Publications by authors named "Stephen Broughton"

Background Prior studies have reported disparities by race in the management of acute myocardial infarction (MI), with many studies having limited covariates or now dated. We examined racial and ethnic differences in the management of MI, specifically non-ST-segment-elevation MI (NSTEMI), in a large, socially diverse cohort of insured patients. We hypothesized that the racial and ethnic disparities in the receipt of coronary angiography or percutaneous coronary intervention would persist in contemporary data.

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BACKGROUND Patients with a prior coronary artery bypass graft (CABG) may have a need for repeat revascularization, which is typically attempted first via percutaneous coronary intervention (PCI) of either a bypass graft or native vessel. Long-term outcomes of native vessel compared to graft PCI after CABG have not yet been explored in a large institution study. METHODS Patients with history of prior CABG who underwent PCI at our institution during 2010-2018 were included.

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Background: Subclinical myocardial injury (SCMI) determined from the Electrocardiographic Cardiac Infarction/Injury Score (CIIS) is associated with increased risk of cardiovascular disease and mortality. We hypothesized that SCMI prevalence and association with mortality would differ by race, categorized as non-Hispanic White (White), non-Hispanic Black (Black), and Mexican American.

Methods: Our analysis included 5,852 participants (age 58.

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Objective: We assessed feasibility of an educational program designed to enhance stakeholder knowledge and perceptions of pharmacogenomics at a federally qualified health center (FQHC).

Design: FQHCs have a rich history of providing care to the underserved, but often are not represented by studies evaluating cutting-edge concepts. We used a novel educational platform to provide participatory genomic testing and classroom education.

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Electrocardiogram (ECG) is the most common method for assessment of left ventricular hypertrophy (LVH) in contemporary clinical trials. However, our understanding of the relation between hypertension and LVH is based on studies used imaging to ascertain LVH. To fill this gap in knowledge, we examined the interrelationships between hypertension, ECG-LVH and cardiovascular disease (CVD) mortality in 6,105 patients free of CVD who were followed for 14.

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Background: It is unknown if normal findings on noninvasive cardiac assessment are able to identify individuals who are low risk for developing heart failure (HF).

Methods: We examined if normal findings on the routine electrocardiogram (ECG) and cardiac magnetic resonance imaging (MRI) were able to identify individuals who are low risk for developing HF in 4986 (mean age=62±10years; 52% women; 39% White; 13% Chinese-American; 26% Black; 22% Hispanic) participants from the Multi-Ethnic Study of Atherosclerosis who were free of clinically apparent HF at baseline. A normal ECG was defined as the absence of major abnormalities by Minnesota Code Classification, and a normal MRI was defined as absence of structural abnormalities and systolic dysfunction.

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Background: The absence of abnormalities on noninvasive cardiac assessment possibly confers a reduced risk of atrial fibrillation (AF) despite the presence of traditional risk factors.

Hypothesis: Normal findings on noninvasive cardiac assessment are associated with a lower risk of AF development.

Methods: We examined the clinical utility of normal findings on routine noninvasive cardiac assessment in 5331 participants (85% white; 57% women) from the Cardiovascular Health Study who were free of baseline AF.

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The lack of abnormalities found on noninvasive cardiac testing possibly improves cardiovascular disease (CVD) risk stratification efforts and conveys reduced risk despite the presence of traditional risk factors. This analysis included 3,805 (95% white and 61% women) participants from the Cardiovascular Health Study (CHS) without baseline CVD. The combination of a normal electrocardiogram (ECG) and echocardiogram was assessed for the development of CVD.

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Background: Frontal QRS-T angle reflects changes in regional action potential duration and the direction of repolarization. Although it has been suggested that abnormal ventricular repolarization predisposes to atrial arrhythmias, it is unknown whether abnormal frontal QRS-T angle is associated with an increased risk of atrial fibrillation (AF).

Methods: We examined the association between frontal QRS-T angle and AF in 4282 participants (95% white; 41% male) from the Cardiovascular Health Study (CHS).

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Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in clinical practice, and it places a substantial burden on the health care system. Despite improvements in our understanding of AF pathophysiology, we have yet to develop targeted preventive therapies. Recently, numerous biological markers have been identified to aid in the prediction of future AF events.

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Background: Prior studies have not examined which cardiovascular outcomes most frequently develop in participants with atrial fibrillation (AF) from population-based cohorts of the elderly.

Methods: This analysis included 4,304 (85% white; 61% women) participants from the Cardiovascular Health Study who were free of baseline cardiovascular disease. AF cases were identified at baseline and as time-updated events during follow-up.

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Background: Left atrial enlargement (LAE) is independently associated with an increased risk of stroke and atrial fibrillation (AF). The combination of both LAE and AF possibly increases the risk of stroke beyond that observed with AF.

Methods: This analysis included 4572 (43% men, 95% white) participants from the Cardiovascular Health Study.

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