David Tepper
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View article: Increased Mortality Associated With Low Use of Clopidogrel in Patients With Heart Failure and Acute Myocardial Infarction Not Undergoing Percutaneous Coronary Intervention
Increased Mortality Associated With Low Use of Clopidogrel in Patients With Heart Failure and Acute Myocardial Infarction Not Undergoing Percutaneous Coronary Intervention Open
Objectives. We studied the association of clopidogrel with mortality in acute myocardial infarction (AMI) patients with heart failure (HF) not receiving percutaneous coronary intervention (PCI). Background. Use of clopidogrel after AMI is …
View article: Comparison of Hospital Mortality With Intra‐Aortic Balloon Counterpulsation Insertion Before vs After Primary Percutaneous Coronary Intervention for Cardiogenic Shock Complicating Acute Myocardial Infarction
Comparison of Hospital Mortality With Intra‐Aortic Balloon Counterpulsation Insertion Before vs After Primary Percutaneous Coronary Intervention for Cardiogenic Shock Complicating Acute Myocardial Infarction Open
Primary percutaneous coronary intervention (PCI) and intra‐aortic balloon pump counterpulsation (IABP) are established treatment modalities in acute myocardial infarction complicated by cardiogenic shock. We hypothesized that the insertion…
View article: Patient Expectations From Implantable Defibrillators to Prevent Death in Heart Failure
Patient Expectations From Implantable Defibrillators to Prevent Death in Heart Failure Open
Background. Indications for implantable cardioverter‐defibrillators (ICDs) in heart failure (HF) are expanding and may include more than 1 million patients. This study examined patient expectations from ICDs for primary prevention of sudde…
View article: Dynamic Cardiovascular Risk Assessment in Elderly People
Dynamic Cardiovascular Risk Assessment in Elderly People Open
Objectives . This study sought to determine whether serial measurement of N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) in com‐munity‐dwelling elderly people would provide additional prognostic information to that from traditional …
View article: The Role of N‐Terminal Pro‐Brain Natriuretic Peptide and Echocardiography for Screening Asymptomatic Left Ventricular Dysfunction in a Population at High Risk for Heart Failure: The PROBE‐HF Study
The Role of N‐Terminal Pro‐Brain Natriuretic Peptide and Echocardiography for Screening Asymptomatic Left Ventricular Dysfunction in a Population at High Risk for Heart Failure: The PROBE‐HF Study Open
Background. Screening for asymptomatic left ventricular dysfunction (ALVD) in patients at risk for heart failure (HF) can affect clinical management. The aim of the present study is to examine the role of N‐terminal pro‐brain natriuretic p…
View article: Tricuspid Regurgitation Contributes to Renal Dysfunction in Patients With Heart Failure
Tricuspid Regurgitation Contributes to Renal Dysfunction in Patients With Heart Failure Open
Background. In heart failure (HF), renal dysfunction is associated with an adverse prognosis. Impaired renal perfusion from left ventricular dysfunction is thought to be a principal underlying mechanism. Less is known about the influence o…
View article: Optimal Left Ventricular Lead Position Predicts Reverse Remodeling and Survival After Cardiac Resynchronization Therapy
Optimal Left Ventricular Lead Position Predicts Reverse Remodeling and Survival After Cardiac Resynchronization Therapy Open
Objectives. The aim of the current study was to evaluate echocardiographic parameters after 6 months of cardiac resynchronization therapy (CRT) as well as long‐term outcome in patients with the left ventricular (LV) lead positioned at the …
View article: Influence of β‐Blocker Continuation or Withdrawal on Outcomes in Patients Hospitalized With Heart Failure: Findings From the OPTIMIZE‐HF Program
Influence of β‐Blocker Continuation or Withdrawal on Outcomes in Patients Hospitalized With Heart Failure: Findings From the OPTIMIZE‐HF Program Open
Objectives. This study ascertains the relationship between continuation or withdrawal of β‐blocker therapy and clinical outcomes in patients hospitalized with systolic heart failure (HF). Background. Whether β‐blocker therapy should be con…
View article: Assessment of Left Ventricular Dyssynchrony by Speckle Tracking Strain Imaging Comparison Between Longitudinal, Circumferential, and Radial Strain in Cardiac Resynchronization Therapy
Assessment of Left Ventricular Dyssynchrony by Speckle Tracking Strain Imaging Comparison Between Longitudinal, Circumferential, and Radial Strain in Cardiac Resynchronization Therapy Open
Objectives. The objective of this study was to assess the usefulness of each type of strain for left ventricular (LV) dyssynchrony assessment and its predictive value for a positive response after cardiac resynchronization therapy (CRT). F…
View article: Evaluation and Long‐Term Prognosis of New‐Onset, Transient, and Persistent Anemia in Ambulatory Patients With Chronic Heart Failure
Evaluation and Long‐Term Prognosis of New‐Onset, Transient, and Persistent Anemia in Ambulatory Patients With Chronic Heart Failure Open
Objectives. This study sought to determine the characteristics and long-term prognosis of anemia in ambulatory patients with chronic heart failure. Background. Anemia is prevalent in heart failure and may portend poor outcomes. Methods. We…
View article: Comparison of the Effects of Cardiac Resynchronization Therapy in Patients With Class II vs Class III and IV Heart Failure (From the InSync/InSync ICD Italian Registry)
Comparison of the Effects of Cardiac Resynchronization Therapy in Patients With Class II vs Class III and IV Heart Failure (From the InSync/InSync ICD Italian Registry) Open
This study compared the effects of Cardiac Resynchronization Therapy (CRT) in patients with New York Heart Association (NYHA) Class II with those in Class III or IV. CRT was provided to 952 patients (188 in NYHA Class II), who were enrolle…
Characterization and Prognostic Value of Persistent Hyponatremia in Patients With Severe Heart Failure in the ESCAPE Trial Open
Background. Mild hyponatremia is relatively common in patients with heart failure (HF). The associations of outcomes have not been evaluated in the context of in-hospital clinical course including central hemodynamics and changes in serum …
View article: Levosimendan vs Dobutamine for Patients With Acute Decompensated Heart Failure: the SURVIVE Randomized Trial
Levosimendan vs Dobutamine for Patients With Acute Decompensated Heart Failure: the SURVIVE Randomized Trial Open
Context. Because acute decompensated heart failure (HF) causes substantial morbidity and mortality, there is a need for agents that at least improve hemodynamics and relieve symptoms without adversely affecting survival. Objective. To asse…
View article: Reversal of End‐Stage Heart Failure—Mechanical and Pharmacologic Interplay
Reversal of End‐Stage Heart Failure—Mechanical and Pharmacologic Interplay Open
Background. In patients with severe heart failure (HF), prolonged unloading of the myocardium with the use of a left ventricular (LV) assist device (LVAD) has been reported to lead to myocardial recovery in small numbers of patients for va…
View article: Reversal of End‐Stage Heart Failure: Mechanical and Pharmacologic Interplay
Reversal of End‐Stage Heart Failure: Mechanical and Pharmacologic Interplay Open
Background. In patients with severe heart failure, prolonged unloading of the myocardium with the use of a left ventricular assist device (LVAD) has been reported to lead to myocardial recovery in small numbers of patients for varying peri…
View article: Diurnal Blood Pressure Pattern and Risk of Congestive Heart Failure
Diurnal Blood Pressure Pattern and Risk of Congestive Heart Failure Open
Context. High blood pressure (BP) is the most important risk factor for congestive heart failure (CHF) at a population level, but the relationship of an altered diurnal BP pattern to the risk of subsequent CHF is unknown. Objectives. To ex…
View article: The Debate Over Anticoagulation in Patients With Heart Failure
The Debate Over Anticoagulation in Patients With Heart Failure Open
Background. It is not clear whether long-term antithrombotic treatment has a beneficial effect on the incidence of thromboembolism in chronic heart failure (HF). HELAS (Heart Failure Long-term Antithrombotic Study) is a multi-center, rando…
View article: Inflammation—Etiology or Consequence of Acute Congestive Heart Failure?
Inflammation—Etiology or Consequence of Acute Congestive Heart Failure? Open
Background. Systemic inflammation has long been recognized as a precipitator of acute congestive heart failure (CHF). The impact of inflammation on prognosis in acute CHF, however, is unknown. Methods. This study evaluated the prognostic r…
View article: T‐Wave Alternans: Is It an Appropriate Test for Primary Prevention Implantable Cardioverter‐Defibrillator Risk Stratification?
T‐Wave Alternans: Is It an Appropriate Test for Primary Prevention Implantable Cardioverter‐Defibrillator Risk Stratification? Open
Background. Several randomized controlled trials have demonstrated benefit for implantable cardio-verter-defibrillator (ICD) prophylaxis in selected patients. However, the absolute benefit of ICD prophylaxis on mortality is relatively smal…
View article: Noninvasive Home Telemonitoring for Patients With Heart Failure at High Risk for Recurrent Admission and Death
Noninvasive Home Telemonitoring for Patients With Heart Failure at High Risk for Recurrent Admission and Death Open
Objectives. We sought to identify whether home telemonitoring (HTM) improves outcomes compared with nurse telephone support (NTS) and usual care (UC) for patients with heart failure (HF) who are at high risk for hospitalization or death. B…
View article: Randomized Comparison of Enoxaparin With Unfractionated Heparin for the Prevention of Venous Thromboembolism in Medical Patients With Heart Failure or Severe Respiratory Disease
Randomized Comparison of Enoxaparin With Unfractionated Heparin for the Prevention of Venous Thromboembolism in Medical Patients With Heart Failure or Severe Respiratory Disease Open
Background. We compared the efficacy and safety of the low-molecular weight heparin enoxaparin with unfractionated heparin (UFH) for the prevention of venous thromboembolic disease in patients with heart failure or severe respiratory disea…
View article: Clinical Outcomes in Patients on Beta‐Blocker Therapy Admitted With Worsening Chronic Heart Failure
Clinical Outcomes in Patients on Beta‐Blocker Therapy Admitted With Worsening Chronic Heart Failure Open
Beta blockers have been shown to reduce morbidity and mortality in patients with heart failure without evidence of overt congestion. No data are available describing outcomes of patients admitted with exacerbated chronic heart failure who …
View article: Obstructive Sleep Apnea
Obstructive Sleep Apnea Open
A 43-year-old man presents with heavy snoring; his bed partner reports that he sometimes stops breathing while he sleeps. He admits to feeling sleepy at times when he drives, although he has not had any motor vehicle accidents. He has hype…
View article: Anemia Is Associated With Worse Symptoms, Greater Impairment in Functional Capacity, and a Significant Increase in Mortality in Patients With Advanced Heart Failure
Anemia Is Associated With Worse Symptoms, Greater Impairment in Functional Capacity, and a Significant Increase in Mortality in Patients With Advanced Heart Failure Open
Objectives. This study aimed to evaluate the relationship between anemia and heart failure (HF) prognosis. Background. Although it is known that chronic diseases, including HF, may be associated with anemia, the impact of hemoglobin (Hb) l…
View article: Surrogate End Points in Heart Failure
Surrogate End Points in Heart Failure Open
Because of the increasing number of pharmacologic strategies available for treatment of heart failure (HF), the time has come to reassess the adequacy of end points used to evaluate therapeutic efficacy. Interest in the use of surrogate en…
View article: A Randomized Trial of the Angiotensin‐Receptor Blocker Valsartan in Chronic Heart Failure
A Randomized Trial of the Angiotensin‐Receptor Blocker Valsartan in Chronic Heart Failure Open
Background. Actions of angiotensin II may contribute to the progression of heart failure despite treatment with currently recommended drugs. We therefore evaluated the long-term effects of the addition of the angiotensin receptor blocker v…
View article: Utility of B‐Natriuretic Peptide As a Rapid, Point‐of‐Care Test for Screening Patients Undergoing Echocardiography to Determine Left Ventricular Dysfunction
Utility of B‐Natriuretic Peptide As a Rapid, Point‐of‐Care Test for Screening Patients Undergoing Echocardiography to Determine Left Ventricular Dysfunction Open
Background. Although echocardiography is an important tool for making the diagnosis of left ventricular (LV) dysfunction, the cost of this procedure limits its use as a routine screening tool for this purpose. Brain natriuretic peptide (BN…
View article: Skeletal Muscle Mass Independently Predicts Peak Oxygen Consumption and Ventilatory Response During Exercise in Noncachectic Patients with Chronic Heart Failure
Skeletal Muscle Mass Independently Predicts Peak Oxygen Consumption and Ventilatory Response During Exercise in Noncachectic Patients with Chronic Heart Failure Open
Objectives. We sought to assess whether skeletal muscle mass might be a predictor of peak oxygen consumption (Vo2) and relation of the ventilation to carbon dioxide production (VE/VCo2) slope in patients with chronic heart failure (HF) ind…