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Coronary Artery Disease: HELP
Articles from Boston University
Based on 158 articles published since 2009
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These are the 158 published articles about Coronary Artery Disease that originated from Boston University during 2009-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7
1 Guideline ACR Appropriateness Criteria 2018

Anonymous2701124 / Shah, Amar B / Kirsch, Jacobo / Bolen, Michael A / Batlle, Juan C / Brown, Richard K J / Eberhardt, Robert T / Hurwitz, Lynne M / Inacio, Joao R / Jin, Jill O / Krishnamurthy, Rajesh / Leipsic, Jonathon A / Rajiah, Prabhakar / Singh, Satinder P / White, Richard D / Zimmerman, Stefan L / Abbara, Suhny. ·Westchester Medical Center, Valhalla, New York. Electronic address: ashah27@northwell.edu. · Panel Chair, Cleveland Clinic Florida, Weston, Florida. · Panel Vice-Chair, Cleveland Clinic, Cleveland, Ohio. · Miami Cardiac and Vascular Institute and Baptist Health of South Florida, Miami, Florida. · University of Michigan Health System, Ann Arbor, Michigan. · Boston University School of Medicine, Boston, Massachusetts; American College of Cardiology. · Duke University Medical Center, Durham, North Carolina. · The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada. · Northwestern University Feinberg School of Medicine, Chicago, Illinois; American College of Physicians. · Nationwide Children's Hospital, Columbus, Ohio. · St. Paul's Hospital, Vancouver, British Columbia, Canada. · UT Southwestern Medical Center, Dallas, Texas. · University of Alabama at Birmingham, Birmingham, Alabama. · The Ohio State University Wexner Medical Center, Columbus, Ohio. · Johns Hopkins Medical Institute, Baltimore, Maryland. · Specialty Chair, UT Southwestern Medical Center, Dallas, Texas. ·J Am Coll Radiol · Pubmed #30392597.

ABSTRACT: Chronic chest pain (CCP) of a cardiac etiology is a common clinical problem. The diagnosis and classification of the case of chest pain has rapidly evolved providing the clinician with multiple cardiac imaging strategies. Though scintigraphy and rest echocardiography remain as appropriate imaging tools in the diagnostic evaluation, new technology is available. Current evidence supports the use of alternative imaging tests such as coronary computed tomography angiography (CCTA), cardiac MRI (CMRI), or Rb-82 PET/CT. Since multiple imaging modalities are available to the clinician, the most appropriate noninvasive imaging strategy will be based upon the patient's clinical presentation and clinical status. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

2 Guideline Risk Assessment for Cardiovascular Disease With Nontraditional Risk Factors: US Preventive Services Task Force Recommendation Statement. 2018

Anonymous2681075 / Curry, Susan J / Krist, Alex H / Owens, Douglas K / Barry, Michael J / Caughey, Aaron B / Davidson, Karina W / Doubeni, Chyke A / Epling, John W / Kemper, Alex R / Kubik, Martha / Landefeld, C Seth / Mangione, Carol M / Silverstein, Michael / Simon, Melissa A / Tseng, Chien-Wen / Wong, John B. ·University of Iowa, Iowa City. · Fairfax Family Practice Residency, Fairfax, Virginia. · Virginia Commonwealth University, Richmond. · Veterans Affairs Palo Alto Health Care System, Palo Alto, California. · Stanford University, Stanford, California. · Harvard Medical School, Boston, Massachusetts. · Oregon Health & Science University, Portland. · Columbia University, New York, New York. · University of Pennsylvania, Philadelphia. · Virginia Tech Carilion School of Medicine, Roanoke. · Nationwide Children's Hospital, Columbus, Ohio. · Temple University, Philadelphia, Pennsylvania. · University of Alabama at Birmingham. · University of California, Los Angeles. · Boston University, Boston, Massachusetts. · Northwestern University, Evanston, Illinois. · University of Hawaii, Honolulu. · Pacific Health Research and Education Institute, Honolulu, Hawaii. · Tufts University, Medford, Massachusetts. ·JAMA · Pubmed #29998297.

ABSTRACT: Importance: Cardiovascular disease (CVD) is the most common cause of death among adults in the United States. Treatment to prevent CVD events by modifying risk factors is currently informed by the Framingham Risk Score, the Pooled Cohort Equations, or similar CVD risk assessment models. If current CVD risk assessment models could be improved by adding more risk factors, treatment might be better targeted, thereby maximizing the benefits and minimizing the harms. Objective: To update the 2009 US Preventive Services Task Force (USPSTF) recommendation on using nontraditional risk factors in coronary heart disease risk assessment. Evidence Review: The USPSTF reviewed the evidence on using nontraditional risk factors in CVD risk assessment, focusing on the ankle-brachial index (ABI), high-sensitivity C-reactive protein (hsCRP) level, and coronary artery calcium (CAC) score; the health benefits and harms of CVD risk assessment and treatment guided by nontraditional risk factors combined with the Framingham Risk Score or Pooled Cohort Equations compared with using either risk assessment model alone; and whether adding nontraditional risk factors to existing CVD risk assessment models improves measures of calibration, discrimination, and risk reclassification. Findings: The USPSTF found adequate evidence that adding the ABI, hsCRP level, and CAC score to existing CVD risk assessment models results in small improvements in discrimination and risk reclassification; however, the clinical meaning of these changes is largely unknown. Evidence on adding the ABI, hsCRP level, and CAC score to the Pooled Cohort Equations is limited. The USPSTF found inadequate evidence to assess whether treatment decisions guided by the ABI, hsCRP level, or CAC score, in addition to risk factors in existing CVD risk assessment models, leads to reduced incidence of CVD events or mortality. The USPSTF found adequate evidence to conceptually bound the harms of early detection and interventions as small. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of using the ABI, hsCRP level, or CAC score in risk assessment for CVD in asymptomatic adults to prevent CVD events. Conclusions and Recommendation: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adding the ABI, hsCRP level, or CAC score to traditional risk assessment for CVD in asymptomatic adults to prevent CVD events. (I statement).

3 Editorial Revascularization for Stable Ischemic Heart Disease: The Courage to Use What We Have Learned. 2018

Jacobs, Alice K / Pande, Ashvin N. ·Department of Medicine, Section of Cardiology, Boston University Medical Center, Boston, Massachusetts. Electronic address: alice.jacobs@bmc.org. · Department of Medicine, Section of Cardiology, Boston University Medical Center, Boston, Massachusetts. ·JACC Cardiovasc Interv · Pubmed #29747918.

ABSTRACT: -- No abstract --

4 Editorial Reconsidering the Gatekeeper Paradigm for Percutaneous Coronary Intervention in Stable Coronary Disease Management. 2017

Schulman-Marcus, Joshua / Weintraub, William S / Boden, William E. ·Division of Cardiology, Albany Medical Center, Albany Medical College,Albany, New York. Electronic address: schulmj1@mail.amc.edu. · Division of Cardiology, Christiana Healthcare System,Newark, Delaware. · VA New England Healthcare System, Massachusetts Veterans Epidemiology, Research, and Informatics Center (MAVERIC), Boston University School of Medicine,Boston, Massachusetts. ·Am J Cardiol · Pubmed #28818317.

ABSTRACT: Major randomized clinical trials over the last decade support the role of optimal medical therapy for the initial management approach for patients with stable coronary artery disease (CAD), whereas percutaneous coronary intervention (PCI) ought to be reserved for patients with persistent symptoms despite optimal medical therapy. Likewise, several studies have continued to demonstrate the superiority of coronary artery bypass grafting surgery over PCI in many patients with extensive multivessel CAD, especially those with diabetes. Nevertheless, the decision-making paradigm for patients with stable CAD often continues to propagate the upfront use of "ad hoc PCI" and disadvantages alternative therapeutic approaches. In our editorial, we discuss how multiple systemic and interpersonal factors continue to favor early revascularization with PCI in stable patients. We discuss whether the interventional cardiologist can be an unbiased "gatekeeper" for the use of PCI or whether other physicians should also be involved with the patient in decision-making. Finally, we offer suggestions that can redefine the gatekeeper role to facilitate an evidence-based approach that embraces shared decision-making.

5 Editorial Role of Imaging in the Management of Stable Ischemic Heart Disease: An Evolving Paradigm Shift. 2017

Boden, William E / Meadows, Judith L. ·VA Boston Healthcare System and the Massachusetts Veterans Epidemiology, Research, and Informatics Center, Boston University School of Medicine, Boston, Massachusetts. Electronic address: william.boden@va.gov. · VA Connecticut Health Care System, Yale University School of Medicine, Division of Cardiology, New Haven, Connecticut. ·JACC Cardiovasc Imaging · Pubmed #28279381.

ABSTRACT: -- No abstract --

6 Editorial Incomplete Revascularization in Patients Treated With Percutaneous Coronary Intervention: When Enough Is Enough. 2016

Ayalon, Nir / Jacobs, Alice K. ·Evans Department of Medicine, Section of Cardiology, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts. · Evans Department of Medicine, Section of Cardiology, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts. Electronic address: alice.jacobs@bmc.org. ·JACC Cardiovasc Interv · Pubmed #26847113.

ABSTRACT: -- No abstract --

7 Editorial Epicardial adipose tissue: a benign consequence of obesity? 2015

Ngo, Doan T / Gokce, Noyan. ·From the Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, MA. · From the Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, MA. Noyan.Gokce@bmc.org. ·Circ Cardiovasc Imaging · Pubmed #25752745.

ABSTRACT: -- No abstract --

8 Editorial Compiling the complement of genes implicated in coronary artery disease. 2014

Andersson, Charlotte / Vasan, Ramachandran S. ·From the The Framingham Heart Study, MA (C.A., R.S.V.) · Department of Cardiology, Gentofte Hospital, University of Copenhagen, Denmark (C.A.) · and Sections of Preventive Medicine and Cardiology, Departments of Medicine and Epidemiology, Boston University Schools of Medicine and Public Health, MA (R.S.V.). ·Circ Cardiovasc Genet · Pubmed #25516622.

ABSTRACT: -- No abstract --

9 Editorial Indexes of subclinical atherosclerosis: signposts on the highway to disease. 2014

Seshadri, Sudha. ·Boston University School of Medicine, Boston, Massachusetts. Electronic address: suseshad@bu.edu. ·JACC Cardiovasc Imaging · Pubmed #25459593.

ABSTRACT: -- No abstract --

10 Editorial Declining coronary artery bypass-related mortality: more than meets the eye? 2012

Bansilal, Sameer / Bhatt, Deepak L. ·VA Boston Healthcare System, Brigham and Women's Hospital, Boston, MA 02132, USA. ·Clin Cardiol · Pubmed #22528147.

ABSTRACT: -- No abstract --

11 Review Usefulness of PA32540 in Protecting the Gastric Layer While Providing Secondary Prevention for Coronary Artery Disease. 2017

Kagolanu, Deepthi / Sayedy, Najia / Haseeb, Syed / Shah, Shivani / Lam, Paul / Munnangi, Swapna / Viswanathan, Prakash / Stephenson, Kent. ·Department of Internal Medicine, Nassau University Medical Center, East Meadow, USA. Electronic address: deepthi.lank@gmail.com. · Department of Internal Medicine, Nassau University Medical Center, East Meadow, USA. · Department of Medical Education, American University of Caribbean, Coral Gables, USA. · School of Public Health, Boston University, Boston, USA. · Department of Infectious Diseases, Harlem Hospital Columbia, Harlem, USA. · Department of Gastroenterology, Albany Medical Center, Albany, USA. · Department of Research, Nassau University Medical Center, East Meadow, USA. · Department of Cardiology, Nassau University Medical Center, East Meadow, USA. ·Am J Cardiol · Pubmed #28803655.

ABSTRACT: Aspirin has been the mainstay for secondary prevention of coronary artery disease to decrease early recurrence and severity of recurrent cardiovascular events. However, an increase in gastrointestinal bleeding due to aspirin is preventing many patients from adhering to this daily regimen. PA32540, a combination pill with aspirin and omeprazole, is a newly emerging intervention that has the potential to reinforce patient compliance with the aspirin regimen due to fewer gastrointestinal adverse effects. This systematic review assessed three recent phase 3 clinical trials investigating the safety and efficacy of PA32540. Clinical trials were chosen based on inclusion criteria such as phase 3, randomized, open-label or blinded studies, utilization of enteric-coated aspirin 325 mg dose, and measured GI adverse effects and major adverse cardiac events (MACE) as primary outcomes. Study A, a 6-month phase-3 study by Whellan et al., used two identically designed, randomized, double-blind trials to compare the GI adverse events and MACE after the use of PA32540 to 325mg of enteric coated Aspirin (EC-ASA) in subjects at risk for aspirin-associated gastric ulcers. Results showed fewer upper GI symptoms, decreased size of ulcers, and improved heartburn symptoms in subjects receiving PA32540 compared to EC-ASA. Study B, a 12-month phase-3 study by Hatoum et al., assessed secondary cardiovascular event prevention in a study population that was treated with PA32540 in comparison to a community setting (CS) group that was started on a standard antiplatelet treatment. Results indicated a 28% reduction of CV events in subjects treated with PA32540 compared to the CS group. Study C, a phase-3 open-label study by Goldstein et al., evaluating secondary prevention of cardiovascular/cerebrovascular events with the use of PA32450 for 12 months found that none of the 12-month completers were reported to have new-onset gastric ulcers. In conclusion, PA32540 could be an effective therapy for secondary prevention of coronary artery disease as studies are showing similar efficacy in preventing MACE with reduced GI side effects.

12 Review Choosing a particular oral anticoagulant and dose for stroke prevention in individual patients with non-valvular atrial fibrillation: part 1. 2017

Diener, Hans-Christoph / Aisenberg, James / Ansell, Jack / Atar, Dan / Breithardt, Günter / Eikelboom, John / Ezekowitz, Michael D / Granger, Christopher B / Halperin, Jonathan L / Hohnloser, Stefan H / Hylek, Elaine M / Kirchhof, Paulus / Lane, Deirdre A / Verheugt, Freek W A / Veltkamp, Roland / Lip, Gregory Y H. ·Department of Neurology, University Hospital Essen, Essen, Germany. · Icahn School of Medicine at Mount Sinai, New York, USA. · Hofstra North Shore/LIJ School of Medicine, Hempstead, USA. · Division of Medicine, Oslo University Hospital, Ullevål and University of Oslo, Oslo, Norway. · Division of Rhythmology, Department of Cardiovascular Medicine, Hospital of the University Münster, Münster, Germany. · Population Health Research Institute, McMaster University, Hamilton, ON, Canada. · Cardiovascular Research Foundation, New York, NY, USA. · Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, PA, USA. · Lankenau Medical Center, Wynnewood, PA, USA. · Department of Medicine, Duke University, Durham, NC, USA. · Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, New York, NY, USA. · Division of Clinical Electrophysiology, Department of Cardiology, J. W. Goethe University, Frankfurt, Germany. · Boston Medical Center, Boston University School of Medicine, Boston, MA, USA. · Institute of Cardiovascular Sciences, University of Birmingham, SWBH and UHB NHS Trusts, Birmingham, UK. · Department of Cardiovascular Medicine, Hospital of the University of Münster, Münster, Germany. · University of Birmingham, Institute of Cardiovascular Sciences, City Hospital, Birmingham, UK. · Afdeling Cardiologie, Hartcentrum OLVG, Amsterdam, The Netherlands. · Stroke Medicine, Imperial College London, London, UK. · University of Birmingham, Birmingham, UK. · Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. ·Eur Heart J · Pubmed #26848149.

ABSTRACT: Patients with atrial fibrillation (AF) have a high risk of stroke and mortality, which can be considerably reduced by oral anticoagulants (OAC). Recently, four non-vitamin-K oral anticoagulants (NOACs) were compared with warfarin in large randomized trials for the prevention of stroke and systemic embolism. Today's clinician is faced with the difficult task of selecting a suitable OAC for a patient with a particular clinical profile or a particular pattern of risk factors and concomitant diseases. We reviewed analyses of subgroups of patients from trials of vitamin K antagonists vs. NOACs for stroke prevention in AF with the aim to identify patient groups who might benefit from a particular OAC more than from another. In the first of a two-part review, we discuss the choice of NOAC for stroke prevention in the following subgroups of patients with AF: (i) stable coronary artery disease or peripheral artery disease, including percutaneous coronary intervention with stenting and triple therapy; (ii) cardioversion, ablation and anti-arrhythmic drug therapy; (iii) mechanical valves and rheumatic valve disease, (iv) patients with time in therapeutic range of >70% on warfarin; (v) patients with a single stroke risk factor (CHA2DS2VASc score of 1 in males, 2 in females); and (vi) patients with a single first episode of paroxysmal AF. Although there are no major differences in terms of efficacy and safety between the NOACs for some clinical scenarios, in others we are able to suggest that particular drugs and/or doses be prioritized for anticoagulation.

13 Review Off-pump coronary artery bypass: past, present and future of a controversial technology. 2015

Lazar, Harold L. ·Division of Cardiac Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA. ·Curr Opin Cardiol · Pubmed #26352244.

ABSTRACT: PURPOSE OF REVIEW: This review will examine the current role of off-pump coronary artery bypass (OPCAB) surgery compared with on-pump coronary artery bypass (ONCAB) surgery for the revascularization of ischemic myocardium. RECENT FINDINGS: Recent studies have confirmed earlier findings that OPCAB is associated with less grafts per patient and less complete revascularization, and increased incidence of recurrent angina and need for repeat revascularization procedures, and more frequent rehospitalization for cardiac-related issues. OPCAB does not prevent postoperative renal dysfunction and is associated with worse long-term outcomes. Hospital costs are not reduced and are increased in those OPCAB patients who require intraoperative conversion to ONCAB procedures; however, when multiple arterial grafts are used and a complete revascularization is performed, OPCAB outcomes are equivalent to those of ONCAB procedures. SUMMARY: OPCAB should only be performed by surgeons experienced in this technique in patients in whom a complete revascularization can be achieved; preferably with multiple arterial grafts.

14 Review Late breaking trials of 2014 in coronary artery disease: Commentary covering ACC, EuroPCR, SCAI, TCT, ESC, and AHA. 2015

Tremmel, Jennifer A / Bhatt, Deepak L / Pinto, Duane S / Grines, Cindy L. ·Department of Medicine (Cardiovascular), Stanford University Medical Center, Stanford, California. · Department of Medicine (Cardiovascular), VA Boston Healthcare System, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts. · Department of Medicine (Cardiovascular), Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts. · Department of Medicine (Cardiovascular), Detroit Medical Center Cardiovascular Institute, Detroit, Michigan. ·Catheter Cardiovasc Interv · Pubmed #25854985.

ABSTRACT: With the plethora of clinical trials, it is difficult for busy interventional cardiologists to stay up to date. Therefore, the SCAI Publications Committee concisely summarizes and provides editorial commentary on the most important coronary trials from the large international meetings of 2014. The intent is to allow quick assimilation of trial results into interventional practice.

15 Review Hitting the mark: blood pressure targets and agents in those with prevalent cardiovascular disease and heart failure. 2015

Rifkin, Dena E / Kiernan, Michael / Sarnak, Mark J. ·Division of Nephrology, Veterans' Affairs Healthcare System, San Diego, CA and University of California, San Diego, CA; Division of Cardiology, Tufts Medical Center, Boston, MA; and Division of Nephrology, Tufts Medical Center, Boston, MA. ·Adv Chronic Kidney Dis · Pubmed #25704351.

ABSTRACT: Blood pressure (BP) is one of the key modifiable risk factors for cardiovascular disease (CVD) both in primary and secondary prevention of disease. In this review, we discuss BP treatment in prevalent CVD and heart failure. Evidence for specific agents based on their neurohormonal effects and evidence for target values for systolic or diastolic BP are covered. The potential adverse effects of overtreatment of BP are also discussed. BP targets for those with CVD should generally be less than 140/90 mm Hg but require individualization of therapy for any further reduction based on the clinical setting.

16 Review Cardiac rehabilitation in the elderly. 2014

Menezes, Arthur R / Lavie, Carl J / Forman, Daniel E / Arena, Ross / Milani, Richard V / Franklin, Barry A. ·Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, LA. · Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, LA; Department of Preventive Cardiology, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA. Electronic address: clavie@ochsner.org. · Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA; New England Geriatric Research, Education, and Clinical Center, VA Boston Healthcare System, Boston, MA. · Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL. · Department of Preventive Cardiology and Rehabilitation, William Beaumont Hospital, Royal Oak, MI. ·Prog Cardiovasc Dis · Pubmed #25216614.

ABSTRACT: Coronary heart disease (CHD) is the leading cause of death worldwide. Advanced age is associated with a higher prevalence of CHD as well as increased morbidity and mortality. One key vulnerability relates to the fact that older individuals are generally among the least fit, least active cohort and at increased risk of complications after an acute cardiac event and/or major surgery. There is ample evidence to demonstrate the beneficial effects of exercised-based cardiac rehabilitation (CR) programs on improving functional capacity and other indices of cardiovascular (CV) health. Although the predominant number of studies is in middle-aged patients, there is an escalating amount of new information that establishes the cardioprotective role of CR and, in particular, structured exercise therapy (ET) among the elderly. The present review summarizes the current data available regarding CR and ET and its salutary impact on today's growing population of older adults with CHD.

17 Review Immune regulators of inflammation in obesity-associated type 2 diabetes and coronary artery disease. 2014

Strissel, Katherine J / Denis, Gerald V / Nikolajczyk, Barbara S. ·aDepartment of Medicine bCancer Research Center cDepartment of Microbiology, Boston University School of Medicine, Boston, Massachusetts, USA. ·Curr Opin Endocrinol Diabetes Obes · Pubmed #25106001.

ABSTRACT: PURPOSE OF REVIEW: To summarize current work identifying inflammatory components that underlie associations between obesity-associated type 2 diabetes and coronary artery disease. RECENT FINDINGS: Recent studies implicate immune cells as drivers of pathogenic inflammation in human type 2 diabetes. Inflammatory lymphocytes characterize unhealthy adipose tissue, but regional adipose volume, primarily visceral and pericardial fat, also predict severity and risk for obesity-associated coronary artery disease. Having a greater understanding of shared characteristics between inflammatory cells from different adipose tissue depots and a more accessible tissue, such as blood, will facilitate progress toward clinical translation of our appreciation of obesity as an inflammatory disease. SUMMARY: Obesity predisposes inflammation and metabolic dysfunction through multiple mechanisms, but these mechanisms remain understudied in humans. Studies of obese patients have identified disproportionate impacts of specific T cell subsets in metabolic diseases like type 2 diabetes. On the basis of demonstration that adipose tissue inflammation is depot-specific, analysis of adiposity by waist-to-hip ratio or MRI will increase interpretive value of lymphocyte-focused studies and aid clinicians in determining which obese individuals are at highest risk for coronary artery disease. New tools to combat obesity-associated coronary artery disease and other comorbidities will stem from identification of immune cell-mediated inflammatory networks that are amenable to pharmacological interventions.

18 Review Newer therapeutic strategies to alter high-density lipoprotein level and function. 2014

Bosch, Nicholas / Frishman, William H. ·From the *Department of Internal Medicine, Boston University Medical Center, Boston University, Boston, MA; and †New York Medical College, Westchester Medical Center, Valhalla, NY. ·Cardiol Rev · Pubmed #23707991.

ABSTRACT: Measurements of low levels of high-density lipoprotein (HDL) cholesterol have been identified as a risk factor for premature coronary artery disease, however, to date, current pharmacologic approaches for raising HDL have provided little benefit, if at all, in reducing cardiovascular outcomes. It has been shown that HDL can modify many aspects of plaque pathogenesis. Its most established role is in reverse cholesterol transportation, but HDL can also affect oxidation, inflammation, cellular adhesion, and vasodilatation. Considering these potential benefits of HDL, newer treatments have been developed to modify HDL activity, which include the use of oral cholesteryl ester transfer protein inhibitors, apolipoprotein (apo)A-I infusions, apoA-I mimetics, drugs to increase apoA-I synthesis, and agonists of the liver X receptor. These new therapies are reviewed in this article.

19 Review Should off-pump coronary artery bypass grafting be abandoned? 2013

Lazar, Harold L. ·Department of Cardiothoracic Surgery, Boston Medical Center, 88 E Newton St, B402, Boston, MA 02118, USA. harold.lazar@bmc.org ·Circulation · Pubmed #23877063.

ABSTRACT: -- No abstract --

20 Review How important is glycemic control during coronary artery bypass? 2012

Lazar, Harold L. ·Department of Cardiothoracic Surgery, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA. harold.lazar@bmc.org ·Adv Surg · Pubmed #22873042.

ABSTRACT: In summary, poor perioperative glycemic control in patients undergoing CABG is associated with increased morbidity and mortality. Maintaining serum glucose less than or equal to 180 mg/dL in patients with diabetes during CABG reduces morbidity and mortality, lowers the incidence of wound infections, reduces hospital length of stay, and enhances long-term survival. In nondiabetic patients undergoing CABG surgery, maintaining serum glucose less than 180 mg/dL has also resulted in improved perioperative outcomes. More aggressive glycemic control (80-120 mg/dL) provides no added improvement in CABG patients with less than or equal to 3 days of ICU care in the absence of ventilatory support or multiorgan failure. Although the precise value for achieving glycemic control in the perioperative period is the subject of much debate, the benefits of perioperative glycemic control with continuous insulin infusions in patients undergoing CABG is no longer debatable.

21 Review Cardiac rehabilitation for women across the lifespan. 2012

Daniels, Karla M / Arena, Ross / Lavie, Carl J / Forman, Daniel E. ·New England Geriatric Research, Education, and Clinical Center, VA Boston Healthcare System, MA, USA. ·Am J Med · Pubmed #22748403.

ABSTRACT: Cardiac rehabilitation improves function and compliance and also reduces morbidity and mortality in female and male cardiovascular disease patients but remains significantly underutilized. At every age, and especially in their senior years, female cardiovascular disease patients are under-referred relative to men. Lack of standardized referral processes, misconceptions by physicians and patients, and idiosyncrasies of female pathophysiology contribute to this pattern. Moreover, confounding factors of age, socioeconomic status, and sex-specific roles and responsibilities exacerbate the problem. This review summarizes barriers to cardiac rehabilitation for female cardiac patients, and highlights opportunities for increased participation and benefit.

22 Review The year in review: surgical revascularization of coronary artery disease--2011. 2012

Lazar, Harold L. ·Department of Cardiothoracic Surgery, Boston Medical Center and the Boston University School of Medicine, Boston, MA 02118, USA. harold.lazar@bmc.org ·J Card Surg · Pubmed #22621718.

ABSTRACT: Important studies highlighting the practice of coronary artery bypass surgery for 2011 are reviewed.

23 Review Cardiac rehabilitation 2012: advancing the field through emerging science. 2012

Kwan, Gene / Balady, Gary J. ·Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, USA. ·Circulation · Pubmed #22354982.

ABSTRACT: -- No abstract --

24 Review Long-term risk of clinical events from stenting side branches of coronary bifurcation lesions with drug-eluting and bare-metal stents: an observational meta-analysis. 2011

Zamani, Payman / Kinlay, Scott. ·Cardiovascular Division, Veterans Affairs Boston Healthcare System, West Roxbury, MA, USA. ·Catheter Cardiovasc Interv · Pubmed #20824754.

ABSTRACT: OBJECTIVES: To compare the long-term risks of coronary bifurcation lesions treated with side-branch stenting using drug-eluting versus bare-metal stents. BACKGROUND: Side-branch stenting is an off-label practice, but when needed, the incidence of late adverse events may differ between drug-eluting and bare-metal stents. METHODS: We systematically searched PubMed, and the National Institutes of Health and Cochrane Registries for studies of coronary bifurcation stenting reporting clinical outcomes over at least 5 months. Data were extracted and cross checked independently by two investigators for inclusion in an observational meta-analysis. Clinical outcomes included major adverse clinical events (MACE), death, myocardial infarction, target vessel revascularization (TVR), and definite stent thrombosis. We used random-effects models and meta-regression in 6,825 subjects from 42 studies. RESULTS: Most (79%) of the heterogeneity in MACE between treatment groups was explained by differences in stent type, side-branch stenting, and length of follow-up. Compared with drug-eluting stents without side-branch stenting, drug-eluting stents with side-branch stenting had a 3% higher incidence of myocardial infarction [95% confidence interval (CI) = 0.3%, 5%, P < 0.05], but no significant increase in MACE, death, TVR, or stent thrombosis. Bare-metal stenting without side-branch stenting had 10% (95% CI = 3%, 16%, P < 0.01) higher MACE, and 10% (95% CI = 4%, 17%, P < 0.01) higher TVR, whereas bare-metal side-branch stenting had 31% (95% CI = 23%, 39%, P < 0.001) higher MACE, and 19% (95% CI = 10%, 28%, P < 0.001) higher TVR. CONCLUSIONS: Side-branch stenting has a much smaller impact on long-term MACE with drug-eluting stents compared with bare-metal stents. Although this study does not support routine side-branch stenting, when side-branch stenting is required, drug-eluting stents are associated with less adverse outcomes.

25 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.

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