Alexander Thomas, MD
Clinical FellowAbout
Research
Publications
2024
Outcomes for Mechanically Ventilated Patients With Acute Myocardial Infarction Admitted to Medical vs Cardiac Intensive Care Units
Shahu A, Namburar S, Banna S, Harris A, Schenck C, Trejo-Paredes C, Thomas A, Ali T, Carnicelli A, Barnett C, Solomon M, Miller P. Outcomes for Mechanically Ventilated Patients With Acute Myocardial Infarction Admitted to Medical vs Cardiac Intensive Care Units. JACC Advances 2024, 3: 101199. DOI: 10.1016/j.jacadv.2024.101199.Peer-Reviewed Original ResearchAcute myocardial infarctionAssociated with lower in-hospital mortalityIn-hospital mortalityLower in-hospital mortalityIntensive care unitMedical ICUPrimary diagnosis of acute myocardial infarctionMultivariable adjustmentCICU admissionInvasive mechanical ventilationVizient Clinical Data BaseBackground Acute myocardial infarctionDiagnosis of acute myocardial infarctionMultivariate logistic regressionMedical intensive care unitClinical outcomesMechanical ventilationCardiogenic shockClinical Data BaseMyocardial infarctionHospital sizeTriage of critically ill patientsMedian ventilator daysTeaching hospitalLogistic regressionTracheostomy in Patients with Acute Myocardial Infarction and Respiratory Failure.
Grammatico M, Banna S, Shahu A, Gastanadui M, Jimenez J, Heck C, Arias-Olson A, Thomas A, Ali T, Miller P. Tracheostomy in Patients with Acute Myocardial Infarction and Respiratory Failure. Journal Of Intensive Care Medicine 2024, 8850666241253202. PMID: 38715423, DOI: 10.1177/08850666241253202.Peer-Reviewed Original ResearchDays of tracheostomyInvasive mechanical ventilationIn-hospital mortalityAcute myocardial infarctionTiming of tracheostomyRespiratory failureAntiplatelet regimensMyocardial infarctionAssociated with lower in-hospital mortalityIncidence of tracheostomyLower in-hospital mortalityProportion of patientsIncidence of patientsDiagnosis of acute myocardial infarctionDAPT interruptionTracheostomy complicationsBlood transfusionOpen tracheostomyAntiplatelet therapyMechanical ventilationMultivariable adjustmentDAPT usePrimary diagnosis of acute myocardial infarctionClinical Data BaseTracheostomyPropofol vs etomidate for induction prior to invasive mechanical ventilation in patients with acute myocardial infarction
Thomas A, Banna S, Shahu A, Ali T, Schenck C, Patel B, Notarianni A, Phommalinh M, Kochar A, Heck C, van Diepen S, Miller P. Propofol vs etomidate for induction prior to invasive mechanical ventilation in patients with acute myocardial infarction. American Heart Journal 2024, 272: 116-125. PMID: 38554762, DOI: 10.1016/j.ahj.2024.03.013.Peer-Reviewed Original ResearchConceptsAssociated with lower mortalityAcute myocardial infarctionInvasive mechanical ventilationLower mortalityUS national databaseClinical Data BaseMyocardial infarctionIll patient populationLength of stayCritically ill patient populationIn-hospital mortalityInverse probability treatmentOptimal induction agentInduction agentNational databaseClinical outcomesMechanical ventilationProbability treatmentPropensity weightingPatient populationRandomized trialsMortalityUtilization of propofolVentilator daysPropofol group
2023
Stress Ulcer Prophylaxis in Mechanically Ventilated Patients With Acute Myocardial Infarction
Banna S, Schenck C, Shahu A, Thomas A, Heck C, Tangredi R, Ali T, Miller P. Stress Ulcer Prophylaxis in Mechanically Ventilated Patients With Acute Myocardial Infarction. JACC Advances 2023, 3: 100750. PMID: 38939822, PMCID: PMC11198220, DOI: 10.1016/j.jacadv.2023.100750.Peer-Reviewed Original ResearchInvasive mechanical ventilationProton pump inhibitorsStress ulcer prophylaxisAcute myocardial infarctionUlcer prophylaxisVentilator-associated pneumoniaMyocardial infarctionVentilator daysST-segment elevation myocardial infarctionBackground Proton pump inhibitorsLess ventilator-associated pneumoniaVizient Clinical Data BaseObservation cohort studyProportion of patientsElevation myocardial infarctionMultivariable logistic regressionClostridium difficile infectionLower hospitalization costsClinical data baseCardiogenic shockHospital mortalityCohort studyMultivariate adjustmentHospitalization costsMechanical ventilationEarly Clinical Outcomes of Patients With Stress-Induced Cardiomyopathy Receiving Acute Mechanical Support in the US
Jang S, Webber F, Alam M, Bae J, Aggarwal A, Thomas A, Zarich S, Ahmad T, Miller P, Davila C. Early Clinical Outcomes of Patients With Stress-Induced Cardiomyopathy Receiving Acute Mechanical Support in the US. Journal Of The Society For Cardiovascular Angiography & Interventions 2023, 2: 101185. PMID: 39131072, PMCID: PMC11308019, DOI: 10.1016/j.jscai.2023.101185.Peer-Reviewed Original ResearchAcute mechanical circulatory supportStress-induced cardiomyopathyRenal replacement therapyCardiogenic shockIndex hospitalizationReplacement therapyIntra-aortic balloon pumpAggressive hemodynamic supportHospital mortality rateNationwide Readmissions DatabaseMechanical circulatory supportFuture prospective studiesLarge national databaseObserved mortality differencesHospital mortalityMore comorbiditiesHospital deathHemodynamic supportBalloon pumpMembrane oxygenationClinical outcomesCirculatory supportProspective studyAdministrative databasesImpellaAntiplatelet Strategies Following PCI: A Review of Trials Informing Current and Future Therapies
Thomas A, Gitto M, Shah S, Saito Y, Tirziu D, Chieffo A, Stefanini G, Lansky A. Antiplatelet Strategies Following PCI: A Review of Trials Informing Current and Future Therapies. Journal Of The Society For Cardiovascular Angiography & Interventions 2023, 2: 100607. PMID: 39130709, PMCID: PMC11307978, DOI: 10.1016/j.jscai.2023.100607.Peer-Reviewed Original ResearchDual antiplatelet therapyAntiplatelet regimensPatient-specific risk profileShorter DAPT durationDuration of therapyPercutaneous coronary interventionDAPT strategyIschemic riskAntiplatelet therapyDAPT durationAntiplatelet strategiesCoronary interventionOngoing trialsMajor trialsRecent trialsPractice guidelinesFuture therapiesRisk profileTherapyStent technologyTrialsRegimensNumber of trialsSignificant reductionSignificant changes
2022
Oxygen Supplementation and Hyperoxia in Critically Ill Cardiac Patients From Pathophysiology to Clinical Practice
Thomas A, van Diepen S, Beekman R, Sinha SS, Brusca SB, Alviar CL, Jentzer J, Bohula EA, Katz JN, Shahu A, Barnett C, Morrow DA, Gilmore EJ, Solomon MA, Miller PE. Oxygen Supplementation and Hyperoxia in Critically Ill Cardiac Patients From Pathophysiology to Clinical Practice. JACC Advances 2022, 1: 100065. PMID: 36238193, PMCID: PMC9555075, DOI: 10.1016/j.jacadv.2022.100065.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsOxygen supplementationIntensive care unit cliniciansHarmful hemodynamic effectsAdverse clinical outcomesIll cardiac patientsManagement of patientsAcute cardiac diseaseAcute myocardial infarctionDirect cellular toxicityCoronary vasoconstrictionPulmonary hypertensionRespiratory failureHemodynamic effectsHeart failureOxygen therapyClinical outcomesSupplemental oxygenAvailable trialsCardiac arrestMyocardial infarctionCardiac patientsCardiac diseaseClinical practiceCardiovascular systemHyperoxiaStaffing models in the cardiac intensive care unit
Quien M, Thomas A, Ludmir J, Miller PE. Staffing models in the cardiac intensive care unit. Current Opinion In Critical Care 2022, 28: 453-459. PMID: 35757936, DOI: 10.1097/mcc.0000000000000958.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsCardiac intensive care unitIntensive care unitCare unitContemporary cardiac intensive care unitsModern cardiac intensive care unitMechanical circulatory supportSick patient populationFuture multicenter studiesStaffing modelsPreponderance of dataShock teamRespiratory failureIll patientsCirculatory supportMulticenter studyCardiac arrestPatient populationCardiac intensivistsIll populationMortalityRecent evidenceIntensivistsPatientsRecent dataPopulationRelation of Ischemic Heart Disease to Outcomes in Patients With Acute Respiratory Distress Syndrome
Biondi M, Jain S, Fuery M, Thomas A, Ali T, Alviar CL, Desai NR, Miller PE. Relation of Ischemic Heart Disease to Outcomes in Patients With Acute Respiratory Distress Syndrome. The American Journal Of Cardiology 2022, 176: 24-29. PMID: 35606175, DOI: 10.1016/j.amjcard.2022.04.034.Peer-Reviewed Original ResearchConceptsIschemic heart diseaseVentilator-free daysHeart diseaseHistory of IHDImpact of IHDAcute respiratory distress syndromePredictors of mortalityRespiratory distress syndromeSeverity of illnessMultivariable logistic regressionMultivariable adjustmentSecondary outcomesDistress syndromeOrgan failurePrimary outcomeClinical outcomesIll subgroupStudy criteriaTreatment paradigmClinical trialsARDS severityPatientsHigh mortalityEnd pointMortalitySafety and Efficacy of the Supreme Biodegradable Polymer Sirolimus-Eluting Stent in Patients With Diabetes Mellitus
Thomas A, Kereiakes D, Baumbach A, Windecker S, Pietras C, Dressler O, Issever M, Curtis M, Bertolet B, Zidar J, Smits P, Díaz V, McLaurin B, Cequier Á, Takahashi A, Cannon L, Amoroso G, Kakuta T, Saito S, Leon M, Lansky A. Safety and Efficacy of the Supreme Biodegradable Polymer Sirolimus-Eluting Stent in Patients With Diabetes Mellitus. Journal Of The Society For Cardiovascular Angiography & Interventions 2022, 1: 100033. PMID: 39132558, PMCID: PMC11307809, DOI: 10.1016/j.jscai.2022.100033.Peer-Reviewed Original ResearchTarget vessel myocardial infarctionVessel myocardial infarctionDiabetes mellitusDP-EESLesion failureIII trialsCardiac deathMyocardial infarctionBiodegradable Polymer Sirolimus-Eluting StentBiodegradable polymer sirolimus-eluting stentsTarget lesion failureTarget lesion revascularizationPercutaneous coronary interventionSirolimus-Eluting StentsLong-term inflammatory responseDiabetic subgroupsLesion revascularizationNondiabetic patientsSecondary endpointsBackground PatientsCoronary interventionPrespecified analysisComposite endpointPrimary safetyWorse outcomes
Links & Media
News
- July 24, 2024
Patient Mortality With Antiplatelet Therapy and Tracheostomy Use
- February 01, 2023
2023 American College of Cardiology late-breaking clinical trials and abstracts from Yale
- January 26, 2022
American College of Cardiology 71st Annual Scientific Session & Expo sessions announced
- August 17, 2021Source: Medscape
How Forgone Heart Failure Care Drives Up Costs