Christopher B. Granger

General Cardiology

Clinical Research Institute

About

Christopher B. Granger works in General Cardiology affiliated with Clinical Research Institute.

Christopher B. Granger is the Fred Cobb, M.D. Distinguished Professor of Medicine in the Division of Cardiology at Duke University and a member of the Duke Clinical Research Institute. He has led large international clinical trials in areas such as heart attacks, unstable angina, heart failure, and atrial fibrillation. He serves as the Chairman of the American Heart Association Mission: Lifeline program and has developed risk prediction tools for heart disease.

Research focus

Atrial Fibrillation Management and OutcomesAcute Myocardial Infarction ReperfusionStroke Prevention in Atrial FibrillationCoronary Artery Disease PreventionCardiovascular Risk Prediction

Impact

64 pubs · 11,971 cites · h-index 24

Training

MD
University of Connecticut School of Medicine
1984
Residency in Internal Medicine
University of Colorado
1987
Fellowship in Cardiovascular Disease
Duke University Hospital
1990

Affiliations

Work Experience

Fred Cobb, M.D. Distinguished Professor of Medicine

Duke University · 2024 - Present

Professor of Medicine

Duke University · 2007 - Present

Professor in the School of Nursing

Duke University · 2015 - Present

Member in the Duke Clinical Research Institute

Duke University · 1988 - Present

Publications

Robert Giugliano

Cardiovascular physician, Brigham and Women's Hospital · Brigham and Women's Hospital

3mo

We felt we had a public service obligation here. We didn't want the wider community to just be leaving elderly patients on a vitamin K antagonist when we think we have a better alternative. At a minimum, doctors should be having the discussion with elderly patients who are frail and say, 'Look, there is a new class of drugs available. Here are the advantages. Here are the disadvantages. They are more costly. And so let's think about what's best for you.'

Outcomes in Older Patients After Switching to a Newer Anticoagulant or Remaining on Warfarin

Journal of the American College of CardiologyNicolau et al.Aug 2025

cohort · n=45,947

JUN 29GoudaJACC Advances

Inappropriate low-dose apixaban linked to ~77% higher mortality versus appropriate full-dose apixaban.

Inappropriate reduced-dose apixaban was associated with higher mortality; leaves open whether stricter adherence to labeling criteria improves outcomes.

19w agoOpen Access

Level 3: Cohort Study

GoudaJACC Advances

Inappropriate low-dose apixaban linked to ~77% higher mortality versus appropriate full-dose apixaban.

Implication

Inappropriate reduced-dose apixaban was associated with higher mortality; leaves open whether stricter adherence to labeling criteria improves outcomes.

meta-analysis

JUL 1SaidJACC Advances

DOACs significantly reduced net clinical outcomes compared to VKAs in high-risk AF patients (HR 0.86; 95% CI 0.81-0.92; P<0.001), but not in low-risk patients (HR 0.93; 95% CI 0.85-1.03; P=0.154).

Renal function, age, and BMI are key predictors of DOAC treatment benefit in AF, suggesting lower-risk patients may derive similar outcomes with VKAs in resource-constrained settings.

18w agoOpen Access

Level 1: Meta-Analysis

SaidJACC Advances

DOACs significantly reduced net clinical outcomes compared to VKAs in high-risk AF patients (HR 0.86; 95% CI 0.81-0.92; P<0.001), but not in low-risk patients (HR 0.93; 95% CI 0.85-1.03; P=0.154).

Implication

Renal function, age, and BMI are key predictors of DOAC treatment benefit in AF, suggesting lower-risk patients may derive similar outcomes with VKAs in resource-constrained settings.

meta-analysis · n=58,634

JUL 1SaidJACC Advances

Standard-dose DOACs reduced the net clinical outcome compared to warfarin across all risk strata, with a modest absolute benefit of 0.3% (95% CI: 0.1%-0.6%) in low-risk patients.

SD-DOACs reduce net clinical events vs warfarin across AF risk strata; extends RCT evidence for broad preference while supporting warfarin in lowest-risk patients with limited DOAC access.

18w agoOpen Access

Level 1: Meta-Analysis

SaidJACC Advances

Standard-dose DOACs reduced the net clinical outcome compared to warfarin across all risk strata, with a modest absolute benefit of 0.3% (95% CI: 0.1%-0.6%) in low-risk patients.

Implication

SD-DOACs reduce net clinical events vs warfarin across AF risk strata; extends RCT evidence for broad preference while supporting warfarin in lowest-risk patients with limited DOAC access.

Cohort Study8 mentionsJACC Highlight

MAR 2025WallentinJournal of the American College of Cardiology

Biomarker-based ABC-AF-stroke score outperforms CHA2DS2-VASc in predicting stroke or systemic embolism.

ABC-AF-stroke may refine AF risk stratification; leaves open routine adoption pending randomized validation.

Mar 2025

JACC Highlight

Level 3: Cohort Study

WallentinJournal of the American College of Cardiology

Biomarker-based ABC-AF-stroke score outperforms CHA2DS2-VASc in predicting stroke or systemic embolism.

Implication

ABC-AF-stroke may refine AF risk stratification; leaves open routine adoption pending randomized validation.

review

SEP 2025PundiJAMA Cardiology

Expert consensus prioritizes real-world data and the consumer-to-patient journey for postmarket wearable evaluation.

This paper provides a conceptual framework for the postmarket evaluation of consumer wearable technologies, highlighting the need to study their downstream clinical and societal impacts.

Sep 2025Open Access

Level 5: Literature Review

PundiJAMA Cardiology

Expert consensus prioritizes real-world data and the consumer-to-patient journey for postmarket wearable evaluation.

Implication

This paper provides a conceptual framework for the postmarket evaluation of consumer wearable technologies, highlighting the need to study their downstream clinical and societal impacts.

RCT

MAR 2025FudimJACC Advances

Appropriately reduced dose apixaban was associated with a lower risk of bleeding and similar rates of ischemic outcomes compared with VKA; similar results were found with standard dose apixaban.

Supports preferring apixaban over VKA for lower bleeding with similar ischemia in AF post-ACS/PCI; challenges prior low-certainty evidence against benefit.

Mar 2025Open Access

Level 2: RCT

FudimJACC Advances

Appropriately reduced dose apixaban was associated with a lower risk of bleeding and similar rates of ischemic outcomes compared with VKA; similar results were found with standard dose apixaban.

Implication

Supports preferring apixaban over VKA for lower bleeding with similar ischemia in AF post-ACS/PCI; challenges prior low-certainty evidence against benefit.

Meta-Analysis

FEB 2025HuaStatistics in Medicine

Network Meta‐Analysis With Individual Participant‐Level Data of Time‐to‐Event Outcomes Using Cox Regression

The accessibility of individual participant-level data (IPD) enhances the evaluation of moderation effects of patient covariates. It facilitates the provision of accurate estimation of intervention effects and confidence intervals by incorporating covariate correlations across multiple clinical trials. With a time-to-event outcome, Cox regression can be applied for network meta-analysis (NMA) using IPD. However, there lacks comprehensive reviews and comparisons of the specifications and assumptions of these Cox models and their impact on the interpretation of hazard ratios, effect moderation, and trial heterogeneity in IPD-NMA. In this paper, we examine various Cox models for IPD-NMA and compare different approaches to modeling trial, treatment, and covariate effects. We employ multiple graphical tools and statistical tests to assess proportional hazard assumptions and discuss their implications. Additionally, we explore the application of extended Cox models when the proportional hazard assumption is violated. Practical guidance on interpreting and reporting NMA results is provided. A simulation study is conducted to compare the performance of different models. We illustrate the methods to conduct IPD-NMA through a real data example.

Feb 2025Open Access

Level 1: Meta-Analysis

HuaStatistics in Medicine

Network Meta‐Analysis With Individual Participant‐Level Data of Time‐to‐Event Outcomes Using Cox Regression

meta-analysis · n=6,546

SEP 2024SchnabelEuropean Heart Journal

Anticoagulation shows greater potential CV benefit in device-detected AF with vascular disease.

Anticoagulation may reduce events more in DDAF with vascular disease than without; extends risk stratification for shared decisions in device-detected AF.

Sep 2024Open Access

SchnabelEuropean Heart Journal

Anticoagulation shows greater potential CV benefit in device-detected AF with vascular disease.

Implication

Anticoagulation may reduce events more in DDAF with vascular disease than without; extends risk stratification for shared decisions in device-detected AF.

cohort · n=20,364

AUG 2024CurtainJAMA Cardiology

Sudden death/RCA occurred in 2.6% of the contemporary PARADISE-MI cohort compared to 7.4% in the historical PARADISE-MI-like VALIANT cohort, with first-month rates of 9.5 (95% CI, 7.0-12.7) vs 19.3 (95% CI, 16.4-22.6) per 100 person-years, respectively.

First-month risk after high-risk AMI remains a clinical priority; leaves open dedicated trials of early sudden-death prevention.

Aug 2024Open Access

Level 3: Cohort Study

CurtainJAMA Cardiology

Sudden death/RCA occurred in 2.6% of the contemporary PARADISE-MI cohort compared to 7.4% in the historical PARADISE-MI-like VALIANT cohort, with first-month rates of 9.5 (95% CI, 7.0-12.7) vs 19.3 (95% CI, 16.4-22.6) per 100 person-years, respectively.

Implication

First-month risk after high-risk AMI remains a clinical priority; leaves open dedicated trials of early sudden-death prevention.

Original Research

AUG 2024SuleimanAnnals of Internal Medicine

In MI with preserved LVEF, long-term β-blocker use vs. no use did not reduce all-cause death or MI at 3.5 y

Yndigegn T, Lindahl B, Mars K, et al; REDUCE-AMI Investigators.

Aug 2024

SuleimanAnnals of Internal Medicine

In MI with preserved LVEF, long-term β-blocker use vs. no use did not reduce all-cause death or MI at 3.5 y

Yndigegn T, Lindahl B, Mars K, et al; REDUCE-AMI Investigators.

cohort · n=18,201

JUN 2015AvezumCirculation

Apixaban showed no differential effect over warfarin in reducing stroke or systemic embolism in patients with versus without valvular heart disease (interaction P=0.38).

Apixaban may suit AF patients with moderate/severe valvular disease; extends ARISTOTLE findings but hypothesis-generating.

Jun 2015Open Access

Level 3: Cohort Study

AvezumCirculation

Apixaban showed no differential effect over warfarin in reducing stroke or systemic embolism in patients with versus without valvular heart disease (interaction P=0.38).

Implication

Apixaban may suit AF patients with moderate/severe valvular disease; extends ARISTOTLE findings but hypothesis-generating.

Cohort Study

MAR 2015RogerAmerican Journal of Epidemiology

Strategic Transformation of Population Studies: Recommendations of the Working Group on Epidemiology and Population Sciences From the National Heart, Lung, and Blood Advisory Council and Board of External Experts

In 2013, the National Heart, Lung, and Blood Institute assembled a working group on epidemiology and population sciences from its Advisory Council and Board of External Experts. The working group was charged with making recommendations to the National Heart, Lung, and Blood Advisory Council about how the National Heart, Lung, and Blood Institute could take advantage of new scientific opportunities and delineate future directions for the epidemiology of heart, lung, blood, and sleep diseases. Seven actionable recommendations were proposed for consideration. The themes included 1) defining the compelling scientific questions and challenges in population sciences and epidemiology of heart, lung, blood, and sleep diseases; 2) developing methods and training mechanisms to integrate "big data" science into the practice of epidemiology; 3) creating a cohort consortium and inventory of major studies to optimize the efficient use of data and specimens; and 4) fostering a more open, competitive approach to evaluating large-scale longitudinal epidemiology and population studies. By building on the track record of success of the heart, lung, blood, and sleep cohorts to leverage new data science opportunities and encourage broad research and training partnerships, these recommendations lay a strong foundation for the transformation of heart, lung, blood, and sleep epidemiology.

Mar 2015Open Access

Level 3: Cohort Study

RogerAmerican Journal of Epidemiology

Strategic Transformation of Population Studies: Recommendations of the Working Group on Epidemiology and Population Sciences From the National Heart, Lung, and Blood Advisory Council and Board of External Experts

Cohort Study

JAN 2014CalvoEuropean Heart Journal

Large streamlined trials in cardiovascular disease

In the search for new and better therapies, reliable evidence of efficacy and safety—usually provided from large-scale randomized trials—is essential to support licensing, inform guidelines, and change clinical practice. However, the size, duration, complexity, and costs of conducting contemporary clinical trials have risen steadily. This coupled with an apparently diminishing likelihood of a positive trial has raised concerns about return on investment to the point of restricting drug development in cardiovascular diseases (CVD).1 efficient ways to conduct randomized trials need to be developed with engagement by the various stakeholders.

Jan 2014

Level 3: Cohort Study

CalvoEuropean Heart Journal

Large streamlined trials in cardiovascular disease

cohort · n=1,903

JUN 2013DiepenCritical Care Medicine

Systemic inflammatory response syndrome at presentation in STEMI patients was associated with increased 90-day death, shock, heart failure, or stroke (31.0% vs 16.7%; adjusted HR 1.78; p<0.001).

The presence of systemic inflammatory response syndrome (SIRS) at presentation or 24 hours is independently associated with worse 90-day clinical outcomes in patients with STEMI.

Jun 2013

Level 3: Cohort Study

DiepenCritical Care Medicine

Systemic inflammatory response syndrome at presentation in STEMI patients was associated with increased 90-day death, shock, heart failure, or stroke (31.0% vs 16.7%; adjusted HR 1.78; p<0.001).

Implication

The presence of systemic inflammatory response syndrome (SIRS) at presentation or 24 hours is independently associated with worse 90-day clinical outcomes in patients with STEMI.

Original Research

APR 2013Al‐KhatibEuropean Heart Journal

Outcomes of apixaban vs. warfarin by type and duration of atrial fibrillation: results from the ARISTOTLE trial

Apixaban benefit consistent across AF types/durations; supports broad use but leaves open dedicated prospective confirmation in paroxysmal AF.

Apr 2013Open Access

Al‐KhatibEuropean Heart Journal

Outcomes of apixaban vs. warfarin by type and duration of atrial fibrillation: results from the ARISTOTLE trial

Implication

Apixaban benefit consistent across AF types/durations; supports broad use but leaves open dedicated prospective confirmation in paroxysmal AF.

Retrospective Study

APR 2013McMurrayCirculation Heart Failure

Apixaban reduced the risk of stroke, systemic embolism, or death compared with warfarin in patients with atrial fibrillation (HR 0.89; 95% CI 0.81-0.98; P=0.02), regardless of HF or LVSD status.

Background— We examined the risk of stroke or systemic embolism (SSE) conferred by heart failure (HF) and left ventricular systolic dysfunction (LVSD) in the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation Trial (ARISTOTLE), as well as the effect of apixaban versus warfarin. Methods and Results— The risk of a number of outcomes, including the composite of SSE or death (to take account of competing risks) and composite of SSE, major bleeding, or death (net clinical benefit) were calculated in 3 patient groups: (1) no HF/no LVSD (n=8728), (2) HF/no LVSD (n=3207), and (3) LVSD with/without symptomatic HF (n=2736). The rate of both outcomes was highest in patients with LVSD (SSE or death 8.06; SSE, major bleeding, or death 10.46 per 100 patient-years), intermediate for HF but preserved LV systolic function (5.32; 7.24), and lowest in patients without HF or LVSD (1.54; 5.27); each comparison P <0.0001. Each outcome was less frequent in patients treated with apixaban: in all ARISTOTLE patients, the apixaban/warfarin hazard ratio for SSE or death was 0.89 (95% confidence interval, 0.81–0.98; P =0.02); for SSE, major bleed, or death it was 0.85 (0.78–0.92; P <0.001). There was no heterogeneity of treatment effect across the 3 groups. Conclusions— Patients with LVSD (with/without HF) had a higher risk of SSE or death (but similar rate of SSE) compared with patients with HF but preserved LV systolic function; both had a greater risk than patients without either HF or LVSD. Apixaban reduced the risk of both outcomes more than warfarin in all 3 patient groups. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00412984.

Apr 2013Open Access

Level 4: Retrospective

McMurrayCirculation Heart Failure

Apixaban reduced the risk of stroke, systemic embolism, or death compared with warfarin in patients with atrial fibrillation (HR 0.89; 95% CI 0.81-0.98; P=0.02), regardless of HF or LVSD status.

RCT

AUG 2011GrangerNew England Journal of Medicine

Apixaban was superior to warfarin in preventing stroke or systemic embolism and caused less bleeding and lower mortality in patients with atrial fibrillation.

Apixaban preferred over warfarin in atrial fibrillation; reinforces consensus for NOAC first-line use with lower bleeding and mortality.

Aug 2011Open Access

GrangerNew England Journal of Medicine

Apixaban was superior to warfarin in preventing stroke or systemic embolism and caused less bleeding and lower mortality in patients with atrial fibrillation.

Implication

Apixaban preferred over warfarin in atrial fibrillation; reinforces consensus for NOAC first-line use with lower bleeding and mortality.

cohort · n=1,018

MAR 2008BrenerEuropean Heart Journal

TIMI myocardial perfusion grade (TMPG) 2/3 after PCI was significantly associated with lower 90-day mortality (adjusted hazard ratio 0.26, 95% CI 0.09-0.78, P = 0.013).

Successful myocardial perfusion (TMPG 2/3) after primary PCI for STEMI is predicted by younger age, patent infarct-related artery at presentation, and shorter ischemic time, and is associated with improved 90-day survival.

Mar 2008Open Access

Level 3: Cohort Study

BrenerEuropean Heart Journal

TIMI myocardial perfusion grade (TMPG) 2/3 after PCI was significantly associated with lower 90-day mortality (adjusted hazard ratio 0.26, 95% CI 0.09-0.78, P = 0.013).

Implication

cohort · n=10,954

MAR 2008EagleEuropean Heart Journal

From 1999 to 2006, primary PCI use increased from 15% to 44% (P < 0.001) and hospital mortality declined from 6.9% to 5.4% (P < 0.01), though 33% of patients still received no reperfusion therapy.

STEMI mortality fell alongside rising primary PCI use; associated with temporal trends but leaves open whether closing the 33% reperfusion gap would yield further gains.

Mar 2008Open Access

Level 3: Cohort Study

EagleEuropean Heart Journal

From 1999 to 2006, primary PCI use increased from 15% to 44% (P < 0.001) and hospital mortality declined from 6.9% to 5.4% (P < 0.01), though 33% of patients still received no reperfusion therapy.

Implication

STEMI mortality fell alongside rising primary PCI use; associated with temporal trends but leaves open whether closing the 33% reperfusion gap would yield further gains.

All publications →

About

Christopher B. Granger works in General Cardiology affiliated with Clinical Research Institute.

Research focus

Atrial Fibrillation Management and OutcomesAcute Myocardial Infarction ReperfusionStroke Prevention in Atrial FibrillationCoronary Artery Disease PreventionCardiovascular Risk Prediction

Impact

64 pubs · 11,971 cites · h-index 24

Training

MD
University of Connecticut School of Medicine
1984
Residency in Internal Medicine
University of Colorado
1987
Fellowship in Cardiovascular Disease
Duke University Hospital
1990

Publications

Robert Giugliano

Cardiovascular physician, Brigham and Women's Hospital · Brigham and Women's Hospital

3mo

We felt we had a public service obligation here. We didn't want the wider community to just be leaving elderly patients on a vitamin K antagonist when we think we have a better alternative. At a minimum, doctors should be having the discussion with elderly patients who are frail and say, 'Look, there is a new class of drugs available. Here are the advantages. Here are the disadvantages. They are more costly. And so let's think about what's best for you.'

Outcomes in Older Patients After Switching to a Newer Anticoagulant or Remaining on Warfarin

Journal of the American College of CardiologyNicolau et al.Aug 2025

cohort · n=45,947

JUN 29GoudaJACC Advances

Inappropriate low-dose apixaban linked to ~77% higher mortality versus appropriate full-dose apixaban.

Inappropriate reduced-dose apixaban was associated with higher mortality; leaves open whether stricter adherence to labeling criteria improves outcomes.

19w agoOpen Access

Level 3: Cohort Study

GoudaJACC Advances

Inappropriate low-dose apixaban linked to ~77% higher mortality versus appropriate full-dose apixaban.

Implication

Inappropriate reduced-dose apixaban was associated with higher mortality; leaves open whether stricter adherence to labeling criteria improves outcomes.

meta-analysis

JUL 1SaidJACC Advances

DOACs significantly reduced net clinical outcomes compared to VKAs in high-risk AF patients (HR 0.86; 95% CI 0.81-0.92; P<0.001), but not in low-risk patients (HR 0.93; 95% CI 0.85-1.03; P=0.154).

Renal function, age, and BMI are key predictors of DOAC treatment benefit in AF, suggesting lower-risk patients may derive similar outcomes with VKAs in resource-constrained settings.

18w agoOpen Access

Level 1: Meta-Analysis

SaidJACC Advances

DOACs significantly reduced net clinical outcomes compared to VKAs in high-risk AF patients (HR 0.86; 95% CI 0.81-0.92; P<0.001), but not in low-risk patients (HR 0.93; 95% CI 0.85-1.03; P=0.154).

Implication

Renal function, age, and BMI are key predictors of DOAC treatment benefit in AF, suggesting lower-risk patients may derive similar outcomes with VKAs in resource-constrained settings.

meta-analysis · n=58,634

JUL 1SaidJACC Advances

Standard-dose DOACs reduced the net clinical outcome compared to warfarin across all risk strata, with a modest absolute benefit of 0.3% (95% CI: 0.1%-0.6%) in low-risk patients.

SD-DOACs reduce net clinical events vs warfarin across AF risk strata; extends RCT evidence for broad preference while supporting warfarin in lowest-risk patients with limited DOAC access.

18w agoOpen Access

Level 1: Meta-Analysis

SaidJACC Advances

Standard-dose DOACs reduced the net clinical outcome compared to warfarin across all risk strata, with a modest absolute benefit of 0.3% (95% CI: 0.1%-0.6%) in low-risk patients.

Implication

SD-DOACs reduce net clinical events vs warfarin across AF risk strata; extends RCT evidence for broad preference while supporting warfarin in lowest-risk patients with limited DOAC access.

Cohort Study8 mentionsJACC Highlight

MAR 2025WallentinJournal of the American College of Cardiology

Biomarker-based ABC-AF-stroke score outperforms CHA2DS2-VASc in predicting stroke or systemic embolism.

ABC-AF-stroke may refine AF risk stratification; leaves open routine adoption pending randomized validation.

Mar 2025

JACC Highlight

Level 3: Cohort Study

WallentinJournal of the American College of Cardiology

Biomarker-based ABC-AF-stroke score outperforms CHA2DS2-VASc in predicting stroke or systemic embolism.

Implication

ABC-AF-stroke may refine AF risk stratification; leaves open routine adoption pending randomized validation.

review

SEP 2025PundiJAMA Cardiology

Expert consensus prioritizes real-world data and the consumer-to-patient journey for postmarket wearable evaluation.

This paper provides a conceptual framework for the postmarket evaluation of consumer wearable technologies, highlighting the need to study their downstream clinical and societal impacts.

Sep 2025Open Access

Level 5: Literature Review

PundiJAMA Cardiology

Expert consensus prioritizes real-world data and the consumer-to-patient journey for postmarket wearable evaluation.

Implication

This paper provides a conceptual framework for the postmarket evaluation of consumer wearable technologies, highlighting the need to study their downstream clinical and societal impacts.

RCT

MAR 2025FudimJACC Advances

Appropriately reduced dose apixaban was associated with a lower risk of bleeding and similar rates of ischemic outcomes compared with VKA; similar results were found with standard dose apixaban.

Supports preferring apixaban over VKA for lower bleeding with similar ischemia in AF post-ACS/PCI; challenges prior low-certainty evidence against benefit.

Mar 2025Open Access

Level 2: RCT

FudimJACC Advances

Appropriately reduced dose apixaban was associated with a lower risk of bleeding and similar rates of ischemic outcomes compared with VKA; similar results were found with standard dose apixaban.

Implication

Supports preferring apixaban over VKA for lower bleeding with similar ischemia in AF post-ACS/PCI; challenges prior low-certainty evidence against benefit.

Meta-Analysis

FEB 2025HuaStatistics in Medicine

Network Meta‐Analysis With Individual Participant‐Level Data of Time‐to‐Event Outcomes Using Cox Regression

Feb 2025Open Access

Level 1: Meta-Analysis

HuaStatistics in Medicine

Network Meta‐Analysis With Individual Participant‐Level Data of Time‐to‐Event Outcomes Using Cox Regression

meta-analysis · n=6,546

SEP 2024SchnabelEuropean Heart Journal

Anticoagulation shows greater potential CV benefit in device-detected AF with vascular disease.

Anticoagulation may reduce events more in DDAF with vascular disease than without; extends risk stratification for shared decisions in device-detected AF.

Sep 2024Open Access

SchnabelEuropean Heart Journal

Anticoagulation shows greater potential CV benefit in device-detected AF with vascular disease.

Implication

Anticoagulation may reduce events more in DDAF with vascular disease than without; extends risk stratification for shared decisions in device-detected AF.

cohort · n=20,364

AUG 2024CurtainJAMA Cardiology

Sudden death/RCA occurred in 2.6% of the contemporary PARADISE-MI cohort compared to 7.4% in the historical PARADISE-MI-like VALIANT cohort, with first-month rates of 9.5 (95% CI, 7.0-12.7) vs 19.3 (95% CI, 16.4-22.6) per 100 person-years, respectively.

First-month risk after high-risk AMI remains a clinical priority; leaves open dedicated trials of early sudden-death prevention.

Aug 2024Open Access

Level 3: Cohort Study

CurtainJAMA Cardiology

Sudden death/RCA occurred in 2.6% of the contemporary PARADISE-MI cohort compared to 7.4% in the historical PARADISE-MI-like VALIANT cohort, with first-month rates of 9.5 (95% CI, 7.0-12.7) vs 19.3 (95% CI, 16.4-22.6) per 100 person-years, respectively.

Implication

First-month risk after high-risk AMI remains a clinical priority; leaves open dedicated trials of early sudden-death prevention.

Original Research

AUG 2024SuleimanAnnals of Internal Medicine

In MI with preserved LVEF, long-term β-blocker use vs. no use did not reduce all-cause death or MI at 3.5 y

Yndigegn T, Lindahl B, Mars K, et al; REDUCE-AMI Investigators.

Aug 2024

SuleimanAnnals of Internal Medicine

In MI with preserved LVEF, long-term β-blocker use vs. no use did not reduce all-cause death or MI at 3.5 y

Yndigegn T, Lindahl B, Mars K, et al; REDUCE-AMI Investigators.

cohort · n=18,201

JUN 2015AvezumCirculation

Apixaban showed no differential effect over warfarin in reducing stroke or systemic embolism in patients with versus without valvular heart disease (interaction P=0.38).

Apixaban may suit AF patients with moderate/severe valvular disease; extends ARISTOTLE findings but hypothesis-generating.

Jun 2015Open Access

Level 3: Cohort Study

AvezumCirculation

Apixaban showed no differential effect over warfarin in reducing stroke or systemic embolism in patients with versus without valvular heart disease (interaction P=0.38).

Implication

Apixaban may suit AF patients with moderate/severe valvular disease; extends ARISTOTLE findings but hypothesis-generating.

Cohort Study

MAR 2015RogerAmerican Journal of Epidemiology

Strategic Transformation of Population Studies: Recommendations of the Working Group on Epidemiology and Population Sciences From the National Heart, Lung, and Blood Advisory Council and Board of External Experts

Mar 2015Open Access

Level 3: Cohort Study

RogerAmerican Journal of Epidemiology

Strategic Transformation of Population Studies: Recommendations of the Working Group on Epidemiology and Population Sciences From the National Heart, Lung, and Blood Advisory Council and Board of External Experts

Cohort Study

JAN 2014CalvoEuropean Heart Journal

Large streamlined trials in cardiovascular disease

Jan 2014

Level 3: Cohort Study

CalvoEuropean Heart Journal

Large streamlined trials in cardiovascular disease

cohort · n=1,903

JUN 2013DiepenCritical Care Medicine

Systemic inflammatory response syndrome at presentation in STEMI patients was associated with increased 90-day death, shock, heart failure, or stroke (31.0% vs 16.7%; adjusted HR 1.78; p<0.001).

The presence of systemic inflammatory response syndrome (SIRS) at presentation or 24 hours is independently associated with worse 90-day clinical outcomes in patients with STEMI.

Jun 2013

Level 3: Cohort Study

DiepenCritical Care Medicine

Systemic inflammatory response syndrome at presentation in STEMI patients was associated with increased 90-day death, shock, heart failure, or stroke (31.0% vs 16.7%; adjusted HR 1.78; p<0.001).

Implication

The presence of systemic inflammatory response syndrome (SIRS) at presentation or 24 hours is independently associated with worse 90-day clinical outcomes in patients with STEMI.

Original Research

APR 2013Al‐KhatibEuropean Heart Journal

Outcomes of apixaban vs. warfarin by type and duration of atrial fibrillation: results from the ARISTOTLE trial

Apixaban benefit consistent across AF types/durations; supports broad use but leaves open dedicated prospective confirmation in paroxysmal AF.

Apr 2013Open Access

Al‐KhatibEuropean Heart Journal

Outcomes of apixaban vs. warfarin by type and duration of atrial fibrillation: results from the ARISTOTLE trial

Implication

Apixaban benefit consistent across AF types/durations; supports broad use but leaves open dedicated prospective confirmation in paroxysmal AF.

Retrospective Study

APR 2013McMurrayCirculation Heart Failure

Apixaban reduced the risk of stroke, systemic embolism, or death compared with warfarin in patients with atrial fibrillation (HR 0.89; 95% CI 0.81-0.98; P=0.02), regardless of HF or LVSD status.

Apr 2013Open Access

Level 4: Retrospective

McMurrayCirculation Heart Failure

Apixaban reduced the risk of stroke, systemic embolism, or death compared with warfarin in patients with atrial fibrillation (HR 0.89; 95% CI 0.81-0.98; P=0.02), regardless of HF or LVSD status.

RCT

AUG 2011GrangerNew England Journal of Medicine

Apixaban was superior to warfarin in preventing stroke or systemic embolism and caused less bleeding and lower mortality in patients with atrial fibrillation.

Apixaban preferred over warfarin in atrial fibrillation; reinforces consensus for NOAC first-line use with lower bleeding and mortality.

Aug 2011Open Access

GrangerNew England Journal of Medicine

Apixaban was superior to warfarin in preventing stroke or systemic embolism and caused less bleeding and lower mortality in patients with atrial fibrillation.

Implication

Apixaban preferred over warfarin in atrial fibrillation; reinforces consensus for NOAC first-line use with lower bleeding and mortality.

cohort · n=1,018

MAR 2008BrenerEuropean Heart Journal

TIMI myocardial perfusion grade (TMPG) 2/3 after PCI was significantly associated with lower 90-day mortality (adjusted hazard ratio 0.26, 95% CI 0.09-0.78, P = 0.013).

Mar 2008Open Access

Level 3: Cohort Study

BrenerEuropean Heart Journal

TIMI myocardial perfusion grade (TMPG) 2/3 after PCI was significantly associated with lower 90-day mortality (adjusted hazard ratio 0.26, 95% CI 0.09-0.78, P = 0.013).

Implication

cohort · n=10,954

MAR 2008EagleEuropean Heart Journal

From 1999 to 2006, primary PCI use increased from 15% to 44% (P < 0.001) and hospital mortality declined from 6.9% to 5.4% (P < 0.01), though 33% of patients still received no reperfusion therapy.

STEMI mortality fell alongside rising primary PCI use; associated with temporal trends but leaves open whether closing the 33% reperfusion gap would yield further gains.

Mar 2008Open Access

Level 3: Cohort Study

EagleEuropean Heart Journal

From 1999 to 2006, primary PCI use increased from 15% to 44% (P < 0.001) and hospital mortality declined from 6.9% to 5.4% (P < 0.01), though 33% of patients still received no reperfusion therapy.

Implication

STEMI mortality fell alongside rising primary PCI use; associated with temporal trends but leaves open whether closing the 33% reperfusion gap would yield further gains.