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3. Prognostic Value of Coronary Artery Calcium in the PROMISE Study (Prospective Multicenter Imaging Study for Evaluation of Chest Pain)

Author

Budoff, Matthew J, Mayrhofer, Thomas, Ferencik, Maros, Bittner, Daniel, Lee, Kerry L, Lu, Michael T, Coles, Adrian, Jang, James, Krishnam, Mayil, Douglas, Pamela S, and Hoffmann, Udo

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Heart Disease - Coronary Heart Disease, Atherosclerosis, Clinical Trials and Supportive Activities, Cardiovascular, Heart Disease, Clinical Research, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Aged, Angina Pectoris, Angina, Unstable, Comparative Effectiveness Research, Computed Tomography Angiography, Coronary Angiography, Coronary Artery Disease, Diagnosis, Differential, Disease Progression, Dyspnea, Echocardiography, Stress, Electrocardiography, Exercise Test, Female, Hospitalization, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Multidetector Computed Tomography, Myocardial Infarction, North America, Predictive Value of Tests, Prognosis, Proportional Hazards Models, Prospective Studies, Risk Factors, Time Factors, Vascular Calcification, calcium, coronary artery disease, diagnostic tests, routine, prognosis, PROMISE Investigators, diagnostic tests, routine, Cardiorespiratory Medicine and Haematology, Public Health and Health Services, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences, Sports science and exercise
Abstract

BackgroundCoronary artery calcium (CAC) is an established predictor of future major adverse atherosclerotic cardiovascular events in asymptomatic individuals. However, limited data exist as to how CAC compares with functional testing (FT) in estimating prognosis in symptomatic patients.MethodsIn the PROMISE trial (Prospective Multicenter Imaging Study for Evaluation of Chest Pain), patients with stable chest pain (or dyspnea) and intermediate pretest probability for obstructive coronary artery disease were randomized to FT (exercise electrocardiography, nuclear stress, or stress echocardiography) or anatomic testing. We evaluated those who underwent CAC testing as part of the anatomic evaluation (n=4209) and compared that with results of FT (n=4602). We stratified CAC and FT results as normal or mildly, moderately, or severely abnormal (for CAC: 0, 1-99 Agatston score [AS], 100-400 AS, and >400 AS, respectively; for FT: normal, mild=late positive treadmill, moderate=early positive treadmill or single-vessel ischemia, and severe=large ischemic region abnormality). The primary end point was all-cause death, myocardial infarction, or unstable angina hospitalization over a median follow-up of 26.1 months. Cox regression models were used to calculate hazard ratios (HRs) and C statistics to determine predictive and discriminatory values.ResultsOverall, the distribution of normal or mildly, moderately, or severely abnormal test results was significantly different between FT and CAC (FT: normal, n=3588 [78.0%]; mild, n=432 [9.4%]; moderate, n=217 [4.7%]; severe, n=365 [7.9%]; CAC: normal, n=1457 [34.6%]; mild, n=1340 [31.8%]; moderate, n=772 [18.3%]; severe, n=640 [15.2%]; P0), whereas fewer than half of events occurred in patients with mildly, moderately, or severely abnormal FT (n=57 of 132, 43%; P

Published
2017

4. Prognostic Value of Noninvasive Cardiovascular Testing in Patients With Stable Chest Pain

Author

Hoffmann, Udo, Ferencik, Maros, Udelson, James E, Picard, Michael H, Truong, Quynh A, Patel, Manesh R, Huang, Megan, Pencina, Michael, Mark, Daniel B, Heitner, John F, Fordyce, Christopher B, Pellikka, Patricia A, Tardif, Jean-Claude, Budoff, Matthew, Nahhas, George, Chow, Benjamin, Kosinski, Andrzej S, Lee, Kerry L, and Douglas, Pamela S

Subjects
Clinical Trials and Supportive Activities, Clinical Research, Cardiovascular, Atherosclerosis, Biomedical Imaging, Heart Disease - Coronary Heart Disease, Pain Research, Heart Disease, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Aged, Chest Pain, Coronary Angiography, Coronary Artery Disease, Echocardiography, Stress, Exercise Test, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Tomography, X-Ray Computed, coronary artery disease, diagnostic tests, routine, prognosis, PROMISE Investigators, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Public Health and Health Services, Cardiovascular System & Hematology
Abstract

BackgroundOptimal management of patients with stable chest pain relies on the prognostic information provided by noninvasive cardiovascular testing, but there are limited data from randomized trials comparing anatomic with functional testing.MethodsIn the PROMISE trial (Prospective Multicenter Imaging Study for Evaluation of Chest Pain), patients with stable chest pain and intermediate pretest probability for obstructive coronary artery disease (CAD) were randomly assigned to functional testing (exercise electrocardiography, nuclear stress, or stress echocardiography) or coronary computed tomography angiography (CTA). Site-based diagnostic test reports were classified as normal or mildly, moderately, or severely abnormal. The primary end point was death, myocardial infarction, or unstable angina hospitalizations over a median follow-up of 26.1 months.ResultsBoth the prevalence of normal test results and incidence rate of events in these patients were significantly lower among 4500 patients randomly assigned to CTA in comparison with 4602 patients randomly assigned to functional testing (33.4% versus 78.0%, and 0.9% versus 2.1%, respectively; both P10%) who had a normal functional test were reclassified as being mildly abnormal, the discriminatory capacity improved to 0.69 (95% CI, 0.64-0.74).ConclusionsCoronary CTA, by identifying patients at risk because of nonobstructive CAD, provides better prognostic information than functional testing in contemporary patients who have stable chest pain with a low burden of obstructive CAD, myocardial ischemia, and events.Clinical trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT01174550.

Published
2017

5. Changes in Medical Therapy and Lifestyle After Anatomical or Functional Testing for Coronary Artery Disease.

Author

Ladapo, Joseph A, Hoffmann, Udo, Lee, Kerry L, Coles, Adrian, Huang, Megan, Mark, Daniel B, Dolor, Rowena J, Pelberg, Robert A, Budoff, Matthew, Sigurdsson, Gardar, Severance, Harry W, and Douglas, Pamela S

Subjects
Humans, Obesity, Aspirin, Adrenergic beta-Antagonists, Platelet Aggregation Inhibitors, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Angiotensin-Converting Enzyme Inhibitors, Echocardiography, Stress, Exercise Test, Exercise, Follow-Up Studies, Smoking, Patient Compliance, Life Style, Aged, Middle Aged, Female, Male, Overweight, Coronary Artery Disease, Randomized Controlled Trials as Topic, Angiotensin Receptor Antagonists, Computed Tomography Angiography, Diet, Healthy, angina, coronary disease, diagnosis, prevention, Cardiovascular, Prevention, Heart Disease, Heart Disease - Coronary Heart Disease, Clinical Research, Nutrition, Atherosclerosis, Cardiorespiratory Medicine and Haematology
Abstract

BackgroundDiagnostic testing in the care of patients newly presenting with symptoms suggestive of coronary artery disease may influence risk factor management, independent of test type or test results. However, little is known about changes in medications and lifestyle after anatomical or functional testing.Methods and resultsWe examined what factors influenced preventive medical therapy and lifestyle practices at 60 days among 10 003 symptomatic patients (53% women; mean age 61 years) randomly assigned to anatomical testing with coronary computed tomographic angiography or functional testing (NCT01174550). We also assessed the association of preventive changes with major cardiovascular events. There were no differences in medications/lifestyle at baseline. At 60 days, relative to baseline, the computed tomographic angiography strategy was associated with a higher proportion of patients newly initiating aspirin (11.8% versus 7.8%), statins (12.7% versus 6.2%), and β-blockers (8.1% versus 5.3%), compared to functional testing (P

Published
2016

7. Economic Outcomes With Anatomical Versus Functional Diagnostic Testing for Coronary Artery Disease.

Author

Mark, Daniel B, Federspiel, Jerome J, Cowper, Patricia A, Anstrom, Kevin J, Hoffmann, Udo, Patel, Manesh R, Davidson-Ray, Linda, Daniels, Melanie R, Cooper, Lawton S, Knight, J David, Lee, Kerry L, Douglas, Pamela S, and PROMISE Investigators

Subjects
PROMISE Investigators, Humans, Chest Pain, Coronary Angiography, Echocardiography, Stress, Heart Function Tests, Electrocardiography, Exercise Test, Prospective Studies, Aged, Middle Aged, Hospital Costs, Fees, Medical, Female, Male, Coronary Artery Disease, Multidetector Computed Tomography, Atherosclerosis, Heart Disease - Coronary Heart Disease, Clinical Research, Cardiovascular, Burden of Illness, Biomedical Imaging, Heart Disease, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Medical and Health Sciences, General & Internal Medicine
Abstract

BackgroundPROMISE (PROspective Multicenter Imaging Study for Evaluation of Chest Pain) found that initial use of at least 64-slice multidetector computed tomography angiography (CTA) versus functional diagnostic testing strategies did not improve clinical outcomes in stable symptomatic patients with suspected coronary artery disease (CAD) requiring noninvasive testing.ObjectiveTo conduct an economic analysis for PROMISE (a major secondary aim of the study).DesignProspective economic study from the U.S. perspective. Comparisons were made according to the intention-to-treat principle, and CIs were calculated using bootstrap methods. (ClinicalTrials.gov: NCT01174550).Setting190 U.S. centers.Patients9649 U.S. patients enrolled in PROMISE between July 2010 and September 2013. Median follow-up was 25 months.MeasurementsTechnical costs of the initial (outpatient) testing strategy were estimated from Premier Research Database data. Hospital-based costs were estimated using hospital bills and Medicare cost-charge ratios. Physician fees were taken from the Medicare Physician Fee Schedule. Costs were expressed in 2014 U.S. dollars, discounted at 3% annually, and estimated out to 3 years using inverse probability weighting methods.ResultsThe mean initial testing costs were $174 for exercise electrocardiography; $404 for CTA; $501 to $514 for pharmacologic and exercise stress echocardiography, respectively; and $946 to $1132 for exercise and pharmacologic stress nuclear testing, respectively. Mean costs at 90 days were $2494 for the CTA strategy versus $2240 for the functional strategy (mean difference, $254 [95% CI, -$634 to $906]). The difference was associated with more revascularizations and catheterizations (4.25 per 100 patients) with CTA use. After 90 days, the mean cost difference between the groups out to 3 years remained small.LimitationCost weights for test strategies were obtained from sources outside PROMISE.ConclusionComputed tomography angiography and functional diagnostic testing strategies in patients with suspected CAD have similar costs through 3 years of follow-up.Primary funding sourceNational Heart, Lung, and Blood Institute.

Published
2016

8. CABG Improves Outcomes in Patients With Ischemic Cardiomyopathy: 10-Year Follow-Up of the STICH Trial

Author

Howlett, Jonathan G., Stebbins, Amanda, Petrie, Mark C., Jhund, Pardeep S., Castelvecchio, Serenella, Cherniavsky, Alexander, Sueta, Carla A., Roy, Ambuj, Piña, Ileana L., Wurm, Raphael, Drazner, Mark H., Andersson, Bert, Batlle, Carmen, Senni, Michele, Chrzanowski, Lukasz, Merkely, Bela, Carson, Peter, Desvigne-Nickens, Patrice M., Lee, Kerry L., Velazquez, Eric J., and Al-Khalidi, Hussein R.

Published
2019
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9. Differential Impact of Mitral Valve Repair on Outcome of Coronary Artery Bypass Grafting with or without Surgical Ventricular Reconstruction in the Surgical Treatment for Ischemic Heart Failure (STICH) Trial

Author

Tsang, Michael Y.C., She, Lilin, Miller, Fletcher A., Choi, Jin-Oh, Michler, Robert E., Grayburn, Paul A., Bonow, Robert O., Menicanti, Lorenzo, Deja, Marek A., Castelvecchio, Serenella, Rao, Vivek, Smith, Peter K., Kukulski, Tomasz, Sopko, George, Prior, David L., Velazquez, Eric J., Lee, Kerry L., and Oh, Jae K.

Published
2019
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13. Impact of Intubation Time on Survival following Coronary Artery Bypass Grafting: Insights from the Surgical Treatment for Ischemic Heart Failure (STICH) Trial

Author

Bouabdallaoui, Nadia, Stevens, Susanna R., Doenst, Torsten, Wrobel, Krzysztof, Bouchard, Denis, Deja, Marek A., Michler, Robert E., Chua, Yeow Leng, Kalil, Renato A.K., Selzman, Craig H., Daly, Richard C., Sun, Benjamin, Djokovic, Ljubomir T., Sopko, George, Velazquez, Eric J., Rouleau, Jean L., Lee, Kerry L., and Al-Khalidi, Hussein R.

Published
2018
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15. Atrial fibrillation and quality of life after pacemaker implantation for sick sinus syndrome: Data from the Mode Selection Trial (MOST)

Author

Fleischmann, Kirsten E, Orav, E John, Lamas, Gervasio A, Mangione, Carol M, Schron, Eleanor B, Lee, Kerry L, Goldman, Lee, and investigators, for the MOST

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Cardiovascular, Heart Disease, Clinical Trials and Supportive Activities, Aged, Aged, 80 and over, Atrial Fibrillation, Cohort Studies, Cross-Over Studies, Female, Follow-Up Studies, Humans, Male, Middle Aged, Multivariate Analysis, Outcome Assessment, Health Care, Pacemaker, Artificial, Prosthesis Design, Quality of Life, Randomized Controlled Trials as Topic, Sick Sinus Syndrome, MOST investigators, Cardiorespiratory Medicine and Haematology, Public Health and Health Services, Cardiovascular System & Hematology, Cardiovascular medicine and haematology
Abstract

BackgroundIn the Mode Selection Trial (MOST) of 2,010 patients with sinus node dysfunction, dual-chamber-paced patients had less atrial fibrillation (AF) and heart failure and had slightly improved health-related quality of life (QOL) compared with rate modulated right ventricular-paced patients. Our objective was to assess the impact of AF on QOL within MOST.MethodsWe analyzed serial QOL measures (Short Form-36, Specific Activity Scale, time trade-off) in 3 groups: (1) those without AF; (2) those with paroxysmal AF (PAF), but not chronic AF (CAF); and (3) those with CAF. We carried forward the last known QOL before crossover for all subsequent time points in patients randomized to rate modulated right ventricular pacing who crossed over to dual-chamber pacing for severe pacemaker syndrome.ResultsThree hundred seventeen patients (15.8%) had AF in the year after implantation, 206 patients within 3 months (191 PAF, 15 CAF), and another 159 (124 PAF, 35 CAF) between 3 and 12 months. There were no significant differences among groups in individual Short Form-36 subscales or time trade-off scores at 12 months as compared with baseline or 3 months. Cardiovascular health status was better at 12 months as compared with baseline or 3 months in those without AF.ConclusionsAtrial fibrillation after pacemaker implantation in elderly patients with sick sinus syndrome was not a major determinant of QOL. However, there was a trend toward better cardiovascular functional status in patients without AF.

Published
2009

16. Safety of coronary CT angiography and functional testing for stable chest pain in the PROMISE trial: A randomized comparison of test complications, incidental findings, and radiation dose

Author

Lu, Michael T., Douglas, Pamela S., Udelson, James E., Adami, Elizabeth, Ghoshhajra, Brian B., Picard, Michael H., Roberts, Rhonda, Lee, Kerry L., Einstein, Andrew J., Mark, Daniel B., Velazquez, Eric J., Carter, William, Ridner, Michael, Al-Khalidi, Hussein R., and Hoffmann, Udo

Published
2017
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18. Pacemaker implantation and quality of life in the Mode Selection Trial (MOST)

Author

Fleischmann, Kirsten E, Orav, E John, Lamas, Gervasio A, Mangione, Carol M, Schron, Eleanor, Lee, Kerry L, and Goldman, Lee

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Aging, Cardiovascular, Clinical Research, Aged, Cardiac Pacing, Artificial, Equipment Design, Female, Humans, Longitudinal Studies, Male, Pacemaker, Artificial, Quality of Life, Randomized Controlled Trials as Topic, Sick Sinus Syndrome, Treatment Outcome, pacemakers, pacing, sinoatrial node, arrhythmia, Biomedical Engineering, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology
Abstract

BackgroundDual-chamber pacemakers restore AV synchrony compared with ventricular pacemakers, but the effects on health-related quality of life (QOL) are uncertain.ObjectivesThe purpose of this study was to assess the effect of pacemaker implantation, clinical factors, and pacing mode on QOL.MethodsThe Mode Selection Trial (MOST) randomized 2,010 patients with sinus node dysfunction to rate-modulated right ventricular (VVIR) or dual-chamber (DDDR) pacing. A longitudinal analysis of serial QOL measures (Short Form-36 [SF-36], Specific Activity Scale, and time trade-off utility) was performed. In patients who crossed over from VVIR to DDDR because of severe pacemaker syndrome, the last known QOL prior to crossover was carried forward.ResultsPacemaker implantation resulted in substantial improvement in almost all QOL measures. Subjects 75 years or older experienced significantly less improvement in functional status and physical component summary scores than did younger subjects. In longitudinal analyses of the effect of pacing mode on QOL, significant improvement in three SF-36 subscales was observed with DDDR pacing compared with VVIR pacing: role physical [62.8 points (95% confidence interval [CI] 60.2, 65.5) vs 56.4 (95% CI 53.7, 59.1)], role emotional [85.0 (95% CI 82.9, 87.0) vs 81.9 (95% CI 79.9, 84.0)], and vitality [51.8 (95% CI 50.3, 53.3) vs 49.3 (95% CI 47.8, 50.7)], but not in other SF-36 subscales, the Specific Activity Scale, or utilities. The gains in QOL were larger than the declines associated with 1 year of aging but smaller than those associated with heart failure.ConclusionPacemaker implantation improved health-related QOL. The mode selected was associated with much smaller, but significant, improvements in several domains, particularly role physical function.

Published
2006

21. Implication of right ventricular dysfunction on long-term outcome in patients with ischemic cardiomyopathy undergoing coronary artery bypass grafting with or without surgical ventricular reconstruction

Author

Kukulski, Tomasz, She, Lilin, Racine, Normand, Gradinac, Sinisa, Panza, Julio A., Velazquez, Eric J., Chan, Kwan, Petrie, Mark C., Lee, Kerry L., Pellikka, Patricia A., Romanov, Alexander, Biernat, Jolanta, Rouleau, Jean L., Batlle, Carmen, Rogowski, Jan, Ferrazzi, Paolo, Zembala, Marian, and Oh, Jae K.

Published
2015
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23. Implantable Cardioverter-Defibrillators for Primary Prevention of Sudden Cardiac Death in CKD: A Meta-analysis of Patient-Level Data From 3 Randomized Trials

Author

Pun, Patrick H., Al-Khatib, Sana M., Han, Joo Yoon, Edwards, Rex, Bardy, Gust H., Bigger, J. Thomas, Buxton, Alfred E., Moss, Arthur J., Lee, Kerry L., Steinman, Richard, Dorian, Paul, Hallstrom, Al, Cappato, Riccardo, Kadish, Alan H., Kudenchuk, Peter J., Mark, Daniel B., Hess, Paul L., Inoue, Lurdes Y.T., and Sanders, Gillian D.

Published
2014
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25. Sex Difference in Patients With Ischemic Heart Failure Undergoing Surgical Revascularization: Results From the STICH Trial (Surgical Treatment for Ischemic Heart Failure)

Author

Piña, Ileana L., Zheng, Qi, She, Lilin, Szwed, Hanna, Lang, Irene M., Farsky, Pedro S., Castelvecchio, Serenella, Biernat, Jolanta, Paraforos, Alexandros, Kosevic, Dragana, Favaloro, Liliana E., Nicolau, José C., Varadarajan, Padmini, Velazquez, Eric J., Pai, Ramdas G., Cyrille, Nicole, Lee, Kerry L., and Desvigne-Nickens, Patrice

Published
2018
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29. Mechanisms of Functional Mitral Regurgitation in Ischemic Cardiomyopathy Determined by Transesophageal Echocardiography (from the Surgical Treatment for Ischemic Heart Failure Trial)

Author

Golba, Krzysztof, Mokrzycki, Krzysztof, Drozdz, Jaroslaw, Cherniavsky, Alexander, Wrobel, Krzysztof, Roberts, Bradley J., Haddad, Haissam, Maurer, Gerald, Yii, Michael, Asch, Federico M., Handschumacher, Mark D., Holly, Thomas A., Przybylski, Roman, Kron, Irving, Schaff, Hartzell, Aston, Susan, Horton, John, Lee, Kerry L., Velazquez, Eric J., and Grayburn, Paul A.

Published
2013
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32. New York Heart Association class and the survival benefit from primary prevention implantable cardioverter defibrillators: A pooled analysis of 4 randomized controlled trials

Author

Friedman, Daniel J., Al-Khatib, Sana M., Zeitler, Emily P., Han, JooYoon, Bardy, Gust H., Poole, Jeanne E., Bigger, Thomas J., Buxton, Alfred E., Moss, Arthur J., Lee, Kerry L., Steinman, Richard, Dorian, Paul, Cappato, Riccardo, Kadish, Alan H., Kudenchuk, Peter J., Mark, Daniel B., Inoue, Lurdes Y.T., and Sanders, Gillian D.

Published
2017
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33. Sudden Cardiac Death in Patients With Ischemic Heart Failure Undergoing Coronary Artery Bypass Grafting: Results From the STICH Randomized Clinical Trial (Surgical Treatment for Ischemic Heart Failure)

Author

Rao, Meena P., Al-Khatib, Sana M., Pokorney, Sean D., She, Lilin, Romanov, Alexander, Nicolau, Jose C., Lee, Kerry L., Carson, Peter, Selzman, Craig H., Stepinska, Janina, Cleland, John G.F., Tungsubutra, Wiwun, Desvigne-Nickens, Patrice M., Sueta, Carla A., Siepe, Matthias, Lang, Irene, Feldman, Arthur M., Yii, Michael, Rouleau, Jean L., and Velazquez, Eric J.

Published
2017
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34. An age- and sex-specific gene expression score is associated with revascularization and coronary artery disease: Insights from the Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) trial

Author

Voora, Deepak, Coles, Adrian, Lee, Kerry L., Hoffmann, Udo, Wingrove, James A., Rhees, Brian, Huang, Lin, Daniels, Susan E., Monane, Mark, Rosenberg, Steven, Shah, Svati H., Kraus, William E., Ginsburg, Geoffrey S., and Douglas, Pamela S.

Published
2017
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40. Renal function and coronary bypass surgery in patients with ischemic heart failure

Author

Doenst, Torsten, primary, Haddad, Haissam, additional, Stebbins, Amanda, additional, Hill, James A., additional, Velazquez, Eric J., additional, Lee, Kerry L., additional, Rouleau, Jean L., additional, Sopko, George, additional, Farsky, Pedro S., additional, Al-Khalidi, Hussein R., additional, Jeemon, Panniyammakal, additional, Szwed, Hanna, additional, Tan, Ru-San, additional, Bigalli, Daniel R., additional, Kosevic, Dragana, additional, Benke, Kalman, additional, Kalil, Renato A.K., additional, Jasinski, Marek, additional, Smith, Peter K., additional, and Chua, Yeow Leng, additional

Published
2022
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41. Association Between Age and Outcomes of Catheter Ablation Versus Medical Therapy for Atrial Fibrillation: Results from the CABANA Trial

Author

Bahnson, Tristram D., Giczewska, Anna, Mark, Daniel B., Russo, Andrea M., Monahan, Kristi H., Al-Khalidi, Hussein R., Silverstein, Adam P, Poole, Jeanne E., Lee, Kerry L., and Packer, Douglas

Subjects
Stroke, Treatment Outcome, Recurrence, Physiology (medical), Atrial Fibrillation, Catheter Ablation, Humans, Hemorrhage, Cardiology and Cardiovascular Medicine, Anti-Arrhythmia Agents, Article, Aged
Abstract

Background: Observational data suggest that catheter ablation may be safe and effective to treat younger and older patients with atrial fibrillation. No large, randomized trial has examined this issue. This report describes outcomes according to age at entry in the CABANA trial (Catheter Ablation versus Antiarrhythmic Drug Therapy for Atrial Fibrillation). Methods: Patients with atrial fibrillation ≥65 years of age, or Results: Of 2204 patients randomly assigned in CABANA, 766 (34.8%) were P value=0.215). A similar pattern was seen with all-cause mortality: for every 10-year increase in age, the aHR increased an average of 46% (interaction P value=0.111). Atrial fibrillation recurrence rates were lower with ablation than with drug therapy across age subgroups (aHR 0.47, 0.58, and 0.49, respectively). Treatment-related complications were infrequent for both arms ( Conclusions: We found age-based variations in clinical outcomes for catheter ablation compared with drug therapy, with the largest relative and absolute benefits of catheter ablation in younger patients. No prognostic benefits for ablation were seen in the oldest patients. No differences were found by age in treatment-related complications or in the relative effectiveness of catheter ablation in preventing recurrent atrial arrhythmias. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT00911508.

Published
2021

43. Outcomes for patients with anterior myocardial infarction and prior cardiac arrest in the home automated external defibrillator trial (HAT)

Author

Starks, Monique Anderson, primary, Jackson, Larry R., additional, Hellkamp, Anne, additional, Al-Khatib, Sana M., additional, Mark, Daniel B., additional, Thomas, Kevin L., additional, Nichol, Graham, additional, Lee, Kerry L., additional, Davidson-Ray, Linda, additional, Poole, Jeanne, additional, Anderson, Jill, additional, Johnson, George, additional, and Bardy, Gust H., additional

Published
2021
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47. Clinical characteristics and outcomes of patients with and without diabetes in the Surgical Treatment for Ischemic Heart Failure (STICH) trial

Author

MacDonald, Michael R., She, Lilin, Doenst, Torsten, Binkley, Philip F., Rouleau, Jean L., Tan, Ru-San, Lee, Kerry L., Miller, Alan B., Sopko, George, Szalewska, Dominika, Waclawiw, Myron A., Dabrowski, Rafal, Castelvecchio, Serenella, Adlbrecht, Christopher, Michler, Robert E., Oh, Jae K., Velazquez, Eric J., and Petrie, Mark C.

Published
2015
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48. Effects of Xanthine Oxidase Inhibition in Hyperuricemic Heart Failure Patients: The Xanthine Oxidase Inhibition for Hyperuricemic Heart Failure Patients (EXACT-HF) Study

Author

Givertz, Michael M., Anstrom, Kevin J., Redfield, Margaret M., Deswal, Anita, Haddad, Haissam, Butler, Javed, Tang, W.H. Wilson, Dunlap, Mark E., LeWinter, Martin M., Mann, Douglas L., Felker, G. Michael, O’Connor, Christopher M., Goldsmith, Steven R., Ofili, Elizabeth O., Saltzberg, Mitchell T., Margulies, Kenneth B., Cappola, Thomas P., Konstam, Marvin A., Semigran, Marc J., McNulty, Steven E., Lee, Kerry L., Shah, Monica R., and Hernandez, Adrian F.

Published
2015
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49. Outcomes of Anatomical versus Functional Testing for Coronary Artery Disease

Author

Douglas, Pamela S., Hoffmann, Udo, Patel, Manesh R., Mark, Daniel B., Al-Khalidi, Hussein R., Cavanaugh, Brendan, Cole, Jason, Dolor, Rowena J., Fordyce, Christopher B., Huang, Megan, Khan, Muhammad Akram, Kosinski, Andrzej S., Krucoff, Mitchell W., Malhotra, Vinay, Picard, Michael H., Udelson, James E., Velazquez, Eric J., Yow, Eric, Cooper, Lawton S., and Lee, Kerry L.

Published
2015
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50. Impact of surgical ventricular reconstruction on sphericity index in patients with ischaemic cardiomyopathy: follow-up from the STICH trial

Author

Choi, Jin-Oh, Daly, Richard C., Lin, Grace, Lahr, Brian D., Wiste, Heather J., Beaver, Thomas M., Iacovoni, Attilio, Malinowski, Marcin, Friedrich, Ivar, Rouleau, Jean L., Favaloro, Roberto R., Sopko, George, Lang, Irene M., White, Harvey D., Milano, Carmelo A., Jones, Robert H., Lee, Kerry L., Velazquez, Eric J., and Oh, Jae K.

Published
2015
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