Featured Publications
Is microvascular dysfunction a systemic disorder with common biomarkers found in the heart, brain, and kidneys? — A scoping review
Nowroozpoor A, Gutterman D, Safdar B. Is microvascular dysfunction a systemic disorder with common biomarkers found in the heart, brain, and kidneys? — A scoping review. Microvascular Research 2020, 134: 104123. PMID: 33333140, DOI: 10.1016/j.mvr.2020.104123.Peer-Reviewed Original ResearchConceptsMicrovascular dysfunctionUnderlying systemic processC-reactive proteinLow-density cholesterolMulti-system involvementUric acidDifferent disease entitiesMulti-system manifestationsVon Willebrand factorNT-proBNPEndothelial dysfunctionTotal cholesterolClinical evidenceImmune activationSystemic disordersVitamin DIL-6Asymmetric dimethylarginineBlood biomarkersInforms cliniciansDisease entityCystatin CVital organsDysfunctionCommon biomarkersDiagnosis of coronary microvascular dysfunction in the clinic
Ong P, Safdar B, Seitz A, Hubert A, Beltrame J, Prescott E. Diagnosis of coronary microvascular dysfunction in the clinic. Cardiovascular Research 2020, 116: 841-855. PMID: 31904824, DOI: 10.1093/cvr/cvz339.Peer-Reviewed Original ResearchConceptsInterventional diagnostic proceduresCoronary microvascular dysfunctionCoronary microcirculationMicrovascular dysfunctionIntracoronary acetylcholine testingCoronary microvascular functionCoronary blood flowIndividual patient characteristicsChronic pathologic conditionsAcetylcholine testingCoronary spasmRecurrent symptomsCoronary vasoconstrictorPatient characteristicsCoronary thrombosisMicrovascular functionInvasive assessmentClinical conditionsEffective treatmentRespective patientsBlood flowCardiac metabolismClinical importancePathologic conditionsInvasive methodElevated 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 populationIdentifying Myocardial Ischemia due to Coronary Microvascular Dysfunction in the Emergency Department: Introducing a New Paradigm in Acute Chest Pain Evaluation
Safdar B, Ong P, Camici PG. Identifying Myocardial Ischemia due to Coronary Microvascular Dysfunction in the Emergency Department: Introducing a New Paradigm in Acute Chest Pain Evaluation. Clinical Therapeutics 2018, 40: 1920-1930. PMID: 30458932, DOI: 10.1016/j.clinthera.2018.09.010.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRecurrent chest painCoronary microvascular dysfunctionChest painEmergency departmentHs-TnTMicrovascular dysfunctionMyocardial ischemiaAcute chest pain evaluationHigh-sensitivity troponin TDiagnosis of AMIType 2 acute myocardial infarctionElevated hs-TnTIschemia/necrosisChest pain evaluationGroup of patientsAssessment of symptomsIdentification of patientsAppropriate medical treatmentSex-specific thresholdsPulmonary embolismVasomotor disordersAortic dissectionPain evaluationEpicardial coronaries
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
Corrigendum to: 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. Corrigendum to: Mild cognitive impairment in middle-aged adults with coronary microvascular dysfunction. European Heart Journal 2021, 43: 1776-1776. PMID: 34897369, DOI: 10.1093/eurheartj/ehab845.Peer-Reviewed Original ResearchCoronary microvascular dysfunctionMiddle-aged adultsMild cognitive impairmentMicrovascular dysfunctionMild 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 diseaseUtility of discovery approach using proteomics to create a biomarker profile for coronary microvascular dysfunction
Nowroozpoor A, Gutterman D, Safdar B. Utility of discovery approach using proteomics to create a biomarker profile for coronary microvascular dysfunction. Microvascular Research 2020, 129: 103985. PMID: 32007502, PMCID: PMC10291513, DOI: 10.1016/j.mvr.2020.103985.Peer-Reviewed Original ResearchConceptsCoronary microvascular dysfunctionCoronary flow reserveMicrovascular dysfunctionNormal coronary flow reservePositron emission tomography/Beta-blocker useAcute myocardial infarctionEmission tomography/Regional perfusion defectsSerum proteinsBaseline characteristicsCoronary calcificationMyocardial infarctionTomography/Perfusion defectsCMD patientsFlow reserveSerial measurementsBiomarker profilesAdvanced imagingPatientsPotential biomarkersPotential protein biomarkersSerum samplesObservation unit
2019
Classification of Patients with Coronary Microvascular Dysfunction
Fodeh S, Li T, Jarad H, Safdar B. Classification of Patients with Coronary Microvascular Dysfunction. IEEE/ACM Transactions On Computational Biology And Bioinformatics 2019, 17: 704-711. PMID: 31056516, DOI: 10.1109/tcbb.2019.2914442.Peer-Reviewed Original Research
2018
Identifying Patients with Coronary Microvascular Dysfunction using Machine Learning
Fodeh S, Li T, Jarad H, Safdar B. Identifying Patients with Coronary Microvascular Dysfunction using Machine Learning. 2018, 00: 715-721. DOI: 10.1109/icdmw.2018.00109.Peer-Reviewed Original Research
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 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 biomarkers