L, Cardillo, G, Sibilio, G, Marino, Ap, Silvestri, F, Predotti, P, Iervoglini, A, De Matteis, C, Sarnicola, P, Matarazzo, Mm, Baldi, S, Iuliano, V, Astarita, C, Cuccaro, P, Liguori, A, Liguori, G, Gregorio, G, Petraglia, L, Antonelli, G, Amodio, G, De Luca, I, Franchini, G, Lenti, Ml, Cavallari, D, D'Agostino, C, Scalera, G, Altamura, Cm, Russo, M, Mascolo, Ar, Pettinati, G, Ciricugno, Sa, Scrutinio, D, Passantino, A, Mastrangelo, D, Di Masi, A, De, R, Cannone, M, Dibiase, F, Pensato, M, Loliva, F, Trapani, F, Panettieri, I, Leone, L, Di, M, Carrone, M, Gallone, V, Cocco, F, Costantini, M, Tritto, C, Cavalieri, F, Stella, L, Magliari, F, Callerame, M, De Giorgi, A, Pellegrino, L, Correra, M, Portulano, V, Nisi, Gl, Grassi, G, Cristallo, E, De Laura, D, Salerno, C, Fanelli, R, Villella, M, Pede, S, Renna, A, De Lorenzi, E, Urso, L, Lenti, V, Peluso, A, Baldi, N, Polimeni, G, Palma, P, Lauletta, R, Tagliamonte, E, Cirillo, T, Centonze, G, D'Alessandro, B, Truncellito, L, Mecca, D, Petruzzi, Ma, Coviello, Ro, Lopizzo, A, Chiaffitelli, M, Barbuzzi, S, Gubelli, S, Germinario, G, Cosentino, N, Mingrone, A, Vico, R, Borrello, G, Mazza, Ml, Cimino, R, Galasso, D, Cassadonte, F, Talarico, U, Perticone, F, Cassano, S, Catapano, F, Calemme, S, Feraco, E, Cloro, C, Misuraca, G, Caporale, R, Vigna, L, Spagnuolo, V, De Rosa, F, Spadafora, G, Zampaglione, G, Russo, R, Schipani, Fa, Ferragina, Af, Stranieri, D, Musca, G, Carpino, C, Bencardino, P, Raimondo, F, Musacchio, D, Pulitano, G, Ruggeri, A, Provenzano, A, Salituri, S, Musolino, M, Calandruccio, S, Marrari, A, Tripodi, E, Scali, R, Anastasio, L, Arone, A, Aragona, P, Donnangelo, L, Comito, Mg, Bilotta, F, Vaccaro, I, Rametta, R, Ventura, V, Bonvegna, A, Alì, A, Cinnirella, C, Raineri, M, Pompeo, F, Ingurgio, Nc, Carini, V, Coco, R, Giunta, G, Leonardi, G, Randazzo, V, Di Blasi, V, Tamburino, C, Russo, G, Mangiameli, S, Cardillo, R, Castelli, D, Inserra, V, Arena, A, Gulizia, Mm, Raciti, S, Rapisarda, G, Romano, R, Prestifilippo, P, Braschi, Gb, Ledda, G, Terrazzino, R, De Caro, M, Scilabra, G, Graffagnino, B, Grassi, R, Scimone, Gf, Vasquez, L, Coppolino, C, Casale, A, Castelli, M, D'Urso, G, D'Antonio, E, Presti, Ll, Badalamenti, E, Conti, P, Sanfilippo, N, Cirrincione, V, Cinà, Mt, Cusimano, G, Taormina, A, Giuliano, P, Bajardi, A, Mandala, V, Canonico, A, Geraci, G, Sabella, Fp, Enia, F, Floresta, Am, Cascio, Il, Gumina, D, Cavallaro, A, Piccione, G, Ferrante, R, Blandino, M, Iudicello, Ms, Mossuti, E, Romano, G, Lombardo, L, Monastra, P, Di Vincenzo, D, Orru, P, Muscas, F, Giardina, G, Corda, M, Locci, G, Podda, A, Ledda, M, Siddi, P, Lai, C, Pili, G, Mercuro, G, Mureddu, G, Ganau, A, Meloni, G, Poddighe, G, Sanna, G., Cosmi, Franco, Di Giulio, Paola, Masson, Serge, Finzi, Andrea, Marfisi, Rosa Maria, Cosmi, Deborah, Scarano, Marco, Tognoni, Gianni, Maggioni, Aldo P, Porcu, Maurizio, Boni, Silvana, Cutrupi, Giovanni, Tavazzi, Luigi, Latini, Roberto, on behalf of the GISSI-HF, Investigator, Margonato, Alberto, DI GIULIO, Paola, Maggioni, Aldo P., GISSI HF, Investigator, and Sinagra, Gianfranco

Subjects
Male, Health Status, Left, Wine, Comorbidity, Ventricular Function, Left, Health Statu, Quality of life, Risk Factors, Surveys and Questionnaires, Prevalence, Ventricular Function, Surveys and Questionnaire, Depression (differential diagnoses), Depression, Medicine (all), Middle Aged, Prognosis, biological marker, Italy, Female, Risk assessment, Cardiology and Cardiovascular Medicine, biological markers, Human, Cardiac function curve, Vasculitis, medicine.medical_specialty, Vasculiti, Alcohol Drinking, Prognosi, Lower risk, Risk Assessment, Internal medicine, medicine, Humans, Protective Factor, Aged, Heart Failure, business.industry, Risk Factor, Stroke Volume, Biomarker, quality of life, wine, aged, alcohol drinking, biomarkers, chronic disease, comorbidity, depression, female, heart failure, humans, italy, male, middle aged, prevalence, prognosis, protective factors, risk assessment, risk factors, stroke volume, surveys and questionnaires, vasculitis, ventricular function, left, health status, cardiology and cardiovascular medicine, Biomarkers, Chronic Disease, Protective Factors, Quality of Life, medicine.disease, Clinical trial, Heart failure, Physical therapy, business
Abstract

Background— Moderate, regular alcohol consumption is generally associated with a lower risk of cardiovascular events but data in patients with chronic heart failure are scarce. We evaluated the relations between wine consumption, health status, circulating biomarkers, and clinical outcomes in a large Italian population of patients with chronic heart failure enrolled in a multicenter clinical trial. Methods and Results— A brief questionnaire on dietary habits was administered at baseline to 6973 patients enrolled in the Gruppo Italiano per lo Studio della Sopravvivenza nell’Insufficienza Cardiaca-Heart Failure (GISSI-HF) trial. The relations between wine consumption, fatal and nonfatal clinical end points, quality of life, symptoms of depression, and circulating biomarkers of cardiac function and inflammation (in subsets of patients) were evaluated with simple and multivariable-adjusted statistical models. Almost 56% of the patients reported drinking at least 1 glass of wine per day. After adjustment, clinical outcomes were not significantly different in the predefined 4 groups of wine consumption. However, patients with more frequent wine consumption had a significantly better perception of health status (Kansas City Cardiomyopathy Questionnaire score, adjusted P P =0.01), and lower plasma levels of biomarkers of vascular inflammation (osteoprotegerin and C-terminal proendothelin-1, adjusted P P =0.01) after adjusting for possible confounders. Conclusions— We show for the first time in a large cohort of patients with chronic heart failure that moderate wine consumption is associated with a better perceived and objective health status, lower prevalence of depression, and less vascular inflammation, but does not translate into more favorable clinical 4-year outcomes. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT0033633.

Published
2015

7. Rationale, design, implementation, and baseline characteristics of patients in the dig trial: A large, simple, long-term trial to evaluate the effect of digitalis on mortality in heart failure

Author

Abernathy, GT, Abrams, J, Akhtar, S, Albitar, I, Amidi, M, Anand, IS, Arnold, JMO, Ashton, T, Aubrey, B, Auger, P, Babb, J, Baigrie, R, Baird, MG, Baitz, T, Barber, NC, Barbour, DJ, Barr, DM, Basu, AK, Baughman, KL, Beckham, V, BekheitSaad, S, Berkson, DM, Bertoglio, M, Bessoudo, R, Beaudoin, J, Bhaskar, G, Binder, A, Bloomfield, D, Bodine, K, Boehmer, JP, Borgersen, K, Borts, D, Bouchard, G, Bourassa, MG, Boutros, G, Bozek, B, Brisbin, D, Brophy, J, Brossoit, R, Brown, E, Brown, J, Bruinsma, N, Burton, G, Cameron, A, Campbell, R, Campeau, J, Campos, EE, Cardello, FP, Carter, RP, Chan, YK, Charles, FR, Chaudhry, MA, Chiaramida, A, Chiaramida, S, Chohan, A, Christie, LG, Clemson, BS, Collin, R, Cook, TH, Copen, DL, Cossett, J, Costantino, T, Crawford, MH, Croke, RP, Crowell, R, DAmours, G, Dagenais, GR, Danisa, K, Davidson, S, Davies, ML, Davies, R, Davies, RA, DeLarochelliere, R, DeLeon, AC, Delage, F, Denes, P, Dennish, GW, Denny, DM, DeVilla, MA, DeYoung, JP, Dhurandhar, RW, DibnerDunlap, M, Dodek, A, Doherty, JE, Dominguez, J, Dubbin, J, Dufton, J, Effron, MB, ElSherif, N, Eladasari, B, Fly, D, Ericson, K, Fahrenholtz, D, Fast, A, Fell, DA, Fishman, S, Fitchett, D, Fleg, JL, Flint, E, Folger, JS, Folkins, D, Forker, AD, Fowles, RE, Fraker, TD, Francis, G, Frerking, TR, Friesinger, GC, Fulop, JC, Gagnon, J, Gamble, L, Ganjavi, F, Garrou, BW, Gervais, PB, Gheorghiade, M, Gilbert, L, Gillie, E, Glatter, TR, Godley, ML, Goeres, M, Goldberger, MH, Gollapudi, A, Goode, JE, Goodman, LS, Gordon, R, Gossard, D, Gosselin, G, Goulet, C, Grant, C, Graettinger, WF, Greene, JG, Greenwood, PV, Gregoratos, G, Gregory, JJ, Groden, DL, Grover, J, Gudapati, R, Guess, MA, Gupta, SC, Habib, N, Hack, I, Hamilton, WP, Hankey, TL, Hanna, M, Harper, D, Harris, DE, Hassapoyannes, CA, Hatheway, RJ, Heinsimer, J, Pequignot, MH, Heiselman, DE, Hess, AR, Hickner, J, Hickey, JE, Higgins, T, Higginson, L, Hill, L, Hobbs, RE, Honos, G, Horner, BA, Horwitz, L, Hsieh, A, Hsueh, JT, Hubbard, J, Hughes, DF, Hui, W, Imrie, JR, Jacobs, MH, Jarmukli, N, Johnson, TH, Johnstone, D, Jutila, CK, Kadri, N, Kahl, FR, Kaimal, PK, Karnegis, J, Kay, R, Kelly, KJ, Kenefick, G, Kennelly, BM, Kent, E, Khan, AH, Khanijo, V, Khouri, M, Kinloch, D, Kirlin, PC, Kiwan, GS, Kline, MD, Kohn, RM, Koilpillai, C, Kornder, JM, Kouz, S, Kumar, VA, Kumar, U, Kuntz, A, Kuritzky, RA, Kuruvilla, G, Kwok, KK, Lader, E, Laforest, M, LaForge, D, Lalonde, G, Lalonde, L, Lang, RM, Latour, Y, Lawal, O, LeBlanc, MH, Lee, AB, Lee, RW, Legault, C, Lemay, M, Lenis, JHF, Lepage, S, Letarte, P, Levesque, C, LevinoffRoth, SN, Lewis, BK, Lipshutz, H, Loungani, RR, Lowery, ML, Lubell, DL, Lucariello, R, LugoRodriguez, JE, Lui, C, Lutterodt, AT, Lutz, L, Machel, T, Macina, G, MacLellan, K, Magnan, O, Mansuri, M, Manyari, DE, Mallis, GI, Marr, D, Mast, DJ, Mathew, J, McBarron, FD, McIntyre, KM, McLean, RW, McMahon, DP, Mercier, M, Methe, M, Miller, AB, Minkowitz, J, Milton, JR, Mizgala, HF, Mohanty, PK, Mohiuddin, S, Montero, A, Mookherjee, S, Morris, A, Morris, L, Morrison, J, Moten, M, Nafziger, A, Nair, PH, Nawaz, S, Neiman, JC, Nutting, P, NguyenPho, HT, OBrien, TK, OKelly, RL, OReilly, MV, Okerson, D, Patel, G, Pande, PN, Papa, LA, Patrick, L, Payne, RM, Perry, G, Philbin, EF, Pierpont, G, Pitt, WA, Poirier, C, Pollak, EM, Popio, K, Poulin, JF, Probst, PA, Pruneau, G, Pu, C, Puram, BS, Putatunda, B, Quinn, B, Rabkin, SW, Racine, N, Raco, DL, Radant, L, Radford, MJ, Radwany, S, Rajachar, M, Ramanathan, KB, Rashkow, A, Rausch, DC, Read, L, Reddy, KR, Reid, R, Rich, MW, Ricci, AJ, Richman, HG, Riley, A, Rim, DA, Rinne, C, Roberge, G, Roberts, DK, Robinson, V, Rodeheffer, RT, Rosenstein, R, Roth, DL, Rothbart, R, Rouleau, JL, Ruble, P, Sacco, J, Safford, RE, Salmon, D, Sahay, BM, Sarma, RJ, Sayeed, MAR, Schick, EC, Schroeder, GS, Seifert, M, Senaratne, MPJ, Sestier, F, Shah, A, Shanes, JG, Sheesley, K, Silverman, A, Shiva, T, Shrestha, DD, Silver, MA, Silverberg, L, Simard, L, Singh, BN, Small, RS, Smith, MR, Smith, S, Sochowski, RA, Southern, RF, Sridharan, MR, StHilaire, R, Stein, M, Stewart, JW, Stillabower, ME, Sullivan, BHM, Sturrock, WA, Sussex, BA, Swan, J, Swenson, L, Talbot, P, Talibi, T, Tamilia, M, Tan, A, Tanser, PH, Tarry, L, Teo, KK, Thadani, U, Thagirisa, S, Thompson, B, Thornton, R, Timmis, GC, Tobin, M, Tommaso, C, Toren, M, Tsuyuki, R, Turek, M, Utley, K, Vanderbush, EJ, VanVoorhees, L, Ventura, H, Vertes, G, Vizel, S, Wagner, KR, Wagner, S, Weeks, A, Weingert, ME, Weinstein, C, Weiss, MM, Weiss, R, Wickemeyer, W, Wielgoz, A, Willens, HJ, Williams, WL, Wong, D, Yarows, SA, Yao, L, Shalev, Y, Young, JB, Yousefian, M, Zajac, EJ, Zatuchni, J, Ziperman, DB, Zoble, RG, Zoneraich, S, Gorlin, R, Sleight, P, Cohn, JN, Collins, R, Deykin, D, Hennekens, C, Kjekshus, J, Smith, TW, Tognoni, G, Collins, JF, Williford, WO, Fye, C, Sather, R, Jolly, MK, Held, CP, Verter, J, Yusuf, S, Egan, D, Garg, R, Johnstone, DE, Montague, T, Bristow, D, Engelhardt, HT, Gent, M, Hood, WB, Jones, S, Meier, P, Pitt, B, Waters, D, Baker, A, Barnhill, S, Carew, B, Hagar, S, Liuni, C, Martin, S, Miles, R, Arthur, MM, Feldbush, MW, Highfield, DA, Hobbins, TE, Kurz, R, Leviton, SP, Libonati, JP, Moore, M, Perez, E, Mills, P, Geller, N, Hunsberger, S, Gold, J, Huang, PC, Burns, A, Caleb, H, Cline, DR, Harris, S, Hockenbrock, R, Horney, RA, Jadwin, LM, King, J, Sexton, P, Spence, ME, Chacon, F, Gagne, W, Maple, S, and Martinez, G

Subjects
Heart Failure, Male, Pharmacology, Digoxin, Treatment Outcome, Patient Selection, Digitalis Glycosides, Humans, Multicenter Studies as Topic, Female, Middle Aged, Aged, Randomized Controlled Trials as Topic
Abstract

This article provides a detailed overview of the rationale for key aspects of the protocol of the Digitalis Investigation Group (DIG) trial. It also highlights unusual aspects of the study implementation and the baseline characteristics. The DIG trial is a large, simple, international placebo-controlled trial whose primary objective is to determine the effect of digoxin on all cause mortality in patients with clinical heart failure who are in sinus rhythm and whose ejection fraction isor = 0.45. An ancillary study examines the effect in those with an ejection fraction0.45. Key aspects of the trial include the simplicity of the design, broad eligibility criteria, essential data collection, and inclusion of various types of centers. A total of 302 centers in the United States and Canada enrolled 7788 patients between February 1991 and September 1993. Follow-up continued until December 1995 with the results available in Spring 1996.

Published
1996

8. Val-HeFT and angiotensin-receptor blockers in perspective: A tale of the blind man and the elephant

Author

Marvin A. Konstam, Tognoni G, and Cohn Jn

Subjects
medicine.medical_specialty, Ejection fraction, business.industry, Captopril, medicine.disease, Sudden death, law.invention, Losartan, Randomized controlled trial, Valsartan, law, Heart failure, Internal medicine, ACE inhibitor, Cardiology, Medicine, Cardiology and Cardiovascular Medicine, business, Intensive care medicine, medicine.drug
Abstract

EDITOR SUMMARY Background: The role of angiotensin-receptor blockers (ARBs) in the therapy of chronic heart failure (CHF) has not been clarified. There are no large placebo-controlled trials with these agents. The second Evaluation of Losartan in the Elderly trial (ELITE-II) compared the ARB losartan with captopril in 3,152 patients ≥60 years old with New York Heart Association (NYHA) class II-IV and left ventricular ejection fraction ≤40% and did not establish the efficacy of the ARB or its equivalent to angiotensin-converting enzyme inhibitor. The Valsartan Heart Failure Trial was designed to determine whether addition of valsartan improved the outcomes of patients receiving standard therapy for heart failure, which in most cases included an ACE inhibitor. Methods and Results: A total of 5,010 patients with NYHA class II-IV CHF and ejection fraction

Published
2002

9. Effects of telmisartan, irbesartan, valsartan, candesartan, and losartan on cancers in 15 trials enrolling 138 769 individuals The ARB Trialists Collaboration

Author

Teo, KK, Sleight, P, Gao, P, Yusuf, S, Connolly, S, Swedberg, K, Pfeffer, MA, Granger, CB, McMurray, JJV, Sjoelie, AK, Massie, BM, Carson, P, Lewis, JB, Wachtell, K, Dahlof, B, Devereux, RB, Kjeldsen, SE, Julius, S, Ibsen, H, Lindholm, LH, Olsen, MH, Okin, PM, Califf, R, Holman, RR, Haffner, SM, Dagenais, G, Probstfield, J, Anderson, C, Diaz, R, Dans, A, Levine, M, Unger, T, Fagard, R, Diener, H-C, Sacco, RL, Zanchetti, A, Cohn, JN, Weber, M, and Collaboration, ARBT

Published
2011

14. Elevated plasma renin activity predicts adverse outcome in chronic heart failure, independently of pharmacologic therapy: data from the Valsartan Heart Failure Trial (Val-HeFT)

Author

Masson S, Solomon S, Angelici L, Latini R, Anand IS, Prescott M, Maggioni AP, Tognoni G, Cohn JN, and Val-Heft Investigators

Abstract

The prognostic value of plasma renin activity (PRA) in chronic heart failure (HF) has been assessed before the widespread use of angiotensin-converting enzyme inhibitors (ACEi) and beta-blockers, which exert opposite effects on renin secretion. We evaluated the association between PRA and outcome in patients with chronic HF treated with ACEi and beta-blockers. [ABSTRACT FROM AUTHOR]

Published
2010
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17. Exploring the potential synergistic action of spironolactone on nitric oxide--enhancing therapy: insights from the African-American Heart Failure Trial.

Author

Ghali JK, Tam SW, Sabolinski ML, Taylor AL, Lindenfeld J, Cohn JN, and Worcel M

Abstract

BACKGROUND: To investigate if treatment with an aldosterone antagonist affects the outcomes of treatment by fixed dose combination of isosorbide dinitrate/hydralazine (FDC I/H) or placebo in black heart failure (HF) patients treated with contemporary HF medications. In the African-American Heart Failure Trial (A-HeFT), FDC I/H was effective in reducing mortality and improving event-free survival. The beneficial effects of aldosterone antagonist (spironolactone [SP]), however have not been adequately assessed in black patients with or without the use of FDC I/H. METHODS AND RESULTS: A retrospective analysis was performed in A-HeFT data base (n = 1050) to determine the effect of using SP (39% of patients) on outcomes. Baseline comparisons were done by 2-sample t-test or Fisher's exact test. Kaplan-Meier survival analyses were used for comparing between and within groups for outcomes. SP had no effect on mortality, event-free survival, or first HF hospitalization in the overall A-HeFT population. However, SP decreased mortality risk in the FDC I/H group by 59% (P = .03), and a favorable trend was noted on event-free survival and first HF hospitalization. In contrast, the use of SP was not associated with a decrease in mortality or HF hospitalizations in the placebo group. CONCLUSIONS: This study suggests that in black patients with systolic heart failure on standard therapy of beta-blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor antagonists, the beneficial effects of aldosterone antagonists require a background therapy of FDC I/H. [ABSTRACT FROM AUTHOR]

Published
2008
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18. Reducing cardiovascular risk by blockade of the renin-angiotensin-aldosterone system.

Author

Cohn JN and Cohn, Jay N

Abstract

Many factors contribute to the overall risk of cardiovascular disease (CVD) in a given patient. Activation of the renin-angiotensin-aldosterone system (RAAS) is pivotal in the pathophysiology of CVD and renal disease and appears to place individuals at high risk for cardiovascular (CV) and renal events. Results from many large-scale, long-term clinical trials have demonstrated that RAAS blockade with an angiotensin-converting-enzyme inhibitor (ACEI) or an angiotensin receptor blocker (ARB) can significantly decrease CV and renal morbidity and mortality in a wide range of patients. Some of the clinical benefits derived from use of these agents appears to be independent of their ability to lower blood pressure. The combined use of an ACEI and an ARB for antihypertensive therapy has begun to receive considerable attention. Such an approach may seem counterintuitive, but ACEIs and ARBs have distinct and potentially complementary pharmacologic effects. Results from clinical trials thus far suggest that combination therapy with an ACEI plus an ARB may be a rational choice in patients with chronic activation of the RAAS, including those with heart failure or impaired left ventricular systolic function, diabetes, proteinuria, impaired renal function, recent myocardial infarction, or multiple CV risk factors. Results from ongoing, large-scale, clinical endpoint trials will provide important additional information about the benefits of dual RAAS inhibition in patients at high risk for CV morbidity and mortality. [ABSTRACT FROM AUTHOR]

Published
2007
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21. The prognostic value of big endothelin-1 in more than 2,300 patients with heart failure enrolled in the Valsartan Heart Failure Trial (Val-HeFT)

Author

Masson S, Latini R, Anand IS, Barlera S, Judd D, Salio M, Perticone F, Perini G, Tognoni G, Cohn JN, and Val-HeFT Investigators

Abstract

BACKGROUND: Endothelin is elevated in heart failure and contributes to neurohormonal activation, hemodynamic deterioration, and cardiovascular remodeling. Here, we examined its prognostic value in a large population of patients with chronic heart failure. METHODS AND RESULTS: Big endothelin-1 (Big ET-1) and 4 other neurohormones were measured at study entry in 2359 patients enrolled in the Valsartan Heart Failure Trial (Val-HeFT) and their concentrations related to outcome over a median follow-up of 23 months. Baseline concentration of Big ET-1 (median 0.80 pmol/L) was proportional to severity of disease (New York Heart Association class, left ventricular structure and function). High circulating concentrations of brain natriuretic peptide (BNP), creatinine and bilirubin, advanced New York Heart Association class, elevated body mass index, and the presence of atrial fibrillation were independently associated to higher concentrations of Big ET-1. Big ET-1 (ranking second just behind BNP among neurohormonal factors) was an independent predictor of outcome defined as all-cause mortality (hazard ratio 1.49, 95% CI 1.20-1.84, P = .0003) or the combined endpoint of mortality and morbidity (hazard ratio 1.43, 95% CI 1.20-1.69, P < .0001) and provided incremental prognostic value compared with BNP. CONCLUSIONS: In a large population of patients with symptomatic heart failure, the circulating concentration of Big ET-1, a precursor of the paracrine and bioactive peptide ET-1, was an independent marker of mortality and morbidity. In this setting, BNP remained the strongest neurohormonal prognostic factor. [ABSTRACT FROM AUTHOR]

Published
2006
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27. Changes in brain natriuretic peptide and norepinephrine over time and mortality and morbidity in the Valsartan Heart Failure Trial (Val-HeFT).

Author

Anand IS, Fisher LD, Chiang Y, Latini R, Masson S, Maggioni AP, Glazer RD, Tognoni G, Cohn JN, Valsartan Heart Failure Trial Investigators, Anand, Inder S, Fisher, Lloyd D, Chiang, Yann-Tong, Latini, Roberto, Masson, Serge, Maggioni, Aldo P, Glazer, Robert D, Tognoni, Gianni, Cohn, Jay N, and Val-HeFT Investigators

Published
2003
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32. How safe are calcium antagonists?

Author

Cohn JN, Parmley W, Weart CW, and Weber MA

Abstract

What's behind the current debate over calcium channel blocker safety? Concerns about using short-acting agents to treat hypertension, angina, and myocardial infarction are well-founded. The cancer data? Preliminary, at best. [ABSTRACT FROM AUTHOR]

Published
1996

33. The proper use of calcium channel blockers.

Author

Cohn JN, Parmley W, and Weart CW

Abstract

All of the calcium channel blockers reduce blood pressure, but most of the similarities end there. Experts advise on the appropriate use of this complex -- and much-discussed -- drug class in treating hypertension, angina, arrhythmias, and other conditions. [ABSTRACT FROM AUTHOR]

Published
1996

34. Options in advanced heart failure... last in a three-part series.

Author

Amsterdam EA, Cohn JN, Konstam MA, and Pitt B

Abstract

The further heart failure progresses, the more variables you have to consider. Experts discuss late-stage complications, exacerbations, comorbid conditions, and high-tech interventions. [ABSTRACT FROM AUTHOR]

Published
1995

35. Today's workup for heart failure... part 1.

Author

Amsterdam EA, Cohn JN, Konstam MA, and Pitt B

Abstract

The bad news: Millions of Americans have heart failure, and millions more are developing it. The good news: You can detect heart failure in time to implement treatments of proven value. [ABSTRACT FROM AUTHOR]

Published
1995

37. Preventing congestive heart failure.

Author

Cohn JN

Abstract

The morbidity, mortality and health care costs associated with congestive heart failure make prevention a more attractive public health strategy than treatment. Aggressive management of etiologic factors, including hypertension, coronary artery disease, valvular disease and excessive alcohol intake, can prevent the left ventricular remodeling and dysfunction that lead to heart failure. Early intervention with angiotensin converting enzyme inhibitors in patients with chronic left ventricular dysfunction can prevent, as well as treat, the syndrome. Several intervention strategies in patients with acute myocardial infarction can slow or prevent the left ventricular remodeling process that antedates congestive heart failure. The primary care physician must be alert to the need for aggressive intervention to reduce the burden of heart failure syndrome on the patient and on society. [ABSTRACT FROM AUTHOR]

Published
1998

39. A review of the haemodynamic effects of labetalol in man.

Author

Cohn, JN, Mehta, J, and Francis, GS

Abstract

1 Labetalol at a dose of 800 to 1600 mg daily inhibited isoprenaline- induced tachycardia and phenylephrine-induced elevation in arterial pressure in hypertensive subjects. The beta-adrenoreceptor effect was four times more potent than the alpha-adrenoreceptor effect. 2 Isoprenaline-induced tachycardia was more effectively blocked than isoprenaline-induced inotropism, thereby raising the possibility of a subselective effect on cardiac beta-adrenoceptors. 3 Labetalol reduced blood pressure in hypertensive subjects with no change in cardiac output in the supine or upright position and with marked inhibition of the heart rate and blood pressure response to treadmill exercise. 4 Labetalol administered in single doses to patients with stable, treated congestive heart failure impaired blood pressure support during exercise. 5 The unique adrenoceptor and haemodynamic effects of labetalol make it a potentially attractive drug for management of hypertension and other cardiovascular disorders. [ABSTRACT FROM AUTHOR]

Published
1982
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40. Direct-acting vasodilators.

Author

Cohn JN, McInnes GT, Shepherd AM, Cohn, Jay N, McInnes, Gordon T, and Shepherd, Alexander M

Abstract

KEY POINTS AND PRACTICAL RECOMMENDATIONS: •  Hydralazine and minoxidil act by dilating resistance arterioles, thus reducing peripheral resistance, with no dilating effect on the venous side of the circulation. •  There is a baroreflex-mediated venoconstriction, resulting in an increase in venous return to the heart, along with a direct catecholamine-mediated positive inotropic and chronotropic stimulation of the heart. •  Hydralazine therapy is usually combined with a sympathetic inhibitor to prevent expression of this reflex, as well as with a diuretic agent to prevent sodium retention caused by reduction in renal perfusion pressure. •  Hydralazine is indicated in the long-term therapy of essential hypertension, in the short-term therapy of pregnancy-induced hypertension and eclampsia, and in the therapy of hypertensive crisis. •  Adverse effects include the anticipated tachycardia, fluid retention, and headache, caused by the vasodilation, especially in the early days of therapy, but may frequently be prevented by the concomitant use of a β-blocker. •  As with other drugs that are N-acetylated, there is a low risk of lupus-like syndrome with high doses and long-term use. •  Because of the severity of adverse effects with minoxidil, its usage is limited to persons with severe hypertension unresponsive to other treatments. •  Hirsutism, a common side effect of minoxidil, is particularly bothersome in women and reverses in a few months after discontinuation. •  Sodium nitroprusside is used in the intensive care setting to lower pressure in hypertensive crisis or to treat severe left ventricular failure, particularly valuable when elevated pressure or severe left ventricular failure threatens the patient's survival. •  Although nitrates have not achieved widespread use as antihypertensive agents, they are effective in producing sustained blood pressure (BP) reductions when added to other antihypertensive regimens. [ABSTRACT FROM AUTHOR]

Published
2011
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44. Small and large artery elasticity indices in peripheral arterial occlusive disease (PAOD)

Author

Duprez, DA, De Buyzere, ML, De Bruyne, L, Clement, DL, and Cohn, JN

Abstract

In peripheral arterial occlusive disease (PAOD), arterial compliance of the central arteries has been reported to be reduced. It is, however, not clear whether, in PAOD, decreased arterial compliance is also accompanied by similar changes in the peripheral arteries. Therefore the aim of the study was to determine the large (C1) and small (C2) artery elasticity indices in PAOD and their relations to its well-accepted characteristics (ankle-brachial index, ABI; pulse pressure, PP; absolute claudication distance, ACD). A total of 43 patients with PAOD (mean age 68 ± 9 years; ABI of the limiting leg 0.65 ± 0.14; SBP (systolic blood pressure) 149 ± 20 mmHg, and ACD 488 ± 187 m) were enrolled as well as 16 control subjects of comparable age (69 ± 4 years) and blood pressure (SBP 147 ± 27 mmHg). All subjects underwent non-invasive pulse wave analysis in order to determine arterial compliance of the aorta and major side branches (C1) and of the distal circulation (C2), using a modified Windkessel model. In PAOD, both C1 (1.41 ± 0.56 ml/mmHg) and C2 (0.023 ± 0.012 ml/mmHg) were comparable to values in an age and blood pressure-matched control group (C1, 1.25 ± 0.66 ml/mmHg; C2, 0.027 ± 0.008 ml/mmHg). C1 was significantly correlated with ACD (r= 0.36, p= 0.02), PP (r=-0.33, p< 0.02) and only borderline with ABI (r= 0.28, p= 0.07). C2 was correlated with PP (r=-0.38, p< 0.01), ABI (r= 0.36, p< 0.02) but not with ACD. Large (C1) and small (C2) artery elasticity indices in PAOD were decreased but comparable to values in an elderly group with isolated systolic hypertension. Moreover, C1 and C2 correlated with markers (ABI and PP) of severity of vascular disease.

Published
1995
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