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Coronary Artery Disease: HELP
Articles by Neal B. Patel
Based on 3 articles published since 2010
(Why 3 articles?)
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Between 2010 and 2020, Neil Patel wrote the following 3 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
1 Review Diagnostic and prognostic testing to evaluate coronary artery disease in patients with diabetes mellitus. 2010

Patel, Neal B / Balady, Gary J. ·Section of Cardiology, Department of Medicine, Boston Medical Center, Boston University School of Medicine, 88 East Newton Street, Boston, MA 02118, USA. ·Rev Endocr Metab Disord · Pubmed #20225090.

ABSTRACT: Coronary artery disease (CAD) continues to be the most common cause of morbidity and mortality in patients with diabetes mellitus (DM). In recent years, the strategies for treatment of CAD in DM have undergone much evolution. Currently, all patients with DM, regardless of symptoms or diagnosed CAD, are treated aggressively for CAD risk factor reduction. In this clinical climate, the ability to specifically identify patients with disease that will benefit from more aggressive and invasive therapies remains a challenge. In this article we review the current literature on diagnostic and prognostic utility of conventional non-invasive modalities for assessment of CAD in patients with DM, as well as on novel and emerging methods for CAD risk stratification.

2 Article Newer-Generation Ultrathin Strut Drug-Eluting Stents Versus Older Second-Generation Thicker Strut Drug-Eluting Stents for Coronary Artery Disease. 2018

Bangalore, Sripal / Toklu, Bora / Patel, Neil / Feit, Frederick / Stone, Gregg W. ·New York University School of Medicine (S.B., F.F.). · Mt. Sinai Beth Israel Medical Center, New York, NY (B.T., N.P.). · Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York (B.T.). · New York Presbyterian Hospital, Columbia University Medical Center and the Cardiovascular Research Foundation (G.W.S.). ·Circulation · Pubmed #29945934.

ABSTRACT: BACKGROUND: Contemporary second-generation drug-eluting stents (DES) have superior efficacy and safety in comparison with early-generation stents in patients undergoing percutaneous coronary intervention, in part, related to their thinner struts. Whether newer-generation ultrathin DES further improve clinical outcomes in comparison with older second-generation thicker strut DES is unknown. METHODS: We searched PubMed, Embase, and Cochrane Central Register of Controlled Trials for randomized clinical trials that compared newer-generation ultrathin strut DES (defined as strut thickness <70 µm) versus thicker strut second-generation DES and reported clinical outcomes. The primary outcome was target lesion failure (composite of cardiovascular death, target vessel myocardial infarction or ischemia-driven target lesion revascularization) evaluated at 1-year follow-up. Tests for subgroup effects based on the ultrathin strut DES type and the comparator DES type were performed by using meta-regression analysis. RESULTS: We identified 10 trials that randomly assigned 11 658 patients and evaluated 3 newer-generation ultrathin strut DES: Orsiro stent (60 μm), MiStent (64 μm), and BioMime (65 µm). In comparison with thicker strut second-generation DES, newer-generation ultrathin strut DES were associated with a 16% reduction in target lesion failure (relative risk, 0.84; 95% CI, 0.72-0.99) driven by less myocardial infarction (relative risk, 0.80; 95% CI, 0.65-0.99). Ultrathin strut DES were also associated with qualitatively lower rates of any stent thrombosis (relative risk, 0.72; 95% CI, 0.51-1.01). Tests for subgroup effects based on the ultrathin strut DES type ( P=0.58) and the comparator DES type ( P=0.98) were not significant, suggesting consistent outcomes across the 3 ultrathin strut DES and with the different DES comparators. CONCLUSIONS: In patients undergoing percutaneous coronary intervention, newer-generation ultrathin strut DES further improve 1-year clinical outcomes in comparison with contemporary thicker strut second-generation DES.

3 Article Variability in utilization of drug eluting stents in United States: Insights from nationwide inpatient sample. 2016

Panaich, Sidakpal S / Badheka, Apurva O / Arora, Shilpkumar / Patel, Nileshkumar J / Thakkar, Badal / Patel, Nilay / Singh, Vikas / Chothani, Ankit / Deshmukh, Abhishek / Agnihotri, Kanishk / Jhamnani, Sunny / Lahewala, Sopan / Manvar, Sohilkumar / Panchal, Vinaykumar / Patel, Achint / Patel, Neil / Bhatt, Parth / Savani, Chirag / Patel, Jay / Savani, Ghanshyambhai T / Solanki, Shantanu / Patel, Samir / Kaki, Amir / Mohamad, Tamam / Elder, Mahir / Kondur, Ashok / Cleman, Michael / Forrest, John K / Schreiber, Theodore / Grines, Cindy. ·Detroit Medical Center, Detroit, Michigan. · Department of Cardiology, Yale School of Medicine, New Haven, Connecticut. · Department of Internal Medicine, Mount Sinai St. Luke's Roosevelt Hospital, New York, New York. · Department of Internal Medicine, Staten Island University Hospital, Staten Island, New York. · Department of Internal Medicine, Tulane School of Public Health & Tropical Medicine, New Orleans, Louisiana. · Department of Internal Medicine, Saint Peter's University Hospital, New Brunswick, New Jersey. · Department of Cardiology, University of Miami Miller School of Medicine, Miami, Florida. · Department of Internal Medicine, MedStar Washington Hospital Center, Washington, District of Columbia. · Department of Cardiology, Mayo Clinic, Rochester, Minnesota. · Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. · Department of Internal Medicine, New York Medical College, Valhalla, New York. · Department of Internal Medicine, Prince George's Hospital Center, Cheverly, Maryland. · Department of Internal Medicine, Western Reserve Health System, Youngstown, Ohio. ·Catheter Cardiovasc Interv · Pubmed #26032938.

ABSTRACT: OBJECTIVES: We studied the trends and predictors of drug eluting stent (DES) utilization from 2006 to 2011 to further expound the inter-hospital variability in their utilization. BACKGROUND: We queried the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample (NIS) between 2006 and 2011 using ICD-9-CM procedure code, 36.06 (bare metal stent) or 36.07 (drug eluting stents) for Percutaneous Coronary Intervention (PCI). Annual hospital volume was calculated using unique identification numbers and divided into quartiles for analysis. METHODS AND RESULTS: We built a hierarchical two level model adjusted for multiple confounding factors, with hospital ID incorporated as random effects in the model. About 665,804 procedures (weighted n = 3,277,884) were analyzed. Safety concerns arising in 2006 reduced utilization DES from 90% of all PCIs performed in 2006 to a nadir of 69% in 2008 followed by increase (76% of all stents in 2009) and plateau (75% in 2011). Significant between-hospital variation was noted in DES utilization irrespective of patient or hospital characteristics. Independent patient level predictors of DES were (OR, 95% CI, P-value) age (0.99, 0.98-0.99, <0.001), female(1.12, 1.09-1.15, <0.001), acute myocardial infarction(0.75, 0.71-0.79, <0.001), shock (0.53, 0.49-0.58, <0.001), Charlson Co-morbidity index (0.81,0.77-0.86, <0.001), private insurance/HMO (1.27, 1.20-1.34, <0.001), and elective admission (1.16, 1.05-1.29, <0.001). Highest quartile hospital (1.64, 1.25-2.16, <0.001) volume was associated with higher DES placement. CONCLUSION: There is significant between-hospital variation in DES utilization and a higher annual hospital volume is associated with higher utilization rate of DES. © 2015 Wiley Periodicals, Inc.