Publications by authors named "J L Fleg"
Article Synopsis
- - The SPIRRIT-HFpEF trial aims to evaluate the benefits of mineralocorticoid receptor antagonists (MRAs) like spironolactone for patients with heart failure and preserved or mildly reduced ejection fraction, focusing on a cost-effective registry-based approach.
- - This multicenter trial involves randomizing patients to receive either MRAs with usual care or just usual care, measuring outcomes such as cardiovascular deaths and heart failure-related hospitalizations over a 6-year enrollment period, with a target of around 2400 patients.
- - The study’s findings will provide insights into the effectiveness of MRAs for heart failure patients and demonstrate the viability of using pragmatic, registry-based trials for research in chronic conditions.
Aging is associated with a significant decline in aerobic capacity assessed by maximal exercise oxygen consumption (V̇o). The relative contributions of the specific V̇o components driving this decline, namely cardiac output (CO) and arteriovenous oxygen difference (A - V)O, remain unclear. We examined this issue by analyzing data from 99 community-dwelling participants (baseline age: 21-96 yr old; average follow-up: 12.
View Article and Find Full Text PDFAgreement among high-sensitivity cardiac troponin assays and non-invasive testing, clinical outcomes, and quality-of-care outcomes based on the 2020 European Society of Cardiology Guidelines.
Eur Heart J Acute Cardiovasc Care
February 2024
Article Synopsis
- The study aimed to analyze how different high-sensitivity cardiac troponin (hs-cTn) assays impact the risk stratification and management of patients suspected of having acute coronary syndrome (ACS) based on the 2020 European Society of Cardiology guidelines.
- Blood samples from 238 patients were tested using four different hs-cTn assays, and results showed a 74% overall concordance in classifying patients, with significant variations in rule-out and observe strata but not in rule-in strata.
- Findings revealed that management decisions and quality of care varied significantly among assays, suggesting that patient outcomes could be influenced by the specific assay used, indicating a need for more research to standardize practices.
Objective: This study aimed to assess whether an obesity paradox (lower event rates with higher body mass index [BMI]) exists in participants with advanced chronic kidney disease (CKD) and chronic coronary disease in the International Study of Comparative Health Effectiveness of Medical and Invasive Approaches (ISCHEMIA)-CKD, and whether BMI modified the effect of initial treatment strategy.
Methods: Baseline BMI was analyzed as both a continuous and categorical variable (< 25, ≥ 25 to < 30, ≥ 30 kg/m). Associations between BMI and the primary outcome of all-cause death or myocardial infarction (D/MI), and all-cause death, cardiovascular death, and MI individually were estimated.