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OUTpatient intravenous LASix Trial in reducing hospitalization for acute decompensated heart failure (OUTLAST)
Hamo, Carine E; Abdelmoneim, Sahar S; Han, Seol Young; Chandy, Elizabeth; Muntean, Cornelia; Khan, Saadat A; Sunkesula, Prasanthi; Meykler, Marcella; Ramachandran, Vidhya; Rosenberg, Emelie; Klem, Igor; Sacchi, Terrence J; Heitner, John F
BACKGROUND:Hospitalization for acute decompensated heart failure (ADHF) remains a major source of morbidity and mortality. The current study aimed to investigate the feasibility, safety, and efficacy of outpatient furosemide intravenous (IV) infusion following hospitalization for ADHF. METHODS:In a single center, prospective, randomized, double-blind study, 100 patients were randomized to receive standard of care (Group 1), IV placebo infusion (Group 2), or IV furosemide infusion (Group 3) over 3h, biweekly for a one-month period following ADHF hospitalization. Patients in Groups 2/3 also received a comprehensive HF-care protocol including bi-weekly clinic visits for dose-adjusted IV-diuretics, medication adjustment and education. Echocardiography, quality of life and depression questionnaires were performed at baseline and 30-day follow-up. The primary outcome was 30-day re-hospitalization for ADHF. RESULTS:Overall, a total of 94 patients were included in the study (mean age 64 years, 56% males, 69% African American). There were a total of 14 (15%) hospitalizations for ADHF at 30 days, 6 (17.1%) in Group 1, 7 (22.6%) in Group 2, and 1 (3.7%) in Group 3 (overall p = 0.11; p = 0.037 comparing Groups 2 and 3). Patients receiving IV furosemide infusion experienced significantly greater urine output and weight loss compared to those receiving placebo without any significant increase creatinine and no significant between group differences in echocardiography parameters, KCCQ or depression scores. CONCLUSION/CONCLUSIONS:The use of a standardized protocol of outpatient IV furosemide infusion for a one-month period following hospitalization for ADHF was found to be safe and efficacious in reducing 30-day re-hospitalization.
PMID: 34170908
ISSN: 1932-6203
CID: 4925762
The Incidence and Natural Progression of New-Onset Postoperative Atrial Fibrillation
Abdelmoneim, Sahar S; Rosenberg, Emelie; Meykler, Marcella; Patel, Bimal; Reddy, Bharath; Ho, Jean; Klem, Igor; Singh, Jaspal; Worku, Berhane; Tranbaugh, Robert F; Sacchi, Terrence J; Heitner, John F
OBJECTIVES/OBJECTIVE:This study aimed to characterize the natural progression and recurrence of new-onset postoperative atrial fibrillation (POAF) during an intermediate-term follow-up post cardiac surgery by using continuous event monitoring. BACKGROUND:New-onset POAF is a common complication after cardiac surgery and is associated with an increased risk for stroke and all-cause mortality. Long-term data on new POAF recurrence and anticoagulation remain sparse. METHODS:This is a single-center, prospective observational study evaluating 42 patients undergoing cardiac surgery and diagnosed during indexed admission with new-onset, transient, POAF between May 2015 and December 2019. Before discharge, all patients received implantable loop recorders for continuous monitoring. Study outcomes were the presence and timing of atrial fibrillation (AF) recurrence (first, second, and more than 2 AF recurrences), all-cause mortality, and cerebrovascular accidents. A "per-month interval" analysis of proportion of patients with any AF recurrence was assessed and reported per period of follow-up time. Kaplan-Meier analysis was used to calculate the time to first AF recurrence and report the first AF recurrence rates. RESULTS:VASc 3.5 ± 1.5) were evaluated during a mean follow-up of 1.7 ± 1.2 years. AF recurrence after discharge occurred in 30 patients (71%) and of those, 59% had AF episodes equal to or longer than 5 minutes (median AF duration at 1 month was 32 minutes [interquartile range 5.5-106], whereas median AF duration beyond 1 month was 15 minutes [interquartile range 6.3-49]). Twenty-four (80%) of the 30 patients had their first AF recurrence within the first month. During months 1 to 12 follow-up, 76% of patients had any AF recurrences (10% had their first AF recurrence, 43% had their second AF recurrence, and 23% had more than 2 AF recurrences). Beyond 1 year of follow-up, 30% of patients had any AF recurrences (10% had their first AF recurrence, 7% had their second AF recurrence, and 13% had more than 2 AF recurrences). Using Kaplan-Meier analysis, the median time to first AF recurrence was 0.83 months (95% confidence interval: 0.37 to 6) and the detection of first AF recurrence rate at 1, 3, 6, 12, 18, and 24 months was 57.1%, 59.5%, 64.3%, 64.3%, 67.3%, and 73.2%, respectively. During follow-up, there was 1 death ([-] AF recurrence) and 2 cerebrovascular accidents ([+] AF recurrence). CONCLUSIONS:In this study of continuous monitoring with implantable loop recorders, the recurrence of AF in patients who develop transient POAF is common in the first month postoperatively. Of the patients who developed postoperative AF, 76% had any recurrence in months 1 to 12, and 30% had any recurrence beyond 1-year follow-up. Current guidelines recommend anticoagulation for POAF for 30 days. The results of this study warrant further investigation into continued monitoring and longer-term anticoagulation in this population within the context of our findings that AF duration was less than 30 minutes beyond 1 month.
PMID: 33933413
ISSN: 2405-5018
CID: 4865802
Prognostic Value of Feature-Tracking Right Ventricular Longitudinal Strain in Severe Functional Tricuspid Regurgitation: A Multicenter Study
Romano, Simone; Dell'atti, Davide; Judd, Robert M; Kim, Raymond J; Weinsaft, Jonathan W; Kim, Jiwon; Heitner, John F; Hahn, Rebecca T; Farzaneh-Far, Afshin
OBJECTIVES/OBJECTIVE:This study sought to evaluate the prognostic value of cardiac magnetic resonance (CMR) feature-tracking-derived right ventricular (RV) free wall longitudinal strain (RVFWLS) in a large multicenter population of patients with severe functional tricuspid regurgitation. BACKGROUND:Tricuspid regurgitation imposes a volume overload on the RV that can lead to progressive RV dilation and dysfunction. Overt RV dysfunction is associated with poor prognosis and increased operative risk. Abnormalities of myocardial strain may provide the earliest evidence of ventricular dysfunction. CMR feature-tracking techniques now allow assessment of strain from routine cine images, without specialized pulse sequences. Whether abnormalities of RV strain measured using CMR feature tracking have prognostic value in patients with tricuspid regurgitation is unknown. METHODS:Consecutive patients with severe functional tricuspid regurgitation undergoing CMR at 4 U.S. medical centers were included in this study. Feature-tracking RVFWLS was calculated from 4-chamber cine views. The primary endpoint was all-cause death. Cox proportional hazards regression modeling was used to examine the independent association between RVFWLS and death. The incremental prognostic value of RVFWLS was assessed in nested models. RESULTS:Of the 544 patients in this study, 128 died during a median follow-up of 6 years. By Kaplan-Meier analysis, patients with RVFWLS ≥median (-16%) had significantly reduced event-free survival compared with those with RVFWLS <median (log-rank p < 0.001). By Cox multivariable regression modeling, RVFWLS was associated with increased risk-of-death after adjustment for clinical and imaging risk factors, including RV size and ejection fraction (hazard ratio: 1.14 per %; p < 0.001). Addition of RVFWLS in this model resulted in significant improvement in the global chi-square (31 to 78; p < 0.001). CONCLUSIONS:CMR feature-tracking-derived RVFWLS is an independent predictor of mortality in patients with severe functional tricuspid regurgitation, incremental to common clinical and imaging risk factors.
PMID: 33865769
ISSN: 1876-7591
CID: 4846542
Staphylococcus Auricularis Endocarditis: A Rare Cause of Subacute Prosthetic Valve Endocarditis with Severe Aortic Stenosis [Case Report]
Ha, Edward T; Heitner, John F
Prosthetic valve endocarditis (PVE) represents 20% of all cases of endocarditis. Herein, we present a rare cause of PVE by Staphylococcus auricularis (S. auricularis) exhibiting features of subacute endocarditis causing severe aortic stenosis and acute myocardial infarction.
PMCID:7883587
PMID: 33614340
ISSN: 2168-8184
CID: 4794132
Stress CMR in patients with obesity: insights from the Stress CMR Perfusion Imaging in the United States (SPINS) registry
Ge, Yin; Steel, Kevin; Antiochos, Panagiotis; Bingham, Scott; Abdullah, Shuaib; Mikolich, J Ronald; Arai, Andrew E; Bandettini, W Patricia; Shanbhag, Sujata M; Patel, Amit R; Farzaneh-Far, Afshin; Heitner, John F; Shenoy, Chetan; Leung, Steve W; Gonzalez, Jorge A; Shah, Dipan J; Raman, Subha V; Nawaz, Haseeb; Ferrari, Victor A; Schulz-Menger, Jeanette; Stuber, Matthias; Simonetti, Orlando P; Kwong, Raymond Y
AIMS/OBJECTIVE:Non-invasive assessment and risk stratification of coronary artery disease in patients with large body habitus is challenging. We aim to examine whether body mass index (BMI) modifies the prognostic value and diagnostic utility of stress cardiac magnetic resonance imaging (CMR) in a multicentre registry. METHODS AND RESULTS/RESULTS:The SPINS Registry enrolled consecutive intermediate-risk patients who presented with a clinical indication for stress CMR in the USA between 2008 and 2013. Baseline demographic data including BMI, CMR indices, and ratings of study quality were collected. Primary outcome was defined by a composite of cardiovascular death and non-fatal myocardial infarction. Of the 2345 patients with available BMI included in the SPINS cohort, 1177 (50%) met criteria for obesity (BMI ≥ 30) with 531 (23%) at or above Class 2 obesity (BMI ≥ 35). In all BMI categories, >95% of studies were of diagnostic quality for cine, perfusion, and late gadolinium enhancement (LGE) sequences. At a median follow-up of 5.4 years, those without ischaemia and LGE experienced a low annual rate of hard events (<1%), across all BMI strata. In patients with obesity, both ischaemia [hazard ratio (HR): 2.14; 95% confidence interval (CI): 1.30-3.50; P = 0.003] and LGE (HR: 3.09; 95% CI: 1.83-5.22; P < 0.001) maintained strong adjusted association with the primary outcome in a multivariable Cox regression model. Downstream referral rates to coronary angiography, revascularization, and cost of care spent on ischaemia testing did not significantly differ within the BMI categories. CONCLUSION/CONCLUSIONS:In this large multicentre registry, elevated BMI did not negatively impact the diagnostic quality and the effectiveness of risk stratification of patients referred for stress CMR.
PMID: 33166994
ISSN: 2047-2412
CID: 4777942
Progression of Myocardial Fibrosis in Nonischemic DCM and Association with Mortality and Heart Failure Outcomes
Mandawat, Aditya; Chattranukulchai, Pairoj; Mandawat, Anant; Blood, Alexander J; Ambati, Sindhoor; Hayes, Brenda; Rehwald, Wolfgang; Kim, Han W; Heitner, John F; Shah, Dipan J; Klem, Igor
OBJECTIVES/OBJECTIVE:The purpose of this study was to assess whether the presence and extent of fibrosis changes over time in patients with nonischemic, dilated cardiomyopathy (DCM) receiving optimal medical therapy and the implications of any such changes on left ventricular ejection fraction (LVEF) and clinical outcomes. BACKGROUND:Myocardial fibrosis on cardiovascular magnetic resonance (CMR) imaging has emerged as important risk marker in patients with DCM. METHODS:In total, 85 patients (age 56 ± 15 years, 45% women) with DCM underwent serial CMR (median interval 1.5 years) for assessment of LVEF and fibrosis. The primary outcome was all-cause mortality; the secondary outcome was a composite of heart failure hospitalization, aborted sudden cardiac death, left ventricular (LV) assist device implantation, or heart transplant. RESULTS:On CMR-1, fibrosis (median 0.0 [interquartile range: 0% to 2.6%]) of LV mass was noted in 34 (40%) patients. On CMR-2, regression of fibrosis was not seen in any patient. Fibrosis findings were stable in 70 (82%) patients. Fibrosis progression (increase >1.8% of LV mass or new fibrosis) was seen in 15 patients (18%); 46% of these patients had no fibrosis on CMR-1. Although fibrosis progression was on aggregate associated with adverse LV remodeling and decreasing LVEF (40 ± 7% to 34 ± 10%; p < 0.01), in 60% of these cases the change in LVEF was minimal (<5%). Fibrosis progression was associated with increased hazards for all-cause mortality (hazard ratio: 3.4 [95% confidence interval: 1.5 to 7.9]; p < 0.01) and heart failure-related complications (hazard ratio: 3.5 [95% confidence interval: 1.5 to 8.1]; p < 0.01) after adjustment for clinical covariates including LVEF. CONCLUSIONS:Once myocardial replacement fibrosis in DCM is present on CMR, it does not regress in size or resolve over time. Progressive fibrosis is often associated with minimal change in LVEF and identifies a high-risk cohort.
PMID: 33454264
ISSN: 1876-7591
CID: 4777962
The Relationship of LVEF and Myocardial Scar to Long-Term Mortality Risk and Mode of Death in Patients with Non-Ischemic Cardiomyopathy
Klem, Igor; Klein, Michael; Khan, Mohammad; Yang, Eric Y; Nabi, Faisal; Ivanov, Alexander; Bhatti, Lubna; Hayes, Brenda; Graviss, Edward A; Nguyen, Duc T; Judd, Robert M; Kim, Raymond J; Heitner, John F; Shah, Dipan J
Background: Non-ischemic cardiomyopathy (NICM) is a leading cause of reduced left ventricular ejection fraction (LVEF) and is associated with high mortality risk from progressive heart failure and arrhythmias. Myocardial scar on cardiovascular magnetic resonance imaging (CMR) is increasingly recognized as risk marker for adverse outcomes, however LV dysfunction remains the basis for determining a patient's eligibility for primary prophylaxis implantable cardioverter-defibrillator (ICD). We wanted to investigate the relationship of LVEF and scar to long term mortality and mode of death in a large cohort of patients with NICM. Methods: This study is a prospective, longitudinal outcomes registry of 1020 consecutive patients with NICM who underwent clinical CMR for the assessment of LVEF and scar at three centers. Results: During a median follow-up of 5.2 (IQR 3.8, 6.6) years 277 (27%) patients died. On survival analysis LVEF≤35% and scar were strongly associated with all-cause (log-rank test p=0.002 and p<0.001, respectively) and cardiac death (p=0.001 and p<0.001, respectively). While scar was strongly related to sudden cardiac death (SCD) (p=0.001), there was no significant association between LVEF≤35% and SCD-risk (p=0.57). On multivariable analysis including established clinical factors, LVEF and scar are independent risk-markers of all-cause and cardiac death. The addition of LVEF provided incremental prognostic value albeit insignificant discrimination improvement by C-statistic for all-cause and cardiac death, however no incremental prognostic value for SCD. Conversely, scar extent demonstrated significant incremental prognostic value and discrimination improvement for all three endpoints. On net reclassification analysis, the addition of LVEF resulted in no significant improvement for all-cause death 11.0% (95% CI -6.2-25.9%), cardiac death 9.8% (95% CI -5.7-29.3%), and SCD 7.5% (95% CI -41.2-42.9%). Conversely, the addition of scar extent resulted in significant reclassification improvement of 25.5% (95% CI 11.7-41.0%) for all-cause death, 27.0% (95% CI 11.6-45.2%) for cardiac death, and 40.6% (95% CI 10.5-71.8%) for SCD. Conclusions: Myocardial scar and LVEF are both risk markers for all-cause and cardiac death in patients with NICM. However, while myocardial scar has strong and incremental prognostic value for SCD risk stratification, LVEF has no incremental prognostic value over clinical parameters. Scar assessment should be incorporated into patient selection criteria for primary prevention ICD placement.
PMID: 33478245
ISSN: 1524-4539
CID: 4777972
Health-Status Outcomes with Invasive or Conservative Care in Coronary Disease
Spertus, John A; Jones, Philip G; Maron, David J; O'Brien, Sean M; Reynolds, Harmony R; Rosenberg, Yves; Stone, Gregg W; Harrell, Frank E; Boden, William E; Weintraub, William S; Baloch, Khaula; Mavromatis, Kreton; Diaz, Ariel; Gosselin, Gilbert; Newman, Jonathan D; Mavromichalis, Stavroula; Alexander, Karen P; Cohen, David J; Bangalore, Sripal; Hochman, Judith S; Mark, Daniel B; Ricci, Joseph; Tello Montoliu, A; Robero Aniorte, A I; Mulder, Abbey; Laddu, Abhay A; Goyal, Abhinav; Dubey, Abhishek; Goyal, Abhishek; Knighton, Abigail; Oomman, Abraham; Jaskowiak, Adam J; Kolodziej, Adam; Witkowski, Adam; Hameed, Adnan; Anesini, Adriana; Hussain, Afshan; Juceviciene, Agne; Urboniene, Agne; Jakal, Agnes; Szramowska, Agnieszka; Khairuddin, Ahmad; Abdel-Latif, Ahmed; Adel, Ahmed; Aljzeeri, Ahmed; Kamal, Ahmed; Talaat, Ahmed; Mann, Aimee; Contreras, Aira; Kumar, Ajit; Kumar, V K; Furukawa, Akemi; Bagai, Akshay; Smigelskaite, Akvile; Furber, Alain; Rheault, Alain; Loehr, Alaine Melanie; Rosen, Alan; Varga, Albert; Qelaj, Albertina; Barioli, Alberto; Russo, Aldo; Moorman, Alec; Gisbert, Alejandro; Fratczak, Aleksandra; Laucevicius, Aleksandras; Kuleshova, Alena; Sionis, Alessandro; Sirker, Alexander A; Chernyavskiy, Alexander M; Craft, Alexandra; Vazquez, Alexandra; Ciappina Hueb, Alexandre; Colafranseschi, Alexandre S; Schaan de Quadros, Alexandre; Tognon, Alexandre; Alghamdi, Ali; Manica Muller, Alice; Nogueira Rabaça, Aline; Peixoto Deiro, Aline; Hallam, Alison; Stone, Allegra; Schley, Allison; Castro, Almudena; Rabelo Ales, Alvaro; Germann, Amanda; O'Malley, Amanda; Uxa, Amar; Ojajuni, Amarachi; Oliveira, Amarino C Jr; Hull, Amber B; Roy, Ambuj; Zarka, Amer; Janmohamed, Amir; Brown, Ammani; Malinay, Ammy; Martinez Monzonis, Amparo; Richards, Amy J; Iskandrian, Amy; Ollinger, Amy; Djordjevic-Dikic, Ana D; Fernández MartÃnez, Ana; Gomes Almeida, Ana; Batista, Ana Paula; Francisco, Ana Rita; Mladenovic, Ana S; Santana, Ana; Siddiqui, Anam; Kuzmina-Krutetskaya, Anastasia M; Vertes, Andras; Sousa, Andre S; Gabriel, Andre; Schmidt, André; Lundeen, Andrea M; Bartykowszki, Andrea; Lorimer, Andrea; Mortara, Andrea; Pascual, Andrea; Coelho, Andreia; Rocha, Andreia; GarcÃa-Rincón, Andrés; Howarth, Andrew G; Moriarty, Andrew J; Docherty, Andrew; Starovoytov, Andrew; Zurick, Andrew; Åabyk, Andrzej; Swiatkowski, Andrzej; Lam, Andy; Kawakami, Anelise; Hoye, Angela; Kim, Angela; Smit, Angelique; Nobre, Angelo; Shah, Anil V; Ljubez, Anja; Anand, Anjali; Sachdeva, Ankush; Greenberg, Ann; Luyten, Ann; Ostrander, Ann; Di Donato, Anna; Cichocka-Radwan, Anna; Fojt, Anna; Plachcinska, Anna; Proietti, Anna; Teresinska, Anna; Webb, Anne Marie; Cartwright, Anne; Heath, Anne; Mackin, Anne; Amaritakomol, Anong; Chaiyasri, Anong; Chauhan, Anoop; Mathew, Anoop; Gemignani, Anthony; Andres, Anto Luigi; Vega, Antonia; Hansen, Antonietta; Iglesias, Antonino Ginel; Carvalho, Antonio Carlos; Di Chiara, Antonio; Serra Peñaranda, Antonio; Carvalho, Antonio; Colombo, Antonio; Fiarresga, Antonio; Rao, Anupama; Valdespino-Estrada, Aquiles; Boan, Araceli; Ishani, Areef; Diaz, Ariel; Ghosh, Arijit; Prommintikul, Arintaya; Roberts, Arline; Seto, Arnold H; Good, Arnold P; Quyyumi, Arshed; Labovitz, Arthur J; Kerner, Arthur; Campos-Santaolalla, Arturo S; Misra, Arunima; Mukherjee, Ashok; Seth, Ashok; Seedhom, Ashraf; Cheema, Asim N; Ahmed, Asker; Mathur, Atul; Verma, Atul; Leong, Audrey W; Ã…kerblom, Axel; Fuentes, Axelle; Naher, Aynun; Valaiyapathi, Badhma; Kaur, Baljeet; Guruge, Bandula; BrzeziÅ„ska, Barbara; Nardi, Barbara; Czarniak, Bartosz; Singh, Bebek; Igual, Begoña; Merkely, Bela; Alvarez, Belen Cid; Spooner, Benjamin J; Chow, Benjamin J W; Cheong, Benjamin; Shah, Benoy N; de Bruyne, Bernard; Valecka, Bernardas; Jäger, Bernhard; Archer, Beth A; Abramson, Beth; Jorgenson, Beth; Harvey, Bethany; O'Neal, Betsy; Atkinson, Bev; Bozek, Bev; Lang, Bevin; Sasidharan, Bijulal; Yang, Bin; Zhang, Bin; Kurian, Binoy Mannekkattukudy; Goebel, Bjoern; Hu, Bob; Popescu, Bogdan A; Crnokrak, Bogdan; Zhu, Bolin; Kirby, Bonnie J; Zimbelman, Brandi D; Starks, Brandy; Beleslin, Branko D; Hart, Brenda; Shapiro, Brian P; McCandless, Brian; Wisniewski, Brianna; Smith, Brigham R; Mirrer, Brooks; McManus, Bruce; Rutkin, Bruce; Paulino, Bruna Edilena; Ascoli, Bruna Maria; Smith, Bryn; Allen, Byron J; Gibson, C Michael; Bairey Merz, C Noel; Pop, Calin; Hague, Cameron; Thais de Ormundo, Camila; Gopaul, Candace; Edillo, Candice P; Polanczyk, CarÃsi A; Krannila, Carita; Vicente, Carla; Gagné, Carl-Éric; Briguori, Carlo; Peña Gil, Carlos; Alvarez, Carlos; Ohmart, Carly; Beladan, Carmen C; Ginghina, Carmen; Kartje, Carol M; Alsweiler, Caroline; Brown, Caroline; Callison, Caroline; Pinheiro, Caroline; Rodgers, Caroline; Spindler, Caroline; Corbett, Carolyn; Drum, Carrie; Riedberger, Casey; Bone, Catherine; Fleming, Catherine; Gordon, Catherine; Jahrsdorfer, Catherine; Lemay, Catherine; Weick, Catherine; Patten, Cathrine; Goletto, Cecilia; Kepka, Cezary; Suvarna, Chandini; Xu, Chang; Mercure, Chantale; Viljoen, Charle A; Wiyarand, Charlene; Jia-Yin Hou, Charles; Lui, Charles Y; Cannan, Charles; Cornet, Charles; Pirro, Charlotte; Rimsukcharoenchai, Chataroon; Wang, Chen; Tsai, Cheng-Ting; Chien, Chen-Yen; Allardyce, Cheryl A; Hedgepeth, Chester M; Patel, Chetan; Attanasio, Chiara; Yen, Chih-Hsuan; Chow, Chi-Ming; Er, Ching Min; Ong, Ching-Ching; Manjunath, Cholenahally Nanjappa; Beck, Chris; Buller, Chris; Vassaliere, Christel; Hamm, Christian; Caldeira, Christiano; Ballantyne, Christie; Björklund, Christina; Hinton, Christine R; Bergeron, Christine; Masson, Christine; Roraff, Christine; Shelley, Christine; Laure, Christophe; Thuaire, Christophe; Kinsey, Christopher; McFarren, Christopher; Spizzieri, Christopher; Travill, Christopher; Liu, Chun-Chieh; Hung, Chung-Lieh; Li, Chunguang; Yun, Chun-Ho; Xia, Chunli; Heard, Ciarra; Schultz, Cidney; Venn-Edmonds, Clare; Hochberg, Claudia P; Wegmayr, Claudia; Cortés, Claudia; Escobar, Claudia; Freixo, Cláudia; Mesquita, Claudio T; Kadalie, Clemens T; Berry, Colin; Philander, Constance; Thobois, Corine; Costantini, Costantino; Page, Courtney; Atkinson, Craig; Barr, Craig; Paterson, Craig; Bare, Cristina; Baumann, Cynthia; Burman, Cynthia; Espinosa, Dalisa; Collison, Damien; Deleanu, Dan; Elian, Dan; Gao, Dan; Oliver, Dana; Vezina, Daniel P; O'Rourke, Daniel; Komar, Daniele; Schade, Danielle; Francis, Darrel P; Malaev, Dastan; Bull, David A; Winchester, David E; Faxon, David P; Booth, David; Cohen, David; DeMets, David; Foo, David; Schlichting, David; Taggart, David; Waters, David; Wohns, David; Vo, Davis; Teodorczyk, Dawid; Shelstad, Dawn; Turnbull, Dawn; Li, Dayuan; Kereiakes, Dean; O'Neill, Deborah; Yip, Deborah; Johnson, Debra K; Dees, Debra; Bhatt, Deepak L; Gopal, Deepika; Kumar, Deepti; Mattina, Deirdre; Murphy, Deirdre; Small, Delano R; Rose, Delsa K; Jiang, Dengke; Phaneuf, Denis Carl; Braganza, Denise; Fine, Denise; Cyr, Derek; Tobin, Desiree; Cukali, Diana; Parra, Diana; Camara, Diane; Minshall Liu, Diane; Vences, Diego Adrián; Franca de Cunha, Diego; Stournaras, Dimitrios; Patel, Dipti; Li, Dongze; Exley, Donna; Grahl, Dorit; Stanojevic, Dragana; Cacela, Duarte; Conway, Dwayne S G; Bermudez, E Pinar; Punnoose, Eapen; Tay, Edgar L; Karanjah, Edgar; Verna, Edoardo; Hernandez-Rangel, Eduardo; Nicol, Edward D; McFalls, Edward O; Martin, Edward T; Kaczmarska, Edyta; Lubinskaya, Ekaterina I; Demchenko, Elena A; Refoyo Salicio, Elena; Feen, Eli; Durán-Cortés, Elihú; Janzen, Elisabeth M; Hannemann, Elise L; Dongen, Elise van; Piloto, Elissa Restelli; Kaplan, Eliza; Srbinovska Kostovska, Elizabeta; Capasso-Gulve, Elizabeth; Congdon, Elizabeth; Ferguson, Elizabeth; Zbyshevskaya, Elizaveta V; Magedanz, Ellen; Fridell, Ellie; Lader, Ellis W; Kedhi, Elvin; Racca, Emanuela; Tachot, Emilie; DeRosa, Emily; Alonso-Ãlvarez, Encarnación; Nicollet, Eric; Peterson, Eric; Rosas, Erick Alexánderson; Morales, Erick Donato; Orvis, Erin; Moga, Ermina; Montpetit, Estelle; Figueiredo, Estevao; Passamani, Eugene; Nikolsky, Eugenia; Yeoh, Eunice; Kretov, Evgeniy I; Szczerba, Ewa; Wojtala, Ewelina; Ribeiro Silva, Expedito Eustáquio; Ortuño, F Marin; Farias, Fabio R; Fimiani, Fabio; Rolfo, Fabrizio; Yu, Fa-Chang; Hage, Fadi; Matar, Fadi; Haider Jafary, Fahim; Feng, Fang; Liu, Fang; Ranjbaran, Fatima; Rodriguez, Fatima; Pinto, Fausto J; Rashid, Fauzia; Ramani, Federica; Wang, Fei; Igansi, Fernanda; Silva, Filipa; Ottani, Filippo; Haines, Fiona; Al Solaiman, Firas; Egydio, Flávia; Lyra, Flavio; Egger, Florian; Farquharson, Fran; Laube, Frances; Carreras Costa, Francesc; de Micco, Francesca; Bianchini, Francesca; Pezzetta, Francesca; Pietrucci, Francesca; Orso, Francesco; Pisano, Francesco; Burt, Francis; Patuleia Figueiras, Francisca; Fernandez-Aviles, Francisco; Mongeon, Francois Pierre; Van de Werf, Frans; Guenther, Franziska; Witherow, Fraser N; Mohr, Fred; Dall'Orto, Frederico; Otsuka, Fumiyuki; De La Morena, G; Karthikeyan, G; Dekany, Gabor; Kerecsen, Gabor; Galeote, Gabriel; Grossmann, Gabriel; Vorobiof, Gabriel; Sanchez de Souza, Gabriela; Guzman, Gabriela; Zeballos, Gabriela; Gabrielli, Gabriele; Jakl-Kotauschek, Gabriele; Shammas, Gail A; Brandt, Gail; Chen, Gang; Lane, Gary E; Luckasen, Gary J; Sharma, Gautam; Mikolaitiene, Gelmina; Yee, Gennie; Nickenig, Georg; Revtyak, George E; Juang, George J; Fletcher, Gerald; Leonard, Gerald; Devlin, Gerard Patrick; Esposito, Gerard; Ãgoston, Gergely; Lamas, Gervasio; Fontos, Geza; Mikhail, Ghada; Cobb, Gia; Perna, Gian Piero; Leone, Gianpiero; Roditi, Giles; Barone-Rochette, Gilles; Mishra, Girish; Tarantini, Giuseppe; Wong, Glenda; Hamroff, Glenn S; Rayos, Glenn; Cheng, Gong; Barge-Caballero, Gonzalo; Davidović, Goran; Stankovic, Goran; Stevanovic, Gordana; Jingyan Wang, Grace; Young, Grace M; Wayser, Graceanne; Scaro, Graciela; Hillis, Graham S; Wong, Graham; Szulczyk, Grazyna Anna; Simonis, Gregor; Kumkumian, Gregory; Peichel, Gretchen Ann; Gajos, Grzegorz; Steinmaurer, Gudrun; Rucatti, Guilherme G; Portugal, Guilherme; Cantinho Lopes, Guilhermina; Pons Lladó, Guillem; Frostfelt, Gunnar; Wander, Gurpreet S; Gulati, Gurpreet; Pucci, Gustavo; Abd Hadi, Hafidz; Zhang, Haibo; Wang, Haitao; Marciniak, Halina; Chen, Han; Kerr, Hanan; Najm, Hani; Douglas, Hanna; Phillips, Hannah; Dai, Hao; Dong, Haojian; Jamil, Haqeel; Sivadasanpillai, Harikrishnan; Suryapranata, Harry; Reda, Hassan; Pomeroy, Hayley; Barrentine, Heather; Golden, Heather; Hurlburt, Heather; Wilson, Heidi; Tucker, Helen C; Abergel, Helene; Siddaram, Hemalata; Osseni, Hermine; Schuchlenz, Herwig; Zeng, Hesong; Skali, Hicham; Solomon, Hilda; Horton, Hollie; Hetrick, Holly; Little, Holly; Park, Holly; Chi, Hongjie; Mahrous, Hossam; Levite, Howard A; Pejkov, Hristo; Li, Huajun; Bloise-Adames, Hugo; Marques, Hugo; Zhong, Hui; Zhang, Hui-Min; Hashim, Humayrah; Yeh, Hung-I; El Fishawy, Hussien; Webb, Ian; Kullo, Iftikhar; Grazhdankin, Igor O; Hamzeh, Ihab; Hassan, Ikraam; Ueda, Ikuko; Pina, Ileana L; Tamasauskiene, Ilona; Bouwhuis, Ilse; Arif, Imran; Wenzelburger, Ina; Zimbarra Cabrita, Inês; Rodrigues, Ines; Robbins, Inga H; Soveri, Inga; Schnittger, Ingela; Karimullah, Iqbal; Dauber, Ira M; Rehman, Iram; Peovska Mitevska, Irena; Marthe Lang, Irene; Subbotina, Irina; Kalibataite-Rutkauskiene, Irma; Yusnida, Irni; Carvajal, Isabel Estela; Palazzo, Isabella C; Hogan, Isabelle; Roy, Isabelle; Syed, Ishba; Tejani, Ishita; Naryshkin, Ivan A; Jankovic, Ivana; Niedzwiecka, Iwona; Knight, J David; Kusmierek, Jacek; White, Jackie M; Chow, Jackie; Udell, Jacob; Tamis-Holland, Jacqueline E; Fannon, Jacqueline; Quin, Jacquelyn A; Do, Jacquelyn; Heo, Jaekyeong; Maksym, Jakub; Davies, James E; O'Keefe, James H Jr; Jang, James J; Cha, James; Harrison, James; Hirsch, James; Stafford, James; Tatoulis, James; Rankin, Jamie; Henzel, Jan; Orga, Jan; Tancredi, Jana; Oliveira, Janaina; Burton, Jane; Eckstein, Jane; Marucci, Jane; Knight, Janet P; Blount, Janet; Halliday, Janet; Kourzenkova, Janetta; Raj, Janitha; Sinning, Jan-Malte; Pozzibon, Jaqueline; Drozdz, Jaroslaw; Karwowski, Jaroslaw; Glover, Jason D; Kwok, Jason Loh; Call, Jason T; Linefsky, Jason; Gomes, Jassira; Anumpa, Jati; Garcia, Javier J; Courtis, Javier; Meisner, Jay; Jayakumar, K; Scales, Jayne; Denaro, Jean E; Juliard, Jean Michel; Ho, Jean; Stansborough, Jeanette K; Juliard, Jean-Michel; Russo, Jeanne; Schoep, Jeannette J M; Thambyrajah, Jeet; Leimberger, Jeff; Breall, Jeffery A; Kohn, Jeffrey A; Milliken, Jeffrey C; Anderson, Jeffrey; Blume, Jeffrey; Kanters, Jeffrey; Lorin, Jeffrey; Moses, Jeffrey; Stepanovic, Jelena J; Celutkiene, Jelena; Djokic, Jelena; Stojkovic, Jelena; Jose, Jenne M; Manchery, Jenne; Mull, Jennifer A; Czerniak, Jennifer H; Stanford, Jennifer L; Gillis, Jennifer; Horst, Jennifer; Isaacs, Jennifer; Langdon, Jennifer; Thomson, Jennifer; Tomfohr, Jennifer; White, Jennifer; Kuo, Jen-Yuan; Rautureau, Jeremy; Fleg, Jerome; Berg, Jessica; Rodriguez, Jessica; Waldron, Jessica; Patro, Jhina; Li, Jia; Mao, Jiajia; Liu, Jiamin; Wang, Jian'an; Li, Jianhua; Zhang, Jianxin; Qi, Jie; Lyo, Jihyun; Marcus, Jill; Blankenship, Jim; Zhang, Jing; Liu, Jingjing; Fan, Jing-Yao; Li, Jiun-Yi; Pradhan, Jiwan; Chen, Jiyan; Rivera Caravaca, J M; Evans, Jo; Garcia Picart, Joan; Hecht, Joan; Jaroch, Joanna; Zalewska, Joanna; Kelly, Joanne; Taaffe, Joanne; Abbud, João Reynaldo; Vitola, João V; Peñafiel, JoaquÃn V; Benatar, Jocelyne; Bindeman, Jody; Sabik, Joe; Klitch, Joel; Christopher, Johann; Aspberg, Johannes; Friedman, John D; Beltrame, John F; Heitner, John F; Graham, John Joseph; Davies, John R; Doan, John; Kotter, John; Kurian, John; Mukai, John; Pownall, John; Sobolewska, Jolanta; Kobashigawa, Jon; Goldberg, Jonathan L; Bazeley, Jonathan W; Byrne, Jonathan; Himmelfarb, Jonathan; Leipsic, Jonathan; Thorsen, Jonean; Trejo Gutierrez, Jorge F; Escobedo, Jorge; Timmer, Jorik; Ortega-RamÃrez, José A; Marin-Neto, José Antonio; Salas, Jose D; Castillo, Jose Enrique; Saraiva, Jose Francisco; Cuenca-Castillo, José J; Diez, Jose L; Narro Villanueva, José Luis; da Vieira, José Luiz; Flores-Palacios, José M; Gonzalez, Jose Ramon; Seijas Amigo, Jose; Fragata, Jose; Padró, Josep Maria; McGarvey, Josheph F X Jr; Hannan, Joseph; Sacco, Joseph; Sweeny, Joseph; Wiesel, Joseph; Abraham, Josephine D; Loh, Joshua P; Burkhardt, Joy; White, Joyce R; Riestenberg-Smith, Joyce; Sebo, Judit; Meadows, Judith L; Wright, Judith; Foltz, Judy Mae; Hung, Judy; Otis, Judy; Stumpf, Juergen; Tsai, Jui-Peng; Dionne, Julia S; de Aveiro Morata, Julia; Bunke, Julie; Morrow, Julie; Figal, Julio César; Fujita, Jun; Jiang, Jun; Li, Junhua; Yang, Junqing; Euathrongchit, Juntima; Garg, Jyotsna; Manjula Rani, K; Preethi, K; Goetschalckx, Kaatje; Eggers, Kai; Surineni, Kamalakar; Hirase, Kanae; Kapilamoorthy, T R; Calfas, Karen; Gratrix, Karen; Hallett, Karen; Hultberg, Karen; Nugent, Karen; Petrosyan, Karen; Swan, Karen; Kryczka, Karolina; Wojtczak-Soska, Karolina; Wojtera, Karolina; Lenk, Karsten; Ramasamy, Karthik; Åuczak, Katarzyna; Malinowska, Katarzyna; Pointon, Kate; Robb, Kate; Martin, Katherine; Claes, Kathleen; Carruthers, Kathryn; Siegel, Kathy E; Drouin, Katia; Fowler-Lehman, Katie; Rawat, Kavita; Rowe, Kay; Fukuda, Keiichi; Fox, Keith A A; Mahaffey, Ken; Unterbrink, Kendra; Giedd, Kenneth; Van Loo, Kerrie; Lee, Kerry; Bonin, Kerstin; Bainey, Kevin R; Harley, Kevin T; Anstrom, Kevin; Chan, Kevin; Croce, Kevin; Landolfo, Kevin; Marzo, Kevin; Patel, Keyur; Abdul-Nour, Khaled; Alfakih, Khaled; Dajani, Khaled; Ziada, Khaled; Baloch, Khaula; Kushniriuk, Khrystyna; Poh, Kian-Keong; Ireland, Kim F; Holland, Kim; Byrne, Kimberly Ann; Halverson, Kimberly E; Elmore, Kimberly; Miller-Cox, Kimberly; Reddy, Kiran; Quiles, Kirsten J; Abercrombie, Kirsty; Matschke, Klaus; Szymczyk, Konrad; Chan, Koo Hui; Preethi, Kotiboinna; Sokhon, Kozhaya; Meemuk, Krissada; Thygesen, Kristian; Salmi, Kristin M; Newby, Kristin; Wippler, Kristina; Arges, Kristine; Teoh, Kristine; Etherington, Krystal; Åoboz-GrudzieÅ„, Krystyna; Reczuch, Krzysztof W; Bury, Krzysztof; Drzymalski, Krzysztof; KukuÅ‚a, Krzysztof; Sung, Kuo-Tzu; Huber, Kurt; Douangvila, Ladda; Sullenberger, Lance; Trama, Larissa Miranda; Matics, Laszlone; Drew, Laura; Flint, Laura; Keinaite, Laura; Sarti, Laura; Kolakaluri, Laurel; Phillips, Lawrence M; Friedman, Lawrence; Phillips, Lawrence; Velicki, Lazar; Howell, Leah; Maranan, Leandro C; Cox, Leanne; Daba, Ledjalem; Zhang, Lei; Dharmarajan, Lekshmi; Bockeria, Leo; Pizzol Caetano, Leonardo; Bridi, Leonardo; Bershtein, Leonid L; Sokalski, Leszek; Yan, Li Hai; Li, Li; Nijmeijer, Lia; Sousa, Lidia; Xu, Lihong; Zhang, Lihua; Zhang, Lili; Schiavi, Lilia; Barbosa, Lilian Mazza; Khor, Lillian L; Felix-Stern, Lina; Hall, Linda L; Hollenweger, Linda M; Arcand, Linda; Davidson-Ray, Linda; Schwarz, Linda; Sikora, Lindsey N; Chi, Lingping; Patricio, Lino; Zhang, Liping; Chaytor, Lisa; Hatch, Lisa; McCloy, Lisa; Wong, Lisa; Persson, Liselotte; Jiang, Lixin; Low, Liz; Pupic, Ljiljana; Bière, Loïc; Monti, Lorenzo; Christensen, Lori; Pritchard, Lori; Black, Loriane; Desimone, Lori-Ann; Larmand, Lori-Ann; McGregor, Lorraine; Morby, Louise; Thomson, Louise; Harvey, Luc; de Pádua Baptista, Luciana; Garcia, Lucilla; Eliahou, Ludivine; Helmer, Ludmila; Smidt, Luis F; Bernanrdes, Luis; Guzman, Luis; Carvalho, Luiz A; Xiong, Luyang; Teo, Lynette L; Neeson, Lynn M; Winstanley, Lynne; Srichai-Parsia, M Barbara; Quintana Giner, M; Sowjanya Reddy, M; Valdés Chávarri, M; Grazia Rossi, M; Simoons, Maarten; Konigstein, Maayan; Lesiak, Maciej; Olsowka, Maciej; Selas, Mafalda; Corfias, Magalie; Madero Rovalo, Magdalena; Åanocha, Magdalena; Miller, Magdalena; Misztal-Teodorczyk, Magdalena; Rantinella, Magdalena; Abdelhamid, Magdy; Jimenez, Magnolia; Alam, Mahboob; Mylarappa, Mahevamma; El Shahawy, Mahfouz; Mohamed, Mahmoud; Al-Bustami, Mahmud; Joseph, Majo X; Frach, Malgorzata; CeliÅ„ska-Spodar, MaÅ‚gorzta; Helm, Malte; Chacko, Manas; Murphy, Mandy; Vinod, Manitha; Rani, Manjula; Dhawan, Manu; Mombelli, Manuela; Weber, Marcel; Galvani, Marcello; Rodrigues, Marcelo Jamus; Dubin, Marcia F; Werner Bayer, Marcia F; Szkopiak, Marcin; Monsalve, Marco Antonio; Santos, Marco Bizzaro; Magnoni, Marco; Marini, Marco; Sicuro, Marco; Zenati, Marco; Coimbra Resende, Marcos Valério; Roik, Marek; Bentzvi, Margalit; Gilsenan, Margaret; Iraola, Margaret; Quinn, Margot C; Alfonso, Maria A; Pereira Moraes, Maria Antonieta; MartÃnez-RuÃz, MarÃa Dolores; Canales, MarÃa Fernanda; Caetano, Maria Inês; Corral, Maria P; Pérez GarcÃa, Maria; Actis, Maria Victoria; Aguirre, Maria; Andreasson, Maria; Aprile, Maria; Colton, Maria; Martin, Maria Eugenia; Lasala, Maria; Lorenzo, Maria; Posada, Maria; Shier, Maria; Thottam, Maria; Furtado, Mariana V; Okada, Mariana Yumi; Dracoulakis, Marianna D A; De Andrade, Marianne; Rubio, Mariano; Essermark, Marie; Scherrer-Crosbie, Marielle; Petrovic, Marija T; Zdravkovic, Marija; Black, Marilyn; Garcia, Marina; Garcia, Mario J; Szulik, Mariola; Orgera, Marisa; de Belder, Mark A; Harbinson, Mark; Hyun, Mark; Peterson, Mark; Xavier, Mark; Mosley, Marlowe; Capinha, Marta; Marcinkiewicz-Siemion, Marta; Swiderek, Marta; Meyer, Martha; Ceseri, Martina; Tricoli, Martina; Kronenberg, Marvin; Williams, Mary; Champagne, Mary Ann; Rogge, Mary Colleen; Soltau, Mary R; Streif, Mary; Villella, Massimo; Leesar, Massoud; Claudia, Matei; Solecki, Mateusz; Mungo, MatÃas Nicolás; Wall, Matthew Jr; Budoff, Matthew; Jezior, Matthew; Luckie, Matthew; Friedrich, Matthias; Haeffner, Mauren P; Tscharre, Maximilian; Winter, Max-Paul; Almeida, Mayana; Krishnam, Mayil S; Patel, Mayuri; Mishra, Meenakshi; Manocchia, Megan; Kakade, Meghana; Munro, Melanie J; Chaplin, Melissa D; LeFevre, Melissa; Andiapen, Mervyn; Gibson, Michael A; Rubens, Michael B; Turner, Michael C; Shapiro, Michael D; Lee, Michael W; Berlowitz, Michael; Davidson, Michael; Mack, Michael; McDaniel, Michael; Mumma, Michael; Wlodarczyk, Michal; Khouri, Michel G; Slama, Michel S; Rawlins, Michele; Bonner, Michelle M; Seib, Michelle M; Chang, Michelle; Crowder, Michelle; Dixon, Michelle; Mayon, Michelle; McEvoy, Michelle; Yee, Michelle; Fernandes, Miguel M; Nobre Menezes, Miguel; Souto Bayarri, Miguel; Barrero, Miguel; Torosoff, Mikhail T; Dobric, Milan R; Dobric, Milan; Dekleva, Milica Nikola; Gadkari, Milind Avdhoot; Gomez, Millie; Kyaw, Min Tun; Brooks, Miriam; Stevo Martinovic, Miroslav; Lustre, Mitchel B; Vakani, Mohammad Tariq; El-Hajjar, Mohammad; Al-Amoodi, Mohammed; Hussain, Mohammed; Saleem, Mohammed; Blanco-Calvo, Moisés; Jiménez-Santos, Moisés; Bhatia, Mona; Rosca, Monica; Laukyte, Monika; Gracida Blanca, Montserrat; Vila Perales, Montserrat; Al-Mallah, Mouaz H; de Oliveira Filho, Moysés; Ntsekhe, Mpiko; Saric, Muhamed; Chen, Mulei; Brousseau, Myriam; Takiuti, Myrthes Emy; Cemerlic-Adjic, Nada; Asif, Nadia; Gakou, Nadia; Hussain, Nafisa; Katamadze, Nana O; Clapp, Nancy L; Aedy, Nancy; Nataraj, Nandita; Wenger, Nanette K; Uchida, Naomi; Ismail, Nasrul; Oliveira, Natalia S; de Carvalho Maffei, Natalia; Spitzer, Natalie; Putnam, Natasha C; Aslam, Naved; Mowafy, Neamat; Pandit, Neeraj; Parakh, Neeraj; Garcevic, Nevena; Meadows, Ngaire; Tran, Nhi N; Danchin, Nicholas; Lakeman, Nicki; Johnston, Nicola; Shammas, Nicolas W; Saint Vrestil, Nicole; Deming, Nicole; Zhong, Nier; Patel, Niket; Boskovic, Nikola N; Karogiannis, Nikolaos; Werner, Nikos; Johnston, Nina; Zhang, Ning; Zhou, Ning; Hindoyan, Niree; Kumar, Nirmal; Chadha, Nitika; Naik, Nitish; Aripova, Nodira; Mtana, Noloyiso; Eskelson, Nona A; Mokhtar, Noor Syamira; Taksaudom, Noppon; Basri, Nor Asiah; Marchelletta, Nora; Hogg, Norma; Jungla, Nungshi; Ferreira, Nuno; Lubyanaya, Oksana A; Nikolaeva, Olga B; Cañavate, Olga; Sobrino, Olga; Walesiak, Olga; Walter, Olga; ZdoÅ„czyk, Olga; Lim, Olivia J; Anaya, Olivia; Mancilla, Olivia; Dubourg, Olivier; Bello, Olugbenga; Almousalli, Omar; Thompson, Omar; Olurinde, Oni; Harel, Or; Raheem, Osama; Méndiz, Oscar; Prada-Delgado, Óscar; Shapira, Oz; Schulze, P Christian; Panpunuan, Pachara; Maurovich-Horvat, Pal; Garg, Pallav; Moraga, Paloma; Singh, Pam; Julian, Pamela; Ouyang, Pamela; Sigel, Pamela; Woodard, Pamela; Zhou, Panpan; Poggio, Paola Emanuela; Smanio, Paola; Calabro, Paolo; Jeetley, Paramjit; Goube, Pascal; Nguyen, Patricia K; Alarie, Patricia; Arakelian, Patricia; Arsenault, Patricia; Blaise, Patricia; Brito, Patricia; Cowper, Patricia; Endsley, Patricia; Mieses, Patricia; Alexander, Patrick B; Donnelly, Patrick; Wilmot, Patrick; Lebioda, Patrycja; Gordon, Paul C; Mesropian, Paul Der; Galiwango, Paul; Hauptman, Paul; Kennedy, Paul; Beardsley, Paula; GarcÃa-González, Paula; Rezende, Paulo Cury; Caramori, Paulo Ricardo; Kozlov, Pavel S; Canas Silva, Pedro; Melo Barros E Silva, Pedro Gabriel; PÃccaro de Oliveira, Pedro; Carvalho, Pedro; Modas, Pedro; Rio, Pedro; Jain, Peeyush; He, Peiyu; McCullough, Peter A; Stone, Peter H; Pollak, Peter M; Douglass, Peter; Henriksen, Peter; OKane, Peter; Ong, Peter; Jones, Philip; Rogal, Philip; Généreux, Philippe; Menasche, Philippe; Rheault, Philippe; Goold, Phoebe; Gervais, Pierre; Michaud, Pierre; Calvillo, Pilar; Chai, Ping; Jakubowski, Piotr; Pruszczyk, Piotr; Slomka, Piotr; Sritara, Piyamitr; Loh, Poay-Huan; Sonawane, Poonam; Samadi, Pouneh; Parikh, Pragnesh P; Deedwania, Prakash; Patel, Pranav M; Polamuri, Praneeth; Sharma, Pratiksha; Vasquez, Precilia; Kamath, Preeti; Thomas, Prince; Arambam, Priyadarshani; Mehta, Puja K; Grant, Purvez; Naik, Pushpa; Zhong, Qi; Zhao, Qian; Zhou, Qiang; Yuan, Qianqian; Yu, Qin; Li, Qingxian; Xie, Qiulan; Zeng, Qiutang; Vindhya, R J; Gerlach, R James; King, Rachel; VuÄić, Rada; Lyubarova, Radmila; Pracon, Radoslaw; Fisher, Raewyn; Beyar, Rafael; Diaz, Rafael; Selgas, Rafael; Bugiardini, Raffaele; Fanelli, Raffaele; Kavalakkat, Raisa; Rajalekshmi, V S; Barua, Rajat S; Menon, Rajeev; Nair, Rajesh Gopalan; Francis, Rajesh; Narang, Rajiv; Yadav, Rakesh; Huston, Ralph Alan; Ramakrishnan, T; de Silva, Ramesh; Mahmoud, Rami El; Carvalho, Ramiro; de Jesús-Pérez, Ramon; Stevens, Ramona; Leng, Ran; Kachru, Ranjan; Nath, Ranjit Kumar; Sanchez, Raquel; Dwyer, Raven R; Lee, Raven; Wyman, Ray; Wong, Raymond C; Little, Raymond W; Ocaranza Sanchez, Raymundo; Wimmer, Rebecca J; Bariciano, Rebecca; Otis, Rebecca; Herrmann, Rebekah R; Yunis, Reem; Hampson, Reinette; Karam, Renato Abdala; Hessian, Renee C; Kaneshiro, Renee; Ravindran, Reshma; Gamma, Reto Andreas; Bhandari, Reyna; Arsanjani, Reza; Lopes, Ricardo L; Mendes Oliveira, Ricardo; Costa, Ricardo; Bhatt, Richa; Davies, Richard F; Trimlett, Richard H J; Goldweit, Richard; Hermanides, Rik; Nakanishi, Rine; Sidh, Rinu R; Patel, Risha; Coram, Rita; Siddiqui, Rizwan A; Beanlands, Rob S; Hamburger, Robert J; Riezebos, Robert K; Donnino, Robert M; Bojar, Robert; Chilton, Robert; Guyton, Robert; Henderson, Robert; Kornberg, Robert; Leber, Robert; Mao, Robert; Stenberg, Robert; Santos, Roberta P; Favaloro, Roberto René; Amati, Roberto; Lima, Rodolfo G S D; Cerci, Rodrigo J; Tumelero, Rogerio; Tandon, Rohit; Tewari, Roma; Miranda-Peats, Romalisa; Wald, Ron; Mastouri, Ronald A; Morford, Ronald G; Schwartz, Ronald G; Pedalino, Ronald P; Hu, Rongrong; Hansen, Ronnell A; Cohen, Ronny A; Hachamovitch, Rory; Homem, Rosa; Sandonato, Rosa; Laimer, Rosane; Gans, Rosann; Yost, Roxanne; Mathew, Roy; Baleón-Espinosa, Rubén; Ramos, Ruben; Gevorgyan, Rubine; Ferreira, Rui; Jing, Rui; Pérez-Fernández, Ruth; Dwivedi, S K; Ramakrishnan, S; Khan, Saadat; Bokhari, Sabahat; Thomas, Sabu; Lubna, Sadath; Khan, Sajeeda Parveen; Govindan, Sajeev Chakanalil; Girotra, Saket; Kassam, Saleem; Canada, Sallie; Cruz-Flores, Salvador; Mohamed, Samaa; Ly, Samantha; El Kaffas, Sameh; Massalha, Samia; Setty, Sampoornima; Nwosu, Samuel; Seth, Sandeep; Singh, Sandeep; Niehe, Sander R; Rivest, Sandra M; Zier, Sandra S; Ahoud, Sandra; Carr, Sandy; Ganapathi, Sanjay; Shetty, Sanjay; Sharma, Sanjeev; Jimenez, Santa; Satheesh, Santhosh; Garcia, Santiago A; Fernandez, Sara; Karlsson, Sara; Salkind, Sara; Temiyasathit, Sara; Medina Rodriguez, Sarah; Beaudry, Sarah; Hadjih, Sarah; Williams, Sarah; Zahrani, Sarah; Ralhan, Sarju; Hinic, Sasa; Kedev, Sasko; Singh, Satinder; Yasuda, Satoshi; Manjunath, Satvic Cholenahally; Lee, Sau; Kaczkowski, Scott M; Kinlay, Scott; Hayes, Sean W; Sobczak, Sebastian; Asier, Senait; Sayganov, Sergey A; Sokol, Seth I; Pandie, Shaheen; Yahaya, Shaiful Azmi; Mehta, Shamir; Nie, Shao-Ping; Chandra, Sharad; Islam, Sharder; Tai, Sharon; Karwa, Sheetal Rupesh; Ussery, Sheri; Bajaj, Sheromani; Crook, Sherron C; Nishimura, Shigeyuki; Nakano, Shintaro; Heydari, Shirin; Choudhary, Shiv Kumar; Patel, Shivali; Ganesan, Shobana; Pandey, Shruti; Zhang, Shuyang; Hande, Shweta; Gadage, Siddharth; Tan, Sik-Yin V; Zottis Poletti, Silvia; Riera, Silvia; Valbuena, Silvia; Walsh, Simon; Maspoli, Simona; Savaris, Simone; Feng, Si-Ting; Cho, So Yang; Yakubov, Solomon; Zhu, Songlin; Wang, Songtao; Guerrero, Sonia; Gupta, Sonika; Salinger Martinovic, Sonja; Brons, Sonya; Brener, Sorin; Gurunathan, Sothinathan; Saba, Souheil; Nayak, Soundarya; Reddy, Sowjanya; Potluri, Srinivasa; Sudarshan, Sriram; Kuanprasert, Srun; Van Oosterhout, Stacie; Lerakis, Stamatios; Cobos, Stanley E; Bertog, Stefan C; Simović, Stefan M; Weikl, Stefan; Di Marco, Stefano; Provasoli, Stefano; Tirado, Stephanie A; Boer, Stephanie C; Lane, Stephanie M; Ferket, Stephanie; Kelly, Stephanie; Wasmiller, Stephanie; McKellar, Stephen H; Hoole, Stephen P; Fremes, Stephen; Preston, Stephen; Leung, Steve; Fein, Steven A; Lindsay, Steven J; Sedlis, Steven P; Giovannone, Steven; Michael, Steven; Weitz, Steven; van Vugt, Stijn; Banerjee, Subhash; Naik, Sudhir; Hosino, Suellen; Desire, Sukie; Yamwong, Sukit; Thambar, Suku T; Mookherjee, Sulagna; Singh, Suman; Mishra, Sundeep; Verma, Sunil Kumar; Kulthawong, Supap; Khwakhong, Supatchara; Naik, Surendra; Babu, Suresh; Woragidpoonpol, Surin; Narayanappa, Suryaprakash; Derbyshire, Susan; Gent, Susan; Mathus, Susan; Milbrandt, Susan; Moore, Susan; Regan, Susan; Stinson, Susan; Webber, Susan; Silva, Susana; Stevens, Susanna; Gruensfelder, Susanne; Aramcharoen, Suthara; Kolhe, Suvarna; Tavares, Suzana; Arnold, Suzanne; Welsh, Suzanne; Apostolovic, Svetlana; Kunhunny, Swapna; Hung, Ta-Chuan; Zappernick, Taissa; Sharir, Tali; Silva, Talita; Soares, Tamara Colaiácovo; Pillay, Tapan Umesh; Mittal, Tarun K; Trifonova, Tatiana; Duarte, Tauane Bello; Huk, Tauqir; Dutoiu, Téodora; Chua, Terrance; Weyand, Terry; Charles, Thabitha; Kofidis, Theodoros; McCreary, Theresa; Lefevre, Thierry; Arumairajah, Thippeekaa; Tepsuwan, Thitipong; Mulhearn, Thomas J; Meyer, Thomas M; Rocco, Thomas P; Downes, Thomas R; Crain, Thomas; Haldis, Thomas; Mathew, Thomas; Redick, Thomas; Devi, Thounaojam Indira; Nageh, Thuraia; Cauthren, Tia; Silva, Tiago; Little, Tiffany; Andric, Tijana; Harding, Tina; Lau, Titus; Formisano, Tiziana; Moccetti, Tiziano; Ciurus, Tomasz; Mazurek, Tomasz; Tarchalski, Tomasz; Nagai, Toshiyuki; Tran, Tri; Youn, Tricia; Tucker, Trish; Milner, Trudie; Bose, Tuhina; Kotecha, Tushar; Sechtem, Udo; Valeti, Uma S; Cucchini, Umberto; Badami, Umesh; Kaul, Upendra; Bahl, V K; Narain, V S; Casali, Valentina; Godoy, Valeria; Robesyn, Valerie; Priya, Vamshi P; Yadav, Vandana; McKinney, Vera; De Lenges, Veronica; Tinnirello, Veronica; Miro, Vicente; Navarro, Victor; Gumerova, Victoria; Hernandez, Victoria; Seeratan, Vidya; Kumar, Vijay; Kozulin, Vikentiy Y; Bulkley, Viktoria; Veiga, Vilmar Jr; Setang, Vincent; Vineeth, C P; Pubull Nuñez, Virginai; Fernández-Figares, Virginia; Gomes, Vitor; Gabriel, Viviana; Dos Santos, Viviane; Almeida, Viviane; Iliescu, Vlad A; Mudrenovic, Vladan; Dzavik, Vladimir; Giga, Vojislav L; Mogrovejo, Walter Enrique; Chan, Wan Xian; Marfori, Wanda C; Parker, Wanda; Mekara, Warangkana; Nona, Wassim; Old, Wayne; Pennachi, Wayne; Nawarawong, Weerachai; Chen, Wei; Su, Wei; Xing, Weibing; Lan, Wei-Ren; Crawford, Wenda; Stewart, Wendy L; Drewes, Wendy; Lin, Wenhua; Abernethy, William B; Salerno, William D; Fearon, William F; Vergoni, William; Weintraub, William; Sia, Winnie C; Musial, Wlodzimierz J; Flores-RÃos, Xacobe; Garcia-Moll Marimon, Xavier; Su, Xi; Ma, Xiang; Gu, Xiangqiong; Wang, Xiao; Li, Xiaomei; Yao, Xiaowei; Fu, Xin; Su, Xin; Zeng, Xin; Yang, Xinchun; Li, Xiuhong; Fang, Xuehua; Wang, Xutong; Geng, Yaming; Yan, Yan; Pépin-Dubois, Yanek; Wang, Yanfu; Wang, Yang; Tian, Yanmeng; Huang, Yaping; Han, Yechen; Zambrano, Yesenia; Yang, Yi-Hsuan; Sia, Ying Tung; Yang, Yining; Ma, Yitong; Peralta, Yolayfi; Wu, Yongjian; Kunwu, Yu; Zhao, Yu; Peng, Yudong; Lin, Yueh-Hung; Zhao, Yulan; Dong, Yumei; Zhao, Yunhai; Wannasopha, Yutthaphan; Taul, Yvonne; Sahul, Zakir; Kudzoeva, Zalina; Kalarus, Zbigniew; Markovic, Zeljko Z; Huang, Zhen; Ji, Zheng; Liu, Zhenyu; Yue, Zhou; Zhang, Zhulin; Li, Zhuxi; Singh Meharwal, Zile; Bai, Ziliang; Yu, Zixiang; Huda, Zohra; Davidovits, Zoltan
BACKGROUND:In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS:We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS:At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS:In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline. (Funded by the National Heart, Lung, and Blood Institute and others; ISCHEMIA ClinicalTrials.gov number, NCT01471522.).
PMID: 32227753
ISSN: 1533-4406
CID: 5451262
Initial Invasive or Conservative Strategy for Stable Coronary Disease
Maron, David J; Hochman, Judith S; Reynolds, Harmony R; Bangalore, Sripal; O'Brien, Sean M; Boden, William E; Chaitman, Bernard R; Senior, Roxy; López-Sendón, Jose; Alexander, Karen P; Lopes, Renato D; Shaw, Leslee J; Berger, Jeffrey S; Newman, Jonathan D; Sidhu, Mandeep S; Goodman, Shaun G; Ruzyllo, Witold; Gosselin, Gilbert; Maggioni, Aldo P; White, Harvey D; Bhargava, Balram; Min, James K; Mancini, G B John; Berman, Daniel S; Picard, Michael H; Kwong, Raymond Y; Ali, Ziad A; Mark, Daniel B; Spertus, John A; Krishnan, Mangalath N; Elghamaz, Ahmed; Moorthy, Nagaraja; Hueb, Whady A; Demkow, Marcin; Mavromatis, Kreton; Bockeria, Olga; Peteiro, Jesus; Miller, Todd D; Szwed, Hanna; Doerr, Rolf; Keltai, Matyas; Selvanayagam, Joseph B; Steg, P Gabriel; Held, Claes; Kohsaka, Shun; Mavromichalis, Stavroula; Kirby, Ruth; Jeffries, Neal O; Harrell, Frank E; Rockhold, Frank W; Broderick, Samuel; Ferguson, T Bruce; Williams, David O; Harrington, Robert A; Stone, Gregg W; Rosenberg, Yves; Ricci, Joseph; 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Moses, Jeffrey; Stepanovic, Jelena J; Celutkiene, Jelena; Djokic, Jelena; Stojkovic, Jelena; Jose, Jenne M; Manchery, Jenne; Mull, Jennifer A; Czerniak, Jennifer H; Stanford, Jennifer L; Gillis, Jennifer; Horst, Jennifer; Isaacs, Jennifer; Langdon, Jennifer; Thomson, Jennifer; Tomfohr, Jennifer; White, Jennifer; Kuo, Jen-Yuan; Rautureau, Jeremy; Fleg, Jerome; Berg, Jessica; Rodriguez, Jessica; Waldron, Jessica; Patro, Jhina; Li, Jia; Mao, Jiajia; Liu, Jiamin; Wang, Jian'an; Li, Jianhua; Zhang, Jianxin; Qi, Jie; Lyo, Jihyun; Marcus, Jill; Blankenship, Jim; Zhang, Jing; Liu, Jingjing; Fan, Jing-Yao; Li, Jiun-Yi; Pradhan, Jiwan; Chen, Jiyan; Rivera Caravaca, J M; Evans, Jo; Garcia Picart, Joan; Hecht, Joan; Jaroch, Joanna; Zalewska, Joanna; Kelly, Joanne; Taaffe, Joanne; Abbud, João Reynaldo; Vitola, João V; Peñafiel, JoaquÃn V; Benatar, Jocelyne; Bindeman, Jody; Sabik, Joe; Klitch, Joel; Christopher, Johann; Aspberg, Johannes; Friedman, John D; Beltrame, John F; Heitner, John F; Graham, John Joseph; Davies, John R; Doan, John; Kotter, John; Kurian, John; Mukai, John; Pownall, John; Sobolewska, Jolanta; Kobashigawa, Jon; Goldberg, Jonathan L; Bazeley, Jonathan W; Byrne, Jonathan; Himmelfarb, Jonathan; Leipsic, Jonathan; Thorsen, Jonean; Trejo Gutierrez, Jorge F; Escobedo, Jorge; Timmer, Jorik; Ortega-RamÃrez, José A; Marin-Neto, José Antonio; Salas, Jose D; Castillo, Jose Enrique; Saraiva, Jose Francisco; Cuenca-Castillo, José J; Diez, Jose L; Narro Villanueva, José Luis; da Vieira, José Luiz; Flores-Palacios, José M; Gonzalez, Jose Ramon; Seijas Amigo, Jose; Fragata, Jose; Padró, Josep Maria; McGarvey, Josheph F X Jr; Hannan, Joseph; Sacco, Joseph; Sweeny, Joseph; Wiesel, Joseph; Abraham, Josephine D; Loh, Joshua P; Burkhardt, Joy; White, Joyce R; Riestenberg-Smith, Joyce; Sebo, Judit; Meadows, Judith L; Wright, Judith; Foltz, Judy Mae; Hung, Judy; Otis, Judy; Stumpf, Juergen; Tsai, Jui-Peng; Dionne, Julia S; de Aveiro Morata, Julia; Bunke, Julie; Morrow, Julie; Figal, Julio César; Fujita, Jun; Jiang, Jun; Li, Junhua; Yang, Junqing; Euathrongchit, Juntima; Garg, Jyotsna; Manjula Rani, K; Preethi, K; Goetschalckx, Kaatje; Eggers, Kai; Surineni, Kamalakar; Hirase, Kanae; Kapilamoorthy, T R; Calfas, Karen; Gratrix, Karen; Hallett, Karen; Hultberg, Karen; Nugent, Karen; Petrosyan, Karen; Swan, Karen; Kryczka, Karolina; Wojtczak-Soska, Karolina; Wojtera, Karolina; Lenk, Karsten; Ramasamy, Karthik; Åuczak, Katarzyna; Malinowska, Katarzyna; Pointon, Kate; Robb, Kate; Martin, Katherine; Claes, Kathleen; Carruthers, Kathryn; Siegel, Kathy E; Drouin, Katia; Fowler-Lehman, Katie; Rawat, Kavita; Rowe, Kay; Fukuda, Keiichi; Fox, Keith A A; Mahaffey, Ken; Unterbrink, Kendra; Giedd, Kenneth; Van Loo, Kerrie; Lee, Kerry; Bonin, Kerstin; Bainey, Kevin R; Harley, Kevin T; Anstrom, Kevin; Chan, Kevin; Croce, Kevin; Landolfo, Kevin; Marzo, Kevin; Patel, Keyur; Abdul-Nour, Khaled; Alfakih, Khaled; Dajani, Khaled; Ziada, Khaled; Baloch, Khaula; Kushniriuk, Khrystyna; Poh, Kian-Keong; Ireland, Kim F; Holland, Kim; Byrne, Kimberly Ann; Halverson, Kimberly E; Elmore, Kimberly; Miller-Cox, Kimberly; Reddy, Kiran; Quiles, Kirsten J; Abercrombie, Kirsty; Matschke, Klaus; Szymczyk, Konrad; Chan, Koo Hui; Preethi, Kotiboinna; Sokhon, Kozhaya; Meemuk, Krissada; Thygesen, Kristian; Salmi, Kristin M; Newby, Kristin; Wippler, Kristina; Arges, Kristine; Teoh, Kristine; Etherington, Krystal; Åoboz-GrudzieÅ„, Krystyna; Reczuch, Krzysztof W; Bury, Krzysztof; Drzymalski, Krzysztof; KukuÅ‚a, Krzysztof; Sung, Kuo-Tzu; Huber, Kurt; Douangvila, Ladda; Sullenberger, Lance; Trama, Larissa Miranda; Matics, Laszlone; Drew, Laura; Flint, Laura; Keinaite, Laura; Sarti, Laura; Kolakaluri, Laurel; Phillips, Lawrence M; Friedman, Lawrence; Phillips, Lawrence; Velicki, Lazar; Howell, Leah; Maranan, Leandro C; Cox, Leanne; Daba, Ledjalem; Zhang, Lei; Dharmarajan, Lekshmi; Bockeria, Leo; Pizzol Caetano, Leonardo; Bridi, Leonardo; Bershtein, Leonid L; Sokalski, Leszek; Yan, Li Hai; Li, Li; Nijmeijer, Lia; Sousa, Lidia; Xu, Lihong; Zhang, Lihua; Zhang, Lili; Schiavi, Lilia; Barbosa, Lilian Mazza; Khor, Lillian L; Felix-Stern, Lina; Hall, Linda L; Hollenweger, Linda M; Arcand, Linda; Davidson-Ray, Linda; Schwarz, Linda; Sikora, Lindsey N; Chi, Lingping; Patricio, Lino; Zhang, Liping; Chaytor, Lisa; Hatch, Lisa; McCloy, Lisa; Wong, Lisa; Persson, Liselotte; Jiang, Lixin; Low, Liz; Pupic, Ljiljana; Bière, Loïc; Monti, Lorenzo; Christensen, Lori; Pritchard, Lori; Black, Loriane; Desimone, Lori-Ann; Larmand, Lori-Ann; McGregor, Lorraine; Morby, Louise; Thomson, Louise; Harvey, Luc; de Pádua Baptista, Luciana; Garcia, Lucilla; Eliahou, Ludivine; Helmer, Ludmila; Smidt, Luis F; Bernanrdes, Luis; Guzman, Luis; Carvalho, Luiz A; Xiong, Luyang; Teo, Lynette L; Neeson, Lynn M; Winstanley, Lynne; Srichai-Parsia, M Barbara; Quintana Giner, M; Sowjanya Reddy, M; Valdés Chávarri, M; Grazia Rossi, M; Simoons, Maarten; Konigstein, Maayan; Lesiak, Maciej; Olsowka, Maciej; Selas, Mafalda; Corfias, Magalie; Madero Rovalo, Magdalena; Åanocha, Magdalena; Miller, Magdalena; Misztal-Teodorczyk, Magdalena; Rantinella, Magdalena; Abdelhamid, Magdy; Jimenez, Magnolia; Alam, Mahboob; Mylarappa, Mahevamma; El Shahawy, Mahfouz; Mohamed, Mahmoud; Al-Bustami, Mahmud; Joseph, Majo X; Frach, Malgorzata; CeliÅ„ska-Spodar, MaÅ‚gorzta; Helm, Malte; Chacko, Manas; Murphy, Mandy; Vinod, Manitha; Rani, Manjula; Dhawan, Manu; Mombelli, Manuela; Weber, Marcel; Galvani, Marcello; Rodrigues, Marcelo Jamus; Dubin, Marcia F; Werner Bayer, Marcia F; Szkopiak, Marcin; Monsalve, Marco Antonio; Santos, Marco Bizzaro; Magnoni, Marco; Marini, Marco; Sicuro, Marco; Zenati, Marco; Coimbra Resende, Marcos Valério; Roik, Marek; Bentzvi, Margalit; Gilsenan, Margaret; Iraola, Margaret; Quinn, Margot C; Alfonso, Maria A; Pereira Moraes, Maria Antonieta; MartÃnez-RuÃz, MarÃa Dolores; Canales, MarÃa Fernanda; Caetano, Maria Inês; Corral, Maria P; Pérez GarcÃa, Maria; Actis, Maria Victoria; Aguirre, Maria; Andreasson, Maria; Aprile, Maria; Colton, Maria; Martin, Maria Eugenia; Lasala, Maria; Lorenzo, Maria; Posada, Maria; Shier, Maria; Thottam, Maria; Furtado, Mariana V; Okada, Mariana Yumi; Dracoulakis, Marianna D A; De Andrade, Marianne; Rubio, Mariano; Essermark, Marie; Scherrer-Crosbie, Marielle; Petrovic, Marija T; Zdravkovic, Marija; Black, Marilyn; Garcia, Marina; Garcia, Mario J; Szulik, Mariola; Orgera, Marisa; de Belder, Mark A; Harbinson, Mark; Hyun, Mark; Peterson, Mark; Xavier, Mark; Mosley, Marlowe; Capinha, Marta; Marcinkiewicz-Siemion, Marta; Swiderek, Marta; Meyer, Martha; Ceseri, Martina; Tricoli, Martina; Kronenberg, Marvin; Williams, Mary; Champagne, Mary Ann; Rogge, Mary Colleen; Soltau, Mary R; Streif, Mary; Villella, Massimo; Leesar, Massoud; Claudia, Matei; Solecki, Mateusz; Mungo, MatÃas Nicolás; Wall, Matthew Jr; Budoff, Matthew; Jezior, Matthew; Luckie, Matthew; Friedrich, Matthias; Haeffner, Mauren P; Tscharre, Maximilian; Winter, Max-Paul; Almeida, Mayana; Krishnam, Mayil S; Patel, Mayuri; Mishra, Meenakshi; Manocchia, Megan; Kakade, Meghana; Munro, Melanie J; Chaplin, Melissa D; LeFevre, Melissa; Andiapen, Mervyn; Gibson, Michael A; Rubens, Michael B; Turner, Michael C; Shapiro, Michael D; Lee, Michael W; Berlowitz, Michael; Davidson, Michael; Mack, Michael; McDaniel, Michael; Mumma, Michael; Wlodarczyk, Michal; Khouri, Michel G; Slama, Michel S; Rawlins, Michele; Bonner, Michelle M; Seib, Michelle M; Chang, Michelle; Crowder, Michelle; Dixon, Michelle; Mayon, Michelle; McEvoy, Michelle; Yee, Michelle; Fernandes, Miguel M; Nobre Menezes, Miguel; Souto Bayarri, Miguel; Barrero, Miguel; Torosoff, Mikhail T; Dobric, Milan R; Dobric, Milan; Dekleva, Milica Nikola; Gadkari, Milind Avdhoot; Gomez, Millie; Kyaw, Min Tun; Brooks, Miriam; Stevo Martinovic, Miroslav; Lustre, Mitchel B; Vakani, Mohammad Tariq; El-Hajjar, Mohammad; Al-Amoodi, Mohammed; Hussain, Mohammed; Saleem, Mohammed; Blanco-Calvo, Moisés; Jiménez-Santos, Moisés; Bhatia, Mona; Rosca, Monica; Laukyte, Monika; Gracida Blanca, Montserrat; Vila Perales, Montserrat; Al-Mallah, Mouaz H; de Oliveira Filho, Moysés; Ntsekhe, Mpiko; Saric, Muhamed; Chen, Mulei; Brousseau, Myriam; Takiuti, Myrthes Emy; Cemerlic-Adjic, Nada; Asif, Nadia; Gakou, Nadia; Hussain, Nafisa; Katamadze, Nana O; Clapp, Nancy L; Aedy, Nancy; Nataraj, Nandita; Wenger, Nanette K; Uchida, Naomi; Ismail, Nasrul; Oliveira, Natalia S; de Carvalho Maffei, Natalia; Spitzer, Natalie; Putnam, Natasha C; Aslam, Naved; Mowafy, Neamat; Pandit, Neeraj; Parakh, Neeraj; Garcevic, Nevena; Meadows, Ngaire; Tran, Nhi N; Danchin, Nicholas; Lakeman, Nicki; Johnston, Nicola; Shammas, Nicolas W; Saint Vrestil, Nicole; Deming, Nicole; Zhong, Nier; Patel, Niket; Boskovic, Nikola N; Karogiannis, Nikolaos; Werner, Nikos; Johnston, Nina; Zhang, Ning; Zhou, Ning; Hindoyan, Niree; Kumar, Nirmal; Chadha, Nitika; Naik, Nitish; Aripova, Nodira; Mtana, Noloyiso; Eskelson, Nona A; Mokhtar, Noor Syamira; Taksaudom, Noppon; Basri, Nor Asiah; Marchelletta, Nora; Hogg, Norma; Jungla, Nungshi; Ferreira, Nuno; Lubyanaya, Oksana A; Nikolaeva, Olga B; Cañavate, Olga; Sobrino, Olga; Walesiak, Olga; Walter, Olga; ZdoÅ„czyk, Olga; Lim, Olivia J; Anaya, Olivia; Mancilla, Olivia; Dubourg, Olivier; Bello, Olugbenga; Almousalli, Omar; Thompson, Omar; Olurinde, Oni; Harel, Or; Raheem, Osama; Méndiz, Oscar; Prada-Delgado, Óscar; Shapira, Oz; Schulze, P Christian; Panpunuan, Pachara; Maurovich-Horvat, Pal; Garg, Pallav; Moraga, Paloma; Singh, Pam; Julian, Pamela; Ouyang, Pamela; Sigel, Pamela; Woodard, Pamela; Zhou, Panpan; Poggio, Paola Emanuela; Smanio, Paola; Calabro, Paolo; Jeetley, Paramjit; Goube, Pascal; Nguyen, Patricia K; Alarie, Patricia; Arakelian, Patricia; Arsenault, Patricia; Blaise, Patricia; Brito, Patricia; Cowper, Patricia; Endsley, Patricia; Mieses, Patricia; Alexander, Patrick B; Donnelly, Patrick; Wilmot, Patrick; Lebioda, Patrycja; Gordon, Paul C; Mesropian, Paul Der; Galiwango, Paul; Hauptman, Paul; Kennedy, Paul; Beardsley, Paula; GarcÃa-González, Paula; Rezende, Paulo Cury; Caramori, Paulo Ricardo; Kozlov, Pavel S; Canas Silva, Pedro; Melo Barros E Silva, Pedro Gabriel; PÃccaro de Oliveira, Pedro; Carvalho, Pedro; Modas, Pedro; Rio, Pedro; Jain, Peeyush; He, Peiyu; McCullough, Peter A; Stone, Peter H; Pollak, Peter M; Douglass, Peter; Henriksen, Peter; OKane, Peter; Ong, Peter; Jones, Philip; Rogal, Philip; Généreux, Philippe; Menasche, Philippe; Rheault, Philippe; Goold, Phoebe; Gervais, Pierre; Michaud, Pierre; Calvillo, Pilar; Chai, Ping; Jakubowski, Piotr; Pruszczyk, Piotr; Slomka, Piotr; Sritara, Piyamitr; Loh, Poay-Huan; Sonawane, Poonam; Samadi, Pouneh; Parikh, Pragnesh P; Deedwania, Prakash; Patel, Pranav M; Polamuri, Praneeth; Sharma, Pratiksha; Vasquez, Precilia; Kamath, Preeti; Thomas, Prince; Arambam, Priyadarshani; Mehta, Puja K; Grant, Purvez; Naik, Pushpa; Zhong, Qi; Zhao, Qian; Zhou, Qiang; Yuan, Qianqian; Yu, Qin; Li, Qingxian; Xie, Qiulan; Zeng, Qiutang; Vindhya, R J; Gerlach, R James; King, Rachel; VuÄić, Rada; Lyubarova, Radmila; Pracon, Radoslaw; Fisher, Raewyn; Beyar, Rafael; Diaz, Rafael; Selgas, Rafael; Bugiardini, Raffaele; Fanelli, Raffaele; Kavalakkat, Raisa; Rajalekshmi, V S; Barua, Rajat S; Menon, Rajeev; Nair, Rajesh Gopalan; Francis, Rajesh; Narang, Rajiv; Yadav, Rakesh; Huston, Ralph Alan; Ramakrishnan, T; de Silva, Ramesh; Mahmoud, Rami El; Carvalho, Ramiro; de Jesús-Pérez, Ramon; Stevens, Ramona; Leng, Ran; Kachru, Ranjan; Nath, Ranjit Kumar; Sanchez, Raquel; Dwyer, Raven R; Lee, Raven; Wyman, Ray; Wong, Raymond C; Little, Raymond W; Ocaranza Sanchez, Raymundo; Wimmer, Rebecca J; Bariciano, Rebecca; Otis, Rebecca; Herrmann, Rebekah R; Yunis, Reem; Hampson, Reinette; Karam, Renato Abdala; Hessian, Renee C; Kaneshiro, Renee; Ravindran, Reshma; Gamma, Reto Andreas; Bhandari, Reyna; Arsanjani, Reza; Lopes, Ricardo L; Mendes Oliveira, Ricardo; Costa, Ricardo; Bhatt, Richa; Davies, Richard F; Trimlett, Richard H J; Goldweit, Richard; Hermanides, Rik; Nakanishi, Rine; Sidh, Rinu R; Patel, Risha; Coram, Rita; Siddiqui, Rizwan A; Beanlands, Rob S; Hamburger, Robert J; Riezebos, Robert K; Donnino, Robert M; Bojar, Robert; Chilton, Robert; Guyton, Robert; Henderson, Robert; Kornberg, Robert; Leber, Robert; Mao, Robert; Stenberg, Robert; Santos, Roberta P; Favaloro, Roberto René; Amati, Roberto; Lima, Rodolfo G S D; Cerci, Rodrigo J; Tumelero, Rogerio; Tandon, Rohit; Tewari, Roma; Miranda-Peats, Romalisa; Wald, Ron; Mastouri, Ronald A; Morford, Ronald G; Schwartz, Ronald G; Pedalino, Ronald P; Hu, Rongrong; Hansen, Ronnell A; Cohen, Ronny A; Hachamovitch, Rory; Homem, Rosa; Sandonato, Rosa; Laimer, Rosane; Gans, Rosann; Yost, Roxanne; Mathew, Roy; Baleón-Espinosa, Rubén; Ramos, Ruben; Gevorgyan, Rubine; Ferreira, Rui; Jing, Rui; Pérez-Fernández, Ruth; Dwivedi, S K; Ramakrishnan, S; Khan, Saadat; Bokhari, Sabahat; Thomas, Sabu; Lubna, Sadath; Khan, Sajeeda Parveen; Govindan, Sajeev Chakanalil; Girotra, Saket; Kassam, Saleem; Canada, Sallie; Cruz-Flores, Salvador; Mohamed, Samaa; Ly, Samantha; El Kaffas, Sameh; Massalha, Samia; Setty, Sampoornima; Nwosu, Samuel; Seth, Sandeep; Singh, Sandeep; Niehe, Sander R; Rivest, Sandra M; Zier, Sandra S; Ahoud, Sandra; Carr, Sandy; Ganapathi, Sanjay; Shetty, Sanjay; Sharma, Sanjeev; Jimenez, Santa; Satheesh, Santhosh; Garcia, Santiago A; Fernandez, Sara; Karlsson, Sara; Salkind, Sara; Temiyasathit, Sara; Medina Rodriguez, Sarah; Beaudry, Sarah; Hadjih, Sarah; Williams, Sarah; Zahrani, Sarah; Ralhan, Sarju; Hinic, Sasa; Kedev, Sasko; Singh, Satinder; Yasuda, Satoshi; Manjunath, Satvic Cholenahally; Lee, Sau; Kaczkowski, Scott M; Kinlay, Scott; Hayes, Sean W; Sobczak, Sebastian; Asier, Senait; Sayganov, Sergey A; Sokol, Seth I; Pandie, Shaheen; Yahaya, Shaiful Azmi; Mehta, Shamir; Nie, Shao-Ping; Chandra, Sharad; Islam, Sharder; Tai, Sharon; Karwa, Sheetal Rupesh; Ussery, Sheri; Bajaj, Sheromani; Crook, Sherron C; Nishimura, Shigeyuki; Nakano, Shintaro; Heydari, Shirin; Choudhary, Shiv Kumar; Patel, Shivali; Ganesan, Shobana; Pandey, Shruti; Zhang, Shuyang; Hande, Shweta; Gadage, Siddharth; Tan, Sik-Yin V; Zottis Poletti, Silvia; Riera, Silvia; Valbuena, Silvia; Walsh, Simon; Maspoli, Simona; Savaris, Simone; Feng, Si-Ting; Cho, So Yang; Yakubov, Solomon; Zhu, Songlin; Wang, Songtao; Guerrero, Sonia; Gupta, Sonika; Salinger Martinovic, Sonja; Brons, Sonya; Brener, Sorin; Gurunathan, Sothinathan; Saba, Souheil; Nayak, Soundarya; Reddy, Sowjanya; Potluri, Srinivasa; Sudarshan, Sriram; Kuanprasert, Srun; Van Oosterhout, Stacie; Lerakis, Stamatios; Cobos, Stanley E; Bertog, Stefan C; Simović, Stefan M; Weikl, Stefan; Di Marco, Stefano; Provasoli, Stefano; Tirado, Stephanie A; Boer, Stephanie C; Lane, Stephanie M; Ferket, Stephanie; Kelly, Stephanie; Wasmiller, Stephanie; McKellar, Stephen H; Hoole, Stephen P; Fremes, Stephen; Preston, Stephen; Leung, Steve; Fein, Steven A; Lindsay, Steven J; Sedlis, Steven P; Giovannone, Steven; Michael, Steven; Weitz, Steven; van Vugt, Stijn; Banerjee, Subhash; Naik, Sudhir; Hosino, Suellen; Desire, Sukie; Yamwong, Sukit; Thambar, Suku T; Mookherjee, Sulagna; Singh, Suman; Mishra, Sundeep; Verma, Sunil Kumar; Kulthawong, Supap; Khwakhong, Supatchara; Naik, Surendra; Babu, Suresh; Woragidpoonpol, Surin; Narayanappa, Suryaprakash; Derbyshire, Susan; Gent, Susan; Mathus, Susan; Milbrandt, Susan; Moore, Susan; Regan, Susan; Stinson, Susan; Webber, Susan; Silva, Susana; Stevens, Susanna; Gruensfelder, Susanne; Aramcharoen, Suthara; Kolhe, Suvarna; Tavares, Suzana; Arnold, Suzanne; Welsh, Suzanne; Apostolovic, Svetlana; Kunhunny, Swapna; Hung, Ta-Chuan; Zappernick, Taissa; Sharir, Tali; Silva, Talita; Soares, Tamara Colaiácovo; Pillay, Tapan Umesh; Mittal, Tarun K; Trifonova, Tatiana; Duarte, Tauane Bello; Huk, Tauqir; Dutoiu, Téodora; Chua, Terrance; Weyand, Terry; Charles, Thabitha; Kofidis, Theodoros; McCreary, Theresa; Lefevre, Thierry; Arumairajah, Thippeekaa; Tepsuwan, Thitipong; Mulhearn, Thomas J; Meyer, Thomas M; Rocco, Thomas P; Downes, Thomas R; Crain, Thomas; Haldis, Thomas; Mathew, Thomas; Redick, Thomas; Devi, Thounaojam Indira; Nageh, Thuraia; Cauthren, Tia; Silva, Tiago; Little, Tiffany; Andric, Tijana; Harding, Tina; Lau, Titus; Formisano, Tiziana; Moccetti, Tiziano; Ciurus, Tomasz; Mazurek, Tomasz; Tarchalski, Tomasz; Nagai, Toshiyuki; Tran, Tri; Youn, Tricia; Tucker, Trish; Milner, Trudie; Bose, Tuhina; Kotecha, Tushar; Sechtem, Udo; Valeti, Uma S; Cucchini, Umberto; Badami, Umesh; Kaul, Upendra; Bahl, V K; Narain, V S; Casali, Valentina; Godoy, Valeria; Robesyn, Valerie; Priya, Vamshi P; Yadav, Vandana; McKinney, Vera; De Lenges, Veronica; Tinnirello, Veronica; Miro, Vicente; Navarro, Victor; Gumerova, Victoria; Hernandez, Victoria; Seeratan, Vidya; Kumar, Vijay; Kozulin, Vikentiy Y; Bulkley, Viktoria; Veiga, Vilmar Jr; Setang, Vincent; Vineeth, C P; Pubull Nuñez, Virginai; Fernández-Figares, Virginia; Gomes, Vitor; Gabriel, Viviana; Dos Santos, Viviane; Almeida, Viviane; Iliescu, Vlad A; Mudrenovic, Vladan; Dzavik, Vladimir; Giga, Vojislav L; Mogrovejo, Walter Enrique; Chan, Wan Xian; Marfori, Wanda C; Parker, Wanda; Mekara, Warangkana; Nona, Wassim; Old, Wayne; Pennachi, Wayne; Nawarawong, Weerachai; Chen, Wei; Su, Wei; Xing, Weibing; Lan, Wei-Ren; Crawford, Wenda; Stewart, Wendy L; Drewes, Wendy; Lin, Wenhua; Abernethy, William B; Salerno, William D; Fearon, William F; Vergoni, William; Weintraub, William; Sia, Winnie C; Musial, Wlodzimierz J; Flores-RÃos, Xacobe; Garcia-Moll Marimon, Xavier; Su, Xi; Ma, Xiang; Gu, Xiangqiong; Wang, Xiao; Li, Xiaomei; Yao, Xiaowei; Fu, Xin; Su, Xin; Zeng, Xin; Yang, Xinchun; Li, Xiuhong; Fang, Xuehua; Wang, Xutong; Geng, Yaming; Yan, Yan; Pépin-Dubois, Yanek; Wang, Yanfu; Wang, Yang; Tian, Yanmeng; Huang, Yaping; Han, Yechen; Zambrano, Yesenia; Yang, Yi-Hsuan; Sia, Ying Tung; Yang, Yining; Ma, Yitong; Peralta, Yolayfi; Wu, Yongjian; Kunwu, Yu; Zhao, Yu; Peng, Yudong; Lin, Yueh-Hung; Zhao, Yulan; Dong, Yumei; Zhao, Yunhai; Wannasopha, Yutthaphan; Taul, Yvonne; Sahul, Zakir; Kudzoeva, Zalina; Kalarus, Zbigniew; Markovic, Zeljko Z; Huang, Zhen; Ji, Zheng; Liu, Zhenyu; Yue, Zhou; Zhang, Zhulin; Li, Zhuxi; Singh Meharwal, Zile; Bai, Ziliang; Yu, Zixiang; Huda, Zohra; Davidovits, Zoltan
BACKGROUND:Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS:We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS:Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, -1.8 percentage points; 95% CI, -4.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS:Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used. (Funded by the National Heart, Lung, and Blood Institute and others; ISCHEMIA ClinicalTrials.gov number, NCT01471522.).
PMID: 32227755
ISSN: 1533-4406
CID: 5451242
Outpatient Intravenous Lasix Trial in Reducing Hospitalization for Acute Decompensated Heart Failure (OUTLAST) [Meeting Abstract]
Hamo, Carine E.; Abdelmoneim, Sahar S.; Han, Seol Young; Chandy, Elizabeth; Muntean, Cornelia; Khan, Saadat A.; Sunkesula, Prasanthi; Meykler, Marcella; Vidhya, Ramachandran; Emelie, Rosenberg; Klem, Igor; Sacchi, Terrence; Heitner, John F.
ISI:000607190403098
ISSN: 0009-7322
CID: 5267352
