Publications by authors named "Winchester D"
Article Synopsis
- The study investigates the significance of cardiac troponin (cTn) levels in predicting mortality in patients with Takotsubo syndrome (TTS), analyzing data from the International Takotsubo Registry.
- It identifies that a cTn increase greater than 28.8 times the upper reference limit signals clinically relevant myocardial injury, correlating with a higher risk of mortality over 5 years (adjusted HR 1.58).
- The findings enhance understanding of patient risk profiles in TTS, emphasizing the need for increased monitoring and follow-up for those with significant troponin elevations.
Article Synopsis
- The study investigated changes in demographics, risk factors, clinical presentations, and outcomes of takotsubo syndrome (TTS) patients from 2004 to 2021, using data from the InterTAK registry.
- Over the years, the proportion of male patients increased, and there was a rise in cases of midventricular TTS as well as significant growth in the incidence of physical triggers.
- There was also a notable increase in 60-day mortality rates, although no significant change in 1-year mortality when excluding early deaths was observed, indicating a complex evolution of TTS and its management in recent years.
Coronary Artery Calcium as a Gatekeeper for Patients With Stable Chest Pain.
JACC Cardiovasc Imaging
October 2024
Purpose: The American Heart Association recommended sodium-glucose cotransporter-2 inhibitors (SGLT2i) for the management of heart failure with preserved ejection fraction (HFpEF). However, little is known about their real-world in-class comparative safety in patients with HFpEF. We aimed to assess the comparative safety of SGLT2i in the risk of urinary tract infection (UTI) or genital infection separately or as a composite outcome among patients with HFpEF.
View Article and Find Full Text PDFThe National Institutes of Health (NIH) recognized the need for a research program to address the underlying structural factors that impact health. To inform the development of the NIH Common Fund Community Partnerships to Advance Science for Society (ComPASS) Program, NIH obtained input through community listening sessions. Through its design, ComPASS recognizes the essential role of community organizations as the lead in addressing persistent structural and social challenges to accelerate progress toward advancing health equity.
View Article and Find Full Text PDFBackground: Patients with dementia are at increased risk for adverse events following valvular surgery. Outcomes after mitral transcatheter edge-to-edge repair (TEER) for mitral regurgitation in this vulnerable population are not well understood.
Methods: We queried the National Inpatient Sample database for all hospitalizations for mitral TEER between 2016 and 2019.
Purpose Of Review: Optimal therapy for patients with chronic coronary artery disease (CCD) has long been a topic under investigation and a subject of debate. Seeking to clarify appropriate management, the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial compared medical management versus coronary angiography for patients with stable ischemic heart disease. Its reception in the medical community has been met with both acclaim and criticism.
View Article and Find Full Text PDFPurpose: Sacubitril/valsartan (SAC/VAL) or angiotensin receptor blockers (ARBs) are recommended therapy for heart failure with preserved ejection fraction (HFpEF), but little is known about their real-world comparative effectiveness among patients with HFpEF. The objective of this study was to determine the comparative effectiveness of SAC/VAL vs ARBs in preventing HF-related hospitalization or all-cause hospitalization among patients with HFpEF.
Methods: We conducted a cohort study using IBM MarketScan commercial and Medicare supplemental databases to identify patients aged 18 years or older with a diagnosis of HFpEF and initiation of SAC/VAL (2015-2020) or ARB (2009-2014) therapy.
Background: Adrenocortical carcinoma has a poor prognosis and multiple clinical, pathological, and treatment variables. Currently, we lack a prognostic and treatment calculator to determine the survival and efficacy of adjuvant chemoradiation. We aimed to validate a calculator to assess prognosis and treatment.
View Article and Find Full Text PDFThis report provides a descriptive summary of the ACC/AHA/ASE/ASNC/ASPC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2023 Multimodality Appropriate Use Criteria for the Detection and Risk Assessment of Chronic Coronary Disease with an emphasis on the role of stress echocardiography.
View Article and Find Full Text PDFThe American College of Cardiology (ACC) Foundation, along with key specialty and subspecialty societies, conducted an appropriate use review of stress testing and anatomic diagnostic procedures for risk assessment and evaluation of known or suspected chronic coronary disease (CCD), formerly referred to as stable ischemic heart disease (SIHD). This document reflects an updating of the prior Appropriate Use Criteria (AUC) published for radionuclide imaging, stress echocardiography (echo), calcium scoring, coronary computed tomography angiography (CCTA), stress cardiac magnetic resonance (CMR), and invasive coronary angiography for SIHD. This is in keeping with the commitment to revise and refine the AUC on a frequent basis.
View Article and Find Full Text PDFPeripheral arterial disease (PAD) is common in patients with symptomatic aortic stenosis. PAD exists as a spectrum, and patients with chronic limb-threatening ischemia (CLTI), the most severe form of PAD, are at high risk for limb loss and death. We seek to determine patient characteristics and clinical outcomes among patients who underwent TAVR with or without CLTI.
View Article and Find Full Text PDFThe genetics and disability communities have had a complicated relationship that is rooted in the history of the eugenics movement. Disability scholars claim that in order for healthcare professionals to provide optimal services to disabled patients, disability education must be implemented into healthcare training programs. No studies have explored the perspectives of disability advocates regarding the implementation and use of disability training in genetic counseling.
View Article and Find Full Text PDFBackground: Congress established the Appropriate Use Criteria (AUC) Program to reduce unnecessary advanced imaging studies. Organizations that wish to develop AUC can apply to the Centers for Medicare & Medicaid Services (CMS) to qualify as provider-led entities (PLEs) under this program. Variable methods, content, and formatting of PLE-generated AUC could lead to clinician uncertainty about whether an advanced imaging test is appropriate or not.
View Article and Find Full Text PDFArticle Synopsis
- Researchers developed a machine learning model to predict in-hospital death risk in Takotsubo syndrome (TTS) patients using data from over 3,400 individuals.
- The model included 31 clinical variables and achieved strong performance results, with AUC values indicating high accuracy in identifying patients at risk of death.
- Clustering analysis revealed six distinct patient groups with varying in-hospital death rates, demonstrating the model's ability to stratify risk profiles effectively.
Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are recommended by the American Heart Association for management of heart failure with preserved ejection fraction (HFpEF), but little is known about their in-class comparative effectiveness in real-world settings.
Objectives: To assess the in-class comparative effectiveness of SGLT2i for preventing HF-related and all-cause hospitalizations among patients with HFpEF.
Methods: Using MarketScan® Commercial and Medicare Supplemental research databases (2012-2020), this cohort study included adults with HFpEF treated with SGLT2i.