2019
Pioglitazone Therapy in Patients With Stroke and Prediabetes
Spence JD, Viscoli CM, Inzucchi SE, Dearborn-Tomazos J, Ford GA, Gorman M, Furie KL, Lovejoy AM, Young LH, Kernan WN. Pioglitazone Therapy in Patients With Stroke and Prediabetes. JAMA Neurology 2019, 76: 526-535. PMID: 30734043, PMCID: PMC6515584, DOI: 10.1001/jamaneurol.2019.0079.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAgedDiabetes Mellitus, Type 2Disease ProgressionFemaleGlycated HemoglobinHeart FailureHospitalizationHumansHypoglycemic AgentsInsulin ResistanceMaleMedication AdherenceMiddle AgedMyocardial InfarctionPioglitazonePrediabetic StateProportional Hazards ModelsRecurrenceSecondary PreventionStrokeConceptsAcute coronary syndromeStroke/myocardial infarctionTransient ischemic attackMyocardial infarctionCoronary syndromeHeart failureIRIS trialInsulin resistanceGood adherenceIschemic attackRecurrent strokeHazard ratioClinical trialsStroke/transient ischemic attackRandomized multicenter clinical trialAmerican Diabetes Association criteriaInsulin Resistance InterventionHemoglobin A1c levelsEffect of pioglitazoneInsulin-sensitizing agentsMulticenter clinical trialPlasma glucose levelsSerious bone fracturesPlacebo cohortPrior stroke
2018
Scoring System to Optimize Pioglitazone Therapy After Stroke Based on Fracture Risk
Viscoli CM, Kent DM, Conwit R, Dearborn JL, Furie KL, Gorman M, Guarino PD, Inzucchi SE, Stuart A, Young LH, Kernan WN, Investigators F. Scoring System to Optimize Pioglitazone Therapy After Stroke Based on Fracture Risk. Stroke 2018, 50: 95-100. PMID: 30580725, PMCID: PMC6557695, DOI: 10.1161/strokeaha.118.022745.Peer-Reviewed Original ResearchTransient ischemic attackAbsolute risk differenceFracture riskIschemic attackPioglitazone therapyFracture risk modelsIschemic strokeMyocardial infarctionRisk strataRisk differenceRandomized placebo-controlled trialFavorable benefit-risk profilePlacebo-controlled trialLow-risk patientsEffect of pioglitazoneBody mass indexHigh-risk groupBenefit-risk profileHigh-risk stratumLow-risk groupSimple point scoreBone fracture riskCardiovascular riskPatient characteristicsDiabetes mellitusMetabolic syndrome identifies normal weight insulin-resistant stroke patients at risk for recurrent vascular disease
Dearborn JL, Viscoli CM, Inzucchi SE, Young LH, Kernan WN. Metabolic syndrome identifies normal weight insulin-resistant stroke patients at risk for recurrent vascular disease. International Journal Of Stroke 2018, 14: 639-645. PMID: 30507360, DOI: 10.1177/1747493018816425.Peer-Reviewed Original ResearchConceptsNormal weight patientsMetabolic syndromeMyocardial infarctionWeight patientsCause mortalityInsulin resistanceHigh riskInsulin Resistance InterventionRecent ischemic strokeRecurrent vascular diseaseNon-diabetic patientsTransient ischemic attackAdverse cardiovascular outcomesMajor comorbid conditionsIschemic attackCardiovascular outcomesObesity paradoxIschemic strokeNormal BMIObese patientsStroke populationBetter prognosisComorbid conditionsNormal weightStroke patientsHeart Failure After Ischemic Stroke or Transient Ischemic Attack in Insulin-Resistant Patients Without Diabetes Mellitus Treated With Pioglitazone
Young LH, Viscoli CM, Schwartz GG, Inzucchi SE, Curtis JP, Gorman MJ, Furie KL, Conwit R, Spatz E, Lovejoy A, Abbott JD, Jacoby DL, Kolansky DM, Ling FS, Pfau SE, Kernan WN. Heart Failure After Ischemic Stroke or Transient Ischemic Attack in Insulin-Resistant Patients Without Diabetes Mellitus Treated With Pioglitazone. Circulation 2018, 138: 1210-1220. PMID: 29934374, PMCID: PMC6202153, DOI: 10.1161/circulationaha.118.034763.Peer-Reviewed Original ResearchConceptsRisk of HFTransient ischemic attackEffect of pioglitazoneHF riskHeart failureInsulin-resistant patientsMyocardial infarctionIschemic attackCardiovascular benefitsIschemic strokeDiabetes mellitusInsulin resistanceHigher C-reactive proteinComposite of strokeHF risk scoreHigher HF riskDrug dose reductionHospitalized heart failureIncident myocardial infarctionLower mean doseC-reactive proteinBaseline patient featuresHF hospitalizationCardiovascular eventsPlacebo group
2017
Targeting Pioglitazone Hydrochloride Therapy After Stroke or Transient Ischemic Attack According to Pretreatment Risk for Stroke or Myocardial Infarction
Kernan WN, Viscoli CM, Dearborn JL, Kent DM, Conwit R, Fayad P, Furie KL, Gorman M, Guarino PD, Inzucchi SE, Stuart A, Young LH. Targeting Pioglitazone Hydrochloride Therapy After Stroke or Transient Ischemic Attack According to Pretreatment Risk for Stroke or Myocardial Infarction. JAMA Neurology 2017, 74: 1319-1327. PMID: 28975241, PMCID: PMC5710663, DOI: 10.1001/jamaneurol.2017.2136.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIschemic attackMyocardial infarctionIschemic strokeHigh riskPioglitazone groupInsulin resistanceLower riskCox proportional hazards regression modelProportional hazards regression modelsMedian riskEfficacy of pioglitazoneInsulin Resistance InterventionQualifying ischemic strokePlacebo-controlled trialHazards regression modelsLow baseline riskType 2 diabetesGreater absolute benefitDay of entryFuture strokeHydrochloride therapyPlacebo groupHazard ratioSecondary preventionPioglitazone Prevents Stroke in Patients With a Recent Transient Ischemic Attack or Ischemic Stroke
Yaghi S, Furie KL, Viscoli CM, Kamel H, Gorman M, Dearborn J, Young LH, Inzucchi SE, Lovejoy AM, Kasner SE, Conwit R, Kernan WN. Pioglitazone Prevents Stroke in Patients With a Recent Transient Ischemic Attack or Ischemic Stroke. Circulation 2017, 137: 455-463. PMID: 29084736, DOI: 10.1161/circulationaha.117.030458.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIschemic strokeIschemic attackNondiabetic patientsStroke outcomeStroke eventsInsulin resistanceRecent transient ischemic attackCox proportional hazards modelQualifying ischemic strokeEffect of pioglitazoneFirst stroke eventProportional hazards modelPrevents strokeHemorrhagic eventsComposite outcomeSecondary preventionRecent strokeIRIS trialMyocardial infarctionTreatment groupsHazards modelPioglitazoneConsensus criteriaSurvival analysisSmoking cessation and outcome after ischemic stroke or TIA
Epstein KA, Viscoli CM, Spence JD, Young LH, Inzucchi SE, Gorman M, Gerstenhaber B, Guarino PD, Dixit A, Furie KL, Kernan WN, Bladin C, Davis S, Wijeratne T, Levi C, Parsons M, Brodtmann A, Ng S, Archer J, Delcourt C, Winder T, Berger L, Boulanger J, Chan R, Spence J, Durocher A, Mackey A, Verreault S, Minuk J, Penn A, Shuaib A, Cote R, Selchen D, Bayer N, Sweet M, Malik S, Stotts G, Griewing B, Soda H, Weinhardt R, Berrouschot J, Stoll A, Witte O, Günther A, Bodechtel U, Schminke U, Hobohm C, Hetzel A, Lambeck J, Wartenberg K, Huttner H, Dittrich R, Nabavi D, Gröschel K, Thomalla G, Rosenkranz M, Jander S, Meisel A, Ludolph A, Althaus K, Huber R, Lorenz M, Tanne D, Merzlyak O, Bornstein N, Telman G, Lampl Y, Streifler J, Weller B, Ifergane G, Wirgin Y, Carolei A, Toni D, Stanzione P, Micieli G, Agnelli G, Caso V, Gandolfo C, Comi G, Consoli D, Rasura M, Di Lazzaro V, Dixit A, Jupp B, Shaw L, Salih I, Esisi B, Power M, Strain W, Elyas S, Manawadu D, Kalra L, O'Brien E, Warburton E, Chatterjee K, Hargroves D, Blight A, Moynihan B, Markus H, Macleod M, Broughton D, Rodgers H, Hlaing T, Muir S, Sajid M, Bath P, Price C, Sekaran L, Vahidassr D, Muir K, McIlmoyle J, Datta P, Davey R, Langhorne P, Stott D, Datta P, England T, Muhidden K, O'Connell J, Majmudar N, Schindler J, Clark W, Sethi P, Rordorf G, Kleindorfer D, Silliman S, Gorman M, Kelly M, Singleton L, Meyer B, Jackson C, Walker J, Ehtisham A, Goodpasture H, Wang D, Fayad P, Cordina S, Naritoku D, Chiu D, Lukovits T, Goddeau R, Clark‐Arbogast R, Leigh R, Wityk R, Pettigrew L, Tayal A, Jarouse J, Friday G, Sen S, Kim A, Johnston S, Elkins J, Barrett A, Leira E, Kelly A, Burgin S, Rempe D, Jacoby M, Hughes D, Majersik J, Skalabrin E, Lee J, Hsu C, Sundararajan S, Slivka A, Minagar A, Alicic R, Geraghty M, Kase C, Lansberg M, Albers G, Dietrich D, Hanna J, Gentile N, Santiago F, Katzan I, Ching M, Sawyer, Warwick T, Yilmaz E, Pedelty L, Schneck M, Coull B, Solenski N, Johnston K, Lee V, Prabhakaran S, Johnson M, Silverman I, Salgado M, Birkhahn R, Strawsburg R, Altafullah I, Cohen D, Zweifler R, Lee Kwen P, Hammer M, Vora N, Tietjen G, Albakri E, Dandapani B, Jickling G, Verro P, Roller M, Hughes R, Simpson J, Vidic T, Lash S, Sigsbee B, Rosenbaum D, Fonzetti P, Fleck J, Goldszmidt A, Alexandrov A, Halsey J, Hart R, Sattin J, Kumar S, Book D, Torbey M, Poock J, King M, Graham G, Sung G, Mirsen T, Dromerick A, Runheim A, Jackson C, Feen E, Reichwein R, Waters M, Amory C, Bernardini G, Bell R, Diamond B, Rosenbaum D, Palestrant D, Segal A, Burger K, Schwartz R, Mitsias P, Kramer J, Kramer J, Robbins D, Silver B, Easton J, Feldmann E, Rymer M, Dorssom J, Ali L, Ovbiagele B, Kirshner H. Smoking cessation and outcome after ischemic stroke or TIA. Neurology 2017, 89: 1723-1729. PMID: 28887378, PMCID: PMC5644463, DOI: 10.1212/wnl.0000000000004524.Peer-Reviewed Original ResearchConceptsMyocardial infarctionIschemic strokeIndex eventProspective observational cohort studyInsulin Resistance InterventionHistory of hypertensionObservational cohort studyDiastolic blood pressureHistory of strokeCoronary artery diseaseTime of randomizationTobacco use historySignificant health benefitsRecurrent strokeNondiabetic menCohort studyCurrent smokersTrial cohortArtery diseaseBlood pressurePrimary outcomeIRIS trialStroke trialsCigarette smokingSmoking cessationCardiac Outcomes After Ischemic Stroke or Transient Ischemic Attack
Young LH, Viscoli CM, Curtis JP, Inzucchi SE, Schwartz GG, Lovejoy AM, Furie KL, Gorman MJ, Conwit R, Abbott JD, Jacoby DL, Kolansky DM, Pfau SE, Ling FS, Kernan WN. Cardiac Outcomes After Ischemic Stroke or Transient Ischemic Attack. Circulation 2017, 135: 1882-1893. PMID: 28246237, PMCID: PMC5511545, DOI: 10.1161/circulationaha.116.024863.Peer-Reviewed Original ResearchConceptsAcute coronary syndromeType 1 myocardial infarctionTransient ischemic attackMyocardial infarctionCoronary syndromeInsulin resistanceIschemic attackIschemic strokeDiabetes mellitusSerum troponinAcute coronary syndrome episodeMean age 63 yearsAcute coronary syndrome eventIndependent clinical events committeeType 2 myocardial infarctionIRIS participantsImpact of pioglitazoneRecent cerebrovascular eventsRecent ischemic strokeClinical events committeeAge 63 yearsEffect of pioglitazoneSmall myocardial infarctionCoronary artery diseaseST-segment elevation
2016
Taking care of volunteers in a stroke trial: a new assisted-management strategy
Stuart AC, Sico JJ, Viscoli CM, Tayal AH, Inzucchi SE, Ford GA, Furie KL, Cote R, Spence JD, Tanne D, Kernan WN. Taking care of volunteers in a stroke trial: a new assisted-management strategy. Stroke And Vascular Neurology 2016, 1: 108. PMID: 28959471, PMCID: PMC5435205, DOI: 10.1136/svn-2016-000029.Peer-Reviewed Original ResearchMeSH KeywordsAgedAnticholesteremic AgentsAntihypertensive AgentsBiomarkersBlood CoagulationBlood PressureCholesterol, LDLDouble-Blind MethodEuropeFemaleFibrinolytic AgentsHumansHypoglycemic AgentsInsulin ResistanceIschemic Attack, TransientIschemic StrokeIsraelMaleMiddle AgedNorth AmericaPioglitazoneRecurrenceRisk AssessmentRisk FactorsRisk Reduction BehaviorSecondary PreventionTime FactorsTreatment OutcomeConceptsPersonal healthcare providerBlood pressureStroke trialsPreventive careTrial participantsLow-density lipoprotein cholesterolPrevention goalsInsulin Resistance InterventionTransient ischemic attackPrevention of strokeSecondary prevention goalsEvidence-based careProportion of participantsIschemic attackAntithrombotic therapyIschemic strokeLipoprotein cholesterolSecondary preventionAntithrombotic useStroke therapyInsulin sensitisersMyocardial infarctionAnnual visitsHealthcare providersResistance InterventionPioglitazone after Ischemic Stroke or Transient Ischemic Attack
Kernan WN, Viscoli CM, Furie KL, Young LH, Inzucchi SE, Gorman M, Guarino PD, Lovejoy AM, Peduzzi PN, Conwit R, Brass LM, Schwartz GG, Adams HP, Berger L, Carolei A, Clark W, Coull B, Ford GA, Kleindorfer D, O'Leary JR, Parsons MW, Ringleb P, Sen S, Spence JD, Tanne D, Wang D, Winder TR. Pioglitazone after Ischemic Stroke or Transient Ischemic Attack. New England Journal Of Medicine 2016, 374: 1321-1331. PMID: 26886418, PMCID: PMC4887756, DOI: 10.1056/nejmoa1506930.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIschemic strokeInsulin resistanceMyocardial infarctionIschemic attackPrimary outcomeRecent ischemic strokeDouble-blind trialFuture cardiovascular eventsHomeostasis model assessmentInsulin resistance indexRisk of strokeEligible patientsNonfatal strokePioglitazone groupCardiovascular eventsCause mortalityPlacebo groupPreventive therapyCerebrovascular diseaseInsulin sensitivityRisk factorsResistance indexHigh riskLower risk
2014
Pioglitazone for secondary prevention after ischemic stroke and transient ischemic attack: Rationale and design of the Insulin Resistance Intervention after Stroke Trial
Viscoli CM, Brass LM, Carolei A, Conwit R, Ford GA, Furie KL, Gorman M, Guarino PD, Inzucchi SE, Lovejoy AM, Parsons MW, Peduzzi PN, Ringleb PA, Schwartz GG, Spence JD, Tanne D, Young LH, Kernan WN, investigators I. Pioglitazone for secondary prevention after ischemic stroke and transient ischemic attack: Rationale and design of the Insulin Resistance Intervention after Stroke Trial. American Heart Journal 2014, 168: 823-829.e6. PMID: 25458644, PMCID: PMC4254508, DOI: 10.1016/j.ahj.2014.07.016.Peer-Reviewed Original ResearchMeSH KeywordsAdultCognition DisordersDose-Response Relationship, DrugDouble-Blind MethodFemaleHumansHypoglycemic AgentsInsulin ResistanceIschemic Attack, TransientMaleMiddle AgedMyocardial InfarctionPatient Outcome AssessmentPioglitazoneRisk AssessmentRisk FactorsSecondary PreventionStrokeSurvival AnalysisThiazolidinedionesConceptsTransient ischemic attackMyocardial infarctionIschemic attackVascular eventsIschemic strokeSecondary preventionIRIS trialInsulin resistanceHomeostasis model assessment-insulin resistanceModel assessment-insulin resistanceEffectiveness of pioglitazoneInsulin Resistance InterventionRecent ischemic strokeRecurrent vascular eventsAssessment-insulin resistanceIschemic vascular eventsAcute coronary syndromeInsulin-resistant patientsInsulin-sensitizing drugsEligible patientsIndex strokeNondiabetic patientsCardiovascular outcomesCause mortalityCoronary syndrome
2003
Impaired insulin sensitivity among nondiabetic patients with a recent TIA or ischemic stroke
Kernan WN, Inzucchi SE, Viscoli CM, Brass LM, Bravata DM, Shulman GI, McVeety JC, Horwitz RI. Impaired insulin sensitivity among nondiabetic patients with a recent TIA or ischemic stroke. Neurology 2003, 60: 1447-1451. PMID: 12743229, DOI: 10.1212/01.wnl.0000063318.66140.a3.Peer-Reviewed Original ResearchConceptsImpaired insulin sensitivityIschemic strokeInsulin sensitivityRecent TIANondiabetic patientsMyocardial infarctionComposite insulin sensitivity indexInsulin sensitivity index valuesOral glucose tolerance testAge 45 yearsGlucose tolerance testInsulin sensitivity indexImportant therapeutic implicationsEligible patientsNondiabetic menStroke etiologyEligible subjectsMedian ageYounger patientsTolerance testHeart diseaseTherapeutic implicationsPatientsGlucose valuesStroke
1997
Functional recovery after myocardial infarction in men: the independent effects of social class.
Ickovics JR, Viscoli CM, Horwitz RI. Functional recovery after myocardial infarction in men: the independent effects of social class. Annals Of Internal Medicine 1997, 127: 518-25. PMID: 9313019, DOI: 10.7326/0003-4819-127-7-199710010-00003.Peer-Reviewed Original ResearchConceptsBeta-Blocker Heart Attack TrialHeart Attack TrialMyocardial infarctionFunctional recoveryAttack TrialNew York Heart Association functional classPsychosocial factorsYork Heart Association functional classFunctional status 1 yearDouble-blind clinical trialCardiovascular-related illnessesPertinent prognostic factorsAcute myocardial infarctionIndependent effectsYears of agePrimary outcomePrognostic factorsClinical outcomesFunctional statusProspective dataClinical trialsInfarctionHigher social classMen 29Baseline assessment
1993
Beta-blockers after myocardial infarction: influence of first-year clinical course on long-term effectiveness.
Viscoli CM, Horwitz RI, Singer BH. Beta-blockers after myocardial infarction: influence of first-year clinical course on long-term effectiveness. Annals Of Internal Medicine 1993, 118: 99-105. PMID: 8416325, DOI: 10.7326/0003-4819-118-2-199301150-00004.Peer-Reviewed Original ResearchConceptsBeta-blocker therapyClinical courseVital statusMyocardial infarctionLong-term beneficial effectsPlacebo-controlled trialRecurrent ischemic eventsInitiation of therapyCongestive heart failureHeart Attack TrialLong-term therapeutic benefitHeterogeneous clinical courseYears of ageLong-term effectivenessEligible patientsSevere comorbiditiesBeta blockersIschemic eventsHeart failureTrial entryAttack TrialClinical centersSubsequent riskWomen 30High risk
1990
Treatment adherence and risk of death after a myocardial infarction
Horwitz RI, Viscoli CM, Donaldson R, Murray C, Ransohoff D, Horwitz R, Berkman L, Horwitz S, Ransohoff D, Sindelar J. Treatment adherence and risk of death after a myocardial infarction. The Lancet 1990, 336: 542-545. PMID: 1975045, DOI: 10.1016/0140-6736(90)92095-y.Peer-Reviewed Original ResearchConceptsRisk of deathTreatment adherenceMyocardial infarctionPoor adherersBeta-Blocker Heart Attack TrialPost-infarction mortalityHeart Attack TrialGood adherersTreatment regimenAttack TrialClinical severitySociodemographic featuresInfarctionAdherersAdherenceDeathMortalityRiskSeverityPlaceboRegimenSmokingPatientsPropranololTrialsDifferences between women and men in survival after myocardial infarction. Biology or methodology?
Fiebach NH, Viscoli CM, Horwitz RI. Differences between women and men in survival after myocardial infarction. Biology or methodology? JAMA 1990, 263: 1092-6. PMID: 2299781, DOI: 10.1001/jama.263.8.1092.Peer-Reviewed Original ResearchConceptsMyocardial infarctionMortality rateHospital survivorsRisk factorsPrevious heart failureHospital mortality rateRetrospective cohort studyIndependent risk factorObserved mortality rateHospital deathCohort studyMultivariate adjustmentHeart failureVentricular functionBaseline differencesSubsequent mortalityInfarctionMortalityWomenMenImpact of genderSurvivorsSurvivalHypertensionGender