Featured Publications
Clinical characteristics and prognosis of patients with microvascular angina: an international and prospective cohort study by the Coronary Vasomotor Disorders International Study (COVADIS) Group
Shimokawa H, Suda A, Takahashi J, Berry C, Camici PG, Crea F, Escaned J, Ford T, Yii E, Kaski JC, Kiyooka T, Mehta PK, Ong P, Ozaki Y, Pepine C, Rimoldi O, Safdar B, Sechtem U, Tsujita K, Yasuda S, Beltrame JF, Merz CNB, Group O. Clinical characteristics and prognosis of patients with microvascular angina: an international and prospective cohort study by the Coronary Vasomotor Disorders International Study (COVADIS) Group. European Heart Journal 2021, 42: 4592-4600. PMID: 34038937, PMCID: PMC8633728, DOI: 10.1093/eurheartj/ehab282.Peer-Reviewed Original ResearchConceptsMajor cardiovascular eventsCoronary artery diseaseMicrovascular anginaPrognosis of patientsInternational Study GroupClinical characteristicsStudy groupPrevious historyMultivariable Cox proportional hazards analysisNon-fatal myocardial infarctionCox proportional hazards analysisSeattle Angina Questionnaire scoresNon-fatal strokeAcute coronary syndromeProspective cohort studyStable angina pectorisProportional hazards analysisImportant health problemComparable prognosisCardiovascular deathCardiovascular eventsCoronary syndromePrimary endpointCohort studyUnstable anginaElevated renalase levels in patients with acute coronary microvascular dysfunction – A possible biomarker for ischemia
Safdar B, Guo X, Johnson C, D'Onofrio G, Dziura J, Sinusas AJ, Testani J, Rao V, Desir G. Elevated renalase levels in patients with acute coronary microvascular dysfunction – A possible biomarker for ischemia. International Journal Of Cardiology 2019, 279: 155-161. PMID: 30630613, PMCID: PMC6482834, DOI: 10.1016/j.ijcard.2018.12.061.Peer-Reviewed Original ResearchConceptsCoronary microvascular dysfunctionFramingham risk scorePET/CTChest painInflammatory markersMicrovascular dysfunctionEmergency departmentRisk scoreRb-82 PET/CTElevated renalase levelsAcute chest painCoronary artery diseaseC-reactive proteinVascular endothelial growth factorAnti-inflammatory proteinTumor necrosis factorEndothelial growth factorAngina historyCMD diagnosisRenalase levelsHypertensive crisisED presentationsHemodynamic instabilityArtery diseaseHeart failurePrevalence and characteristics of coronary microvascular dysfunction among chest pain patients in the emergency department
Safdar B, D’Onofrio G, Dziura J, Russell RR, Johnson C, Sinusas AJ. Prevalence and characteristics of coronary microvascular dysfunction among chest pain patients in the emergency department. European Heart Journal Acute Cardiovascular Care 2018, 9: 5-13. PMID: 29543037, DOI: 10.1177/2048872618764418.Peer-Reviewed Original ResearchConceptsCoronary microvascular dysfunctionCoronary artery diseaseCardiac positron emission tomography/Positron emission tomography/Chest pain patientsArtery diseaseAcute myocardial infarctionEmission tomography/Chest painMyocardial infarctionMicrovascular dysfunctionPain patientsEmergency departmentTomography/General emergency department populationLower coronary flow reserveNon-obstructive coronary arteriesPrior emergency department visitsTraditional cardiac risk factorsCardiac risk factorsModerate-risk patientsEmergency department visitsEmergency department patientsCoronary flow reserveEmergency department population
2024
Sex differences in proteomics of cardiovascular disease: results from the Yale-CMD registry
Liu Y, Wang Z, Collins S, Testani J, Kleinstein S, Safdar B. Sex differences in proteomics of cardiovascular disease: results from the Yale-CMD registry. European Heart Journal 2024, 45: ehae666.3091. DOI: 10.1093/eurheartj/ehae666.3091.Peer-Reviewed Original ResearchCoronary microvascular dysfunctionCoronary artery diseaseUpregulation of lipidCardiovascular diseaseAcute heart failureCoronary artery disease cohortHistory of diabetesPathophysiology of CVDProximity extension assayBody mass indexSignificant sex differencesRegulation of blood flowSerum proteomic profilesSex differencesProteomic profilingAngiogenesis-related proteinsCardiac PET/CTHemodynamic instabilityIschemic symptomsMicrovascular dysfunctionFalse discovery rateHeart failureFebrile illnessFunctional pathway analysisMass index
2021
Mild cognitive impairment in middle-aged adults with coronary microvascular dysfunction
Nowroozpoor A, Sharp E, Gordon R, Malicki C, Hwang U, Dziura J, D'Onofrio' G, Safdar B. Mild cognitive impairment in middle-aged adults with coronary microvascular dysfunction. European Heart Journal 2021, 42: ehab724.2744. DOI: 10.1093/eurheartj/ehab724.2744.Peer-Reviewed Original ResearchCoronary microvascular dysfunctionCoronary flow reservePerfusion defectsCognitive impairmentMean ageCMD patientsCardiac positron emission tomography/Chest pain observation unitPositron emission tomography/Coronary artery diseaseSmall vessel diseaseEmission tomography/Montreal Cognitive AssessmentChest discomfortHypertensive urgencyMicrovascular dysfunctionArtery diseaseHeart failureVessel diseaseMyocardial infarctionTomography/Odds ratioFlow reserveNormal groupYears of educationUse of peripheral arterial tonometry in detection of abnormal coronary flow reserve
Gaeta M, Nowroozpoor A, Dziura J, D'Onofrio G, Sinusas AJ, Safdar B. Use of peripheral arterial tonometry in detection of abnormal coronary flow reserve. Microvascular Research 2021, 138: 104223. PMID: 34256085, PMCID: PMC10227886, DOI: 10.1016/j.mvr.2021.104223.Peer-Reviewed Original ResearchConceptsLower coronary flow reserveCoronary flow reserveCoronary microvascular dysfunctionCoronary artery diseaseClinical screening toolPET/CTFlow reserveRubidium-82 positron emission tomography/Large vessel coronary artery diseaseNormal coronary flow reserveTraditional CAD risk factorsVessel coronary artery diseaseAbnormal coronary flow reservePositron emission tomography/Screening toolPeripheral arterial tonometryCAD risk factorsEmission tomography/Presence of calcificationLower RHIHyperemia indexArterial tonometryMicrovascular dysfunctionArtery diseaseAugmentation index
2020
International prospective cohort study of microvascular angina – Rationale and design
Suda A, Takahashi J, Beltrame JF, Berry C, Camici PG, Crea F, Escaned J, Ford T, Kaski J, Kiyooka T, Metha PK, Ong P, Ozaki Y, Pepine C, Rimoldi O, Safdar B, Sechtem U, Tsujita K, Yii E, Merz C, Shimokawa H, Group O. International prospective cohort study of microvascular angina – Rationale and design. IJC Heart & Vasculature 2020, 31: 100630. PMID: 32984497, PMCID: PMC7494778, DOI: 10.1016/j.ijcha.2020.100630.Peer-Reviewed Original ResearchCoronary artery diseaseLong-term prognosisCoronary microvascular dysfunctionMajor cardiovascular eventsMicrovascular anginaClinical characteristicsMyocardial ischemiaMicrovascular dysfunctionMVA patientsDiagnostic criteriaNon-obstructive coronary artery diseaseNon-fatal myocardial infarctionObstructive coronary artery diseaseInternational prospective cohort studyCoronary functional abnormalitiesProspective registry studyNon-fatal strokeProspective cohort studyCardiovascular deathCardiovascular eventsPrimary endpointCohort studyRegistry studyUnstable anginaArtery disease
2017
Ranolazine and Microvascular Angina by PET in the Emergency Department: Results From a Pilot Randomized Controlled Trial
Safdar B, D’Onofrio G, Dziura J, Russell RR, Johnson C, Sinusas AJ. Ranolazine and Microvascular Angina by PET in the Emergency Department: Results From a Pilot Randomized Controlled Trial. Clinical Therapeutics 2017, 39: 55-63. PMID: 28081848, PMCID: PMC10345862, DOI: 10.1016/j.clinthera.2016.12.002.Peer-Reviewed Original ResearchConceptsCoronary microvascular dysfunctionCoronary flow reserveCoronary artery diseaseChest painSymptomatic patientsArtery diseasePrimary outcomeEmergency departmentNonobstructive coronary artery diseaseRb-82 positron emission tomographyEffect of ranolazineRate-pressure productEmergency department patientsQTc-prolonging drugsRobust clinical trialsPositron emission tomographyHypertensive urgencyMicrovascular anginaMicrovascular dysfunctionUnderdiagnosed causeControlled TrialsDepartment patientsHeart failureAcute symptomsPressure product
2016
Women and Chest Pain: Recognizing the Different Faces of Angina in the Emergency Department.
Safdar B, D'Onofrio G. Women and Chest Pain: Recognizing the Different Faces of Angina in the Emergency Department. The Yale Journal Of Biology And Medicine 2016, 89: 227-38. PMID: 27354848, PMCID: PMC4918863.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseAcute coronary syndromeChest painEmergency departmentMicrovascular dysfunctionED patientsCoronary artery endothelial dysfunctionCause of anginaCoronary artery dissectionCoronary artery spasmPersistent chest painRecurrent chest painSex-specific causesQuality of lifeArtery spasmArtery dissectionCoronary syndromeEndothelial dysfunctionMyocardial bridgingArtery diseasePoor functionCardinal symptomsAnginaPainPatientsMICROVASCULAR ANGINA IN THE ABSENCE OF CORONARY ARTERY DISEASE IS COMMON IN UNDIFFERENTIATED CHEST PAIN PATIENTS IN THE EMERGENCY DEPARTMENT
Safdar B, D’Onofrio G, Dziura J, Russell R, Naftilan M, Johnson C, Sinusas A. MICROVASCULAR ANGINA IN THE ABSENCE OF CORONARY ARTERY DISEASE IS COMMON IN UNDIFFERENTIATED CHEST PAIN PATIENTS IN THE EMERGENCY DEPARTMENT. Journal Of The American College Of Cardiology 2016, 67: 1824. DOI: 10.1016/s0735-1097(16)31825-3.Peer-Reviewed Original ResearchMicrovascular Dysfunction as Opposed to Conduit Artery Disease Explains Sex-specific Chest Pain in Emergency Department Patients With Low to Moderate Cardiac Risk
Safdar B, Ali A, D’Onofrio G, Katz SD. Microvascular Dysfunction as Opposed to Conduit Artery Disease Explains Sex-specific Chest Pain in Emergency Department Patients With Low to Moderate Cardiac Risk. Clinical Therapeutics 2016, 38: 240-255.e1. PMID: 26778090, DOI: 10.1016/j.clinthera.2015.12.010.Peer-Reviewed Original ResearchConceptsChest painControl subjectsMicrovascular dysfunctionArtery diseaseObstructive coronary artery diseaseCommon emergency department presentationConduit vessel functionCoronary artery vasomotionTransient forearm ischemiaAcute chest painCardiac risk factorsPersistent chest painAcute coronary syndromeBrachial artery diameterFramingham risk scoreProspective cohort studyChest pain centerSystolic blood pressureAsymptomatic healthy volunteersCoronary artery diseaseEmergency department presentationsBrachial artery reactivityPeripheral microvascular dysfunctionHigh-resolution ultrasoundArtery dysfunction
2014
Gender‐specific Research for Emergency Diagnosis and Management of Ischemic Heart Disease: Proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup
Safdar B, Nagurney JT, Anise A, DeVon HA, D'Onofrio G, Hess EP, Hollander JE, Legato MJ, McGregor AJ, Scott J, Tewelde S, Diercks DB. Gender‐specific Research for Emergency Diagnosis and Management of Ischemic Heart Disease: Proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup. Academic Emergency Medicine 2014, 21: 1350-1360. PMID: 25413468, PMCID: PMC6402042, DOI: 10.1111/acem.12527.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseIschemic heart diseaseHeart diseaseCardiac ischemiaSymptomatic coronary artery diseaseObstructive coronary artery diseaseSex-specific pathophysiologyCoronary artery dissectionAge-matched menSex-specific riskPatient-centered outcomesPatient-provider communicationHealth care practitionersEmergency medical servicesGender-specific researchAcademic Emergency Medicine consensus conferencePerson meetingsBasic science researchArtery dissectionCardiovascular outcomesMonthly conference callsMicrovascular dysfunctionArtery diseasePatient outcomesCardiac biomarkersElevated CK-MB with a Normal Troponin Does Not Predict 30-Day Adverse Cardiac Events in Emergency Department Chest Pain Observation Unit Patients
Safdar B, Bezek SK, Sinusas AJ, Russell RR, Klein MR, Dziura JD, D’onofrio G. Elevated CK-MB with a Normal Troponin Does Not Predict 30-Day Adverse Cardiac Events in Emergency Department Chest Pain Observation Unit Patients. Critical Pathways In Cardiology A Journal Of Evidence-Based Medicine 2014, 13: 14-19. PMID: 24526146, DOI: 10.1097/hpc.0000000000000001.Peer-Reviewed Original ResearchConceptsAdverse cardiac eventsCPU patientsNormal troponinAdverse eventsCardiac eventsMultiple logistic regression modelComposite adverse eventsElevated creatinine kinaseObservation unit patientsSerial troponin testingStandardized chart reviewRetrospective cohort studyAcute coronary syndromeNational Death RegistryCoronary artery diseaseLogistic regression modelsPositive troponinPrior CADRenal insufficientCoronary syndromeHemodynamic instabilityChart reviewCohort studyDeath RegistryIschemic electrocardiogram
2001
S UBCUTANEOUS E PINEPHRINE IN THE P REHOSPITAL S ETTING
Safdar B, Cone D, Pham K. S UBCUTANEOUS E PINEPHRINE IN THE P REHOSPITAL S ETTING. Prehospital Emergency Care 2001, 5: 200-207. PMID: 11339733, DOI: 10.1080/10903120190940137.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseSubcutaneous epinephrineOlder patientsArtery diseaseAmerican Heart Association Emergency Cardiovascular Care CommitteeAdverse effectsCardiovascular side effectsTreatment of asthmaLife-threatening conditionHealth care personnelStrength of evidenceRelative contraindicationP REHOSPITAL S ETTINGCase reportAdverse reactionsPrehospital settingAllergic reactionsPrehospital useCare personnelSytematic reviewSide effectsAsthmaCare CommitteeLevel IIIEpinephrine