2015
The influence of clopidogrel on ischemia diagnosed by myocardial perfusion stress testing
Jovin IS, Ebisu KA, Oprea AD, Brandt CA, Natale D, Finta LA, Dziura J, Wackers FJ. The influence of clopidogrel on ischemia diagnosed by myocardial perfusion stress testing. Journal Of Nuclear Cardiology 2015, 23: 773-779. PMID: 26338428, DOI: 10.1007/s12350-015-0268-3.Peer-Reviewed Original ResearchConceptsReversible perfusion defectsOdds ratioPerfusion defectsMyocardial perfusion stress testMyocardial perfusion stress testingStress testStress myocardial perfusion scansMyocardial single photon emissionAdenosine stress testInfluence of clopidogrelLikelihood of ischemiaMyocardial perfusion testingUse of clopidogrelCoronary vascular toneExercise stress testMyocardial perfusion scanMyocardial perfusion imagingSingle photon emissionAdenosine receptor antagonistDiagnosis of ischemiaPerfusion scanPerfusion testingVascular toneReceptor antagonistTomography scan
2014
Predictors of Physical Inactivity in Men and Women With Type 2 Diabetes From the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Study
McCarthy M, Davey J, Wackers F, Chyun D. Predictors of Physical Inactivity in Men and Women With Type 2 Diabetes From the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Study. The Science Of Diabetes Self-Management And Care 2014, 40: 678-687. PMID: 24942531, PMCID: PMC4169341, DOI: 10.1177/0145721714540055.Peer-Reviewed Original ResearchMeSH KeywordsCanadaDiabetes Mellitus, Type 2Diabetic AngiopathiesExerciseFemaleFollow-Up StudiesHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedMotor ActivityMyocardial IschemiaPeripheral Nervous System DiseasesPredictive Value of TestsPrevalenceProspective StudiesRisk FactorsSedentary BehaviorTime FactorsUnited StatesConceptsAsymptomatic Diabetics (DIAD) studyPhysical inactivityType 2 diabetesDetection of ischemiaDiabetic studyOverweight/obesityPrimary care practicesPhysical activity dataGender-related differencesAsymptomatic patientsAutonomic neuropathySilent ischemiaSecondary data analysisCare practicesType 2Secondary analysisIschemiaDiabetesTime pointsInactivityBaselineWomenMenGender differencesYearsCall for a standard unit of defect size
Wackers F. Call for a standard unit of defect size. Journal Of Nuclear Cardiology 2014, 21: 682-684. PMID: 24715620, DOI: 10.1007/s12350-014-9874-8.Peer-Reviewed Original Research
2012
Left Ventricular Ejection Fraction and Left Ventricular End‐Diastolic Volume in Patients With Diastolic Dysfunction
Jovin IS, Ebisu K, Liu Y, Finta LA, Oprea AD, Brandt CA, Dziura J, Wackers FJ. Left Ventricular Ejection Fraction and Left Ventricular End‐Diastolic Volume in Patients With Diastolic Dysfunction. Congestive Heart Failure 2012, 19: 130-134. PMID: 23241105, DOI: 10.1111/chf.12013.Peer-Reviewed Original ResearchConceptsLVEF of patientsLeft ventricular ejection fractionLower peak filling ratePeak filling rateEnd-diastolic volumeNormal peak filling ratesEquilibrium radionuclide angiocardiographyVentricular ejection fractionDiastolic dysfunctionAsymptomatic patientsEjection fractionLow left ventricular ejection fractionNormal left ventricular ejection fractionVentricular end-diastolic volumeMild systolic dysfunctionNormal systolic functionEDV indexSystolic dysfunctionSystolic functionRadionuclide angiocardiographyPatientsDysfunctionRepeat scansFilling rateAngiocardiographyThe heart rate response to adenosine: A simple predictor of adverse cardiac outcomes in asymptomatic patients with type 2 diabetes
Hage FG, Wackers FJ, Bansal S, Chyun DA, Young LH, Inzucchi SE, Iskandrian AE. The heart rate response to adenosine: A simple predictor of adverse cardiac outcomes in asymptomatic patients with type 2 diabetes. International Journal Of Cardiology 2012, 167: 2952-2957. PMID: 22981277, PMCID: PMC3723723, DOI: 10.1016/j.ijcard.2012.08.011.Peer-Reviewed Original ResearchConceptsAbnormal myocardial perfusion imagingMyocardial perfusion imagingHeart rate responseCardiac eventsMPI abnormalitiesAsymptomatic patientsAdenosine myocardial perfusion imagingHard cardiac event rateCardiovascular risk factor managementCox proportional regression modelType 2 diabetes mellitusAsymptomatic Diabetics (DIAD) studyCardiac event rateNonfatal myocardial infarctionCardiac autonomic neuropathyRate responseRisk factor managementYears of followAdverse cardiac outcomesProportional regression modelHigh cardiac riskType 2 diabetesDetection of ischemiaAbnormal HRRAutonomic neuropathyAcute chest pain of uncertain etiology, the short and long view
Wackers F. Acute chest pain of uncertain etiology, the short and long view. Journal Of Nuclear Cardiology 2012, 19: 220-223. PMID: 22271368, DOI: 10.1007/s12350-012-9514-0.Peer-Reviewed Original ResearchGender-based divergence of cardiovascular outcomes in asymptomatic patients with type 2 diabetes: Results from the DIAD study
Tandon S, Wackers F, Inzucchi SE, Bansal S, Staib LH, Chyun DA, Davey JA, Young LH. Gender-based divergence of cardiovascular outcomes in asymptomatic patients with type 2 diabetes: Results from the DIAD study. Diabetes And Vascular Disease Research 2012, 9: 124-130. PMID: 22228772, DOI: 10.1177/1479164111431470.Peer-Reviewed Original ResearchMeSH KeywordsAgedAsymptomatic DiseasesCanadaCardiovascular DiseasesDiabetes ComplicationsDiabetes Mellitus, Type 2FemaleHumansIncidenceKaplan-Meier EstimateMaleMass ScreeningMiddle AgedMyocardial Perfusion ImagingPredictive Value of TestsPrognosisProspective StudiesRisk AssessmentRisk FactorsSex FactorsTime FactorsUnited StatesConceptsType 2 diabetesMyocardial perfusion imagingCardiovascular outcomesStress myocardial perfusion imagingAsymptomatic Diabetics (DIAD) studyBetter cardiac outcomesHigh-risk womenCoronary artery diseaseHigh-risk menDetection of ischemiaMPI abnormalitiesAsymptomatic patientsAsymptomatic menCardiac eventsCardiac outcomesArtery diseaseAsymptomatic womenAbnormal screeningDiabetic studyPerfusion imagingDIAD studyWomenMenDiabetesOutcomes
2011
85% of maximal age-predicted heart rate is not a valid endpoint for exercise treadmill testing
Jain M, Nkonde C, Lin BA, Walker A, Wackers FJ. 85% of maximal age-predicted heart rate is not a valid endpoint for exercise treadmill testing. Journal Of Nuclear Cardiology 2011, 18: 1026-1035. PMID: 21922347, DOI: 10.1007/s12350-011-9454-0.Peer-Reviewed Original ResearchConceptsMaximal age-predicted heart rateAge-predicted heart rateInducible ischemiaPeak exerciseExercise testingPositive ECGHeart rateExercise endpointPositive exercise ECGExercise treadmill testingRegistry patientsProspective registryExercise capacityRetrospective cohortTreadmill testingPatient cohortExercise ECGValid endpointPatientsMore womenEndpointIschemiaClinical laboratoriesECGCohort
2010
Five-Year Outcomes in High-Risk Participants in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Study A post hoc analysis
Bansal S, Wackers FJ, Inzucchi SE, Chyun DA, Davey JA, Staib LH, Young LH, . Five-Year Outcomes in High-Risk Participants in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Study A post hoc analysis. Diabetes Care 2010, 34: 204-209. PMID: 20929989, PMCID: PMC3005488, DOI: 10.2337/dc10-1194.Peer-Reviewed Original ResearchConceptsCardiac event rateBaseline cardiovascular riskAnnual cardiac event rateHigh cardiovascular riskCardiovascular riskHigh-risk participantsDetection of ischemiaEvent ratesInducible ischemiaRisk engineUK Prospective Diabetes Study risk engineHigh baseline cardiovascular riskAsymptomatic Diabetics (DIAD) studyFive-year outcomesUKPDS risk engineLow-risk groupRisk stratification approachStudy of DiabetesLow-risk participantsAsymptomatic diabeticsCardiac eventsFramingham scoreMetabolic syndromeRisk groupsDiabetic studyHyperglycemia on admission predicts larger infarct size in patients undergoing percutaneous coronary intervention for acute ST-segment elevation myocardial infarction
Cruz-Gonzalez I, Chia S, Raffel O, Sanchez-Ledesma M, Senatore F, Wackers F, Nathan D, Jang I. Hyperglycemia on admission predicts larger infarct size in patients undergoing percutaneous coronary intervention for acute ST-segment elevation myocardial infarction. Diabetes Research And Clinical Practice 2010, 88: 97-102. PMID: 20083319, DOI: 10.1016/j.diabres.2010.01.001.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionPrimary percutaneous coronary interventionAcute ST-segment elevation myocardial infarctionPrimary PCILarger infarct sizeElevation myocardial infarctionPercutaneous coronary interventionInfarct sizeCoronary interventionMyocardial infarctionDay 5Final TIMI 3 flowTIMI 3 flowMultivariate linear regression analysisSingle photon emissionAdmission correlateSTEMI patientsBaseline characteristicsDiabetic statusHyperglycemia groupIndependent predictorsHyperglycemiaPatientsLinear regression analysisAdmission
2009
How to Identify the Asymptomatic High-Risk Patient?
Schuijf J, Achenbach S, Zoghbi W, Boersma E, Raggi P, Weber M, Nagel E, Narula J, Wackers F, Poldermans D, Bax J. How to Identify the Asymptomatic High-Risk Patient? Current Problems In Cardiology 2009, 34: 539-577. PMID: 19804855, DOI: 10.1016/j.cpcardiol.2009.07.001.Peer-Reviewed Original ResearchConceptsElevated riskAsymptomatic high-risk patientsCardiovascular disease eventsHigh-risk patientsCause of mortalityUse of biomarkersNoninvasive imaging modalityIntermediate riskAsymptomatic individualsCardiovascular diseaseHigh riskDisease eventsPreventive measuresImaging modalitiesSubstantial proportionMorbidityPatientsRisk assessmentAdditional strategiesRiskMortalityTraditional risk assessmentLarge proportionGreat benefitIndividualsCardiac Outcomes After Screening for Asymptomatic Coronary Artery Disease in Patients With Type 2 Diabetes : The DIAD Study: A Randomized Controlled Trial
Young LH, Wackers FJ, Chyun DA, Davey JA, Barrett EJ, Taillefer R, Heller GV, Iskandrian AE, Wittlin SD, Filipchuk N, Ratner RE, Inzucchi SE, Investigators F. Cardiac Outcomes After Screening for Asymptomatic Coronary Artery Disease in Patients With Type 2 Diabetes : The DIAD Study: A Randomized Controlled Trial. JAMA 2009, 301: 1547-1555. PMID: 19366774, PMCID: PMC2895332, DOI: 10.1001/jama.2009.476.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseType 2 diabetesNonfatal myocardial infarctionAsymptomatic coronary artery diseaseMyocardial perfusion imagingCardiac event rateMyocardial infarctionCardiac deathMPI defectsCardiac outcomesEvent ratesScreened groupArtery diseaseSymptoms of CADRadionuclide myocardial perfusion imagingAsymptomatic Diabetics (DIAD) studyHigh cardiac riskLow event ratesPositive predictive valueDetection of ischemiaPrimary medical preventionCoronary revascularizationDiabetes clinicIdentifies patientsControlled TrialsDetection of coronary artery disease with perfusion stress echocardiography using a novel ultrasound imaging agent: two Phase 3 international trials in comparison with radionuclide perfusion imaging
Senior R, Monaghan M, Main M, Zamorano J, Tiemann K, Agati L, Weissman N, Klein A, Marwick T, Ahmad M, DeMaria A, Zabalgoitia M, Becher H, Kaul S, Udelson J, Wackers F, Walovitch R, Picard M. Detection of coronary artery disease with perfusion stress echocardiography using a novel ultrasound imaging agent: two Phase 3 international trials in comparison with radionuclide perfusion imaging. European Heart Journal - Cardiovascular Imaging 2009, 10: 26-35. PMID: 19131498, DOI: 10.1093/ejechocard/jen321.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overArea Under CurveContrast MediaCoronary Artery DiseaseDipyridamoleEchocardiography, StressFemaleFluorocarbonsGated Blood-Pool ImagingHumansImage EnhancementImage Interpretation, Computer-AssistedInternational CooperationMaleMiddle AgedObserver VariationROC CurveSensitivity and SpecificityStatistics, NonparametricTomography, Emission-Computed, Single-PhotonYoung AdultConceptsChest pain patientsPain patientsStress echocardiographyPerfusion imagingNon-inferior sensitivityPhase 3 trialCoronary artery diseaseCoronary artery disease detectionQuantitative coronary angiographyNon-inferiority analysisRadionuclide perfusion imagingSingle photon emissionAdverse eventsArtery diseaseCoronary angiographyBlinded cardiologistsClinical reviewDipyridamole stressMyocardial perfusionSPECT perfusionInternational trialRAMP 1Diagnostic performanceSPECTCharacteristic curve
2008
Association of Leukocyte and Neutrophil Counts With Infarct Size, Left Ventricular Function and Outcomes After Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction
Chia S, Nagurney J, Brown D, Raffel O, Bamberg F, Senatore F, Wackers F, Jang I. Association of Leukocyte and Neutrophil Counts With Infarct Size, Left Ventricular Function and Outcomes After Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction. The American Journal Of Cardiology 2008, 103: 333-337. PMID: 19166685, DOI: 10.1016/j.amjcard.2008.09.085.Peer-Reviewed Original ResearchConceptsPrimary percutaneous coronary interventionLeft ventricular ejection fractionPrimary PCIST-segment elevation myocardial infarctionElevation myocardial infarctionLarger infarct sizePercutaneous coronary interventionInfarct sizeNeutrophil countMyocardial infarctionElevated leukocytesLeukocyte countCardiac eventsCoronary interventionFirst ST-segment elevation myocardial infarctionAcute Myocardial Infarction StudyST-elevation myocardial infarctionAssociation of leukocytesComposite cardiac eventsIntracellular calcium modulatorsLeft Ventricular SalvageAdverse cardiac eventsElevated leukocyte countPlacebo-controlled trialMyocardial Infarction StudyUtility of Cardiac Biomarkers in Predicting Infarct Size, Left Ventricular Function, and Clinical Outcome After Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction
Chia S, Senatore F, Raffel O, Lee H, Wackers F, Jang I. Utility of Cardiac Biomarkers in Predicting Infarct Size, Left Ventricular Function, and Clinical Outcome After Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction. JACC Cardiovascular Interventions 2008, 1: 415-423. PMID: 19463339, DOI: 10.1016/j.jcin.2008.04.010.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngioplasty, Balloon, CoronaryBenzenesulfonatesBiomarkersCardiovascular AgentsCoronary AngiographyCreatine Kinase, MB FormDisease-Free SurvivalFemaleHumansKaplan-Meier EstimateMaleMiddle AgedMyocardial InfarctionMyocardiumPiperazinesPredictive Value of TestsProportional Hazards ModelsProspective StudiesRisk AssessmentStroke VolumeTime FactorsTomography, Emission-Computed, Single-PhotonTreatment OutcomeTroponin ITroponin TUnited StatesVentricular Function, LeftConceptsST-segment elevation myocardial infarctionPrimary percutaneous coronary interventionPrimary PCIElevation myocardial infarctionPercutaneous coronary interventionInfarct sizeClinical outcomesMyocardial infarctionCardiac biomarkersCoronary interventionCreatine kinaseCK-MBLarge ST-segment elevation myocardial infarctionTroponin TIntracellular calcium modulatorsLarger infarct sizeVentricular ejection fractionCardiac biomarker levelsLeft ventricular functionComposite clinical eventsTime-concentration curveEVOLVE trialLower LVEFAdverse eventsEjection fractionDifferent manifestations of coronary artery disease by stress SPECT myocardial perfusion imaging, coronary calcium scoring, and multislice CT coronary angiography in asymptomatic patients with type 2 diabetes mellitus
Scholte A, Schuijf J, Kharagjitsingh A, Dibbets-Schneider P, Stokkel M, Jukema J, van der Wall E, Bax J, Wackers F. Different manifestations of coronary artery disease by stress SPECT myocardial perfusion imaging, coronary calcium scoring, and multislice CT coronary angiography in asymptomatic patients with type 2 diabetes mellitus. Journal Of Nuclear Cardiology 2008, 15: 503-509. PMID: 18674717, DOI: 10.1016/j.nuclcard.2008.02.015.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCalcinosisComorbidityCoronary Artery DiseaseDiabetes Mellitus, Type 2FemaleHumansIncidenceMaleMiddle AgedNetherlandsReproducibility of ResultsRisk AssessmentRisk FactorsSensitivity and SpecificityTomography, Emission-Computed, Single-PhotonTomography, X-Ray ComputedVentricular Dysfunction, LeftConceptsType 2 diabetes mellitusCoronary artery diseaseMSCT coronary angiographyAsymptomatic patientsCoronary angiographyDiabetes mellitusPositive CAC scoreMyocardial perfusion imagingCAC scoreCoronary atherosclerosisArtery diseaseCAC scoringCalcium scoringPerfusion imagingAbnormal diagnostic test resultsSilent coronary artery diseaseStress single-photon emissionCoronary artery calcium scoringMultislice CT coronary angiographyTomography myocardial perfusion imagingStress SPECT myocardial perfusion imagingSilent coronary atherosclerosisSPECT myocardial perfusion imagingRelative prognostic valueTomographic coronary angiography
2007
A randomized, double-blind, placebo-controlled study of the safety and efficacy of intravenous MCC-135 as an adjunct to primary percutaneous coronary intervention in patients with acute myocardial infarction: Evaluation of MCC-135 for left ventricular salvage in acute myocardial infarction (EVOLVE)
Jang I, Weissman N, Picard M, Zile M, Pettigrew V, Shen S, Tatsuno J, Hibberd M, Tzivoni D, Wackers F, Investigators T. A randomized, double-blind, placebo-controlled study of the safety and efficacy of intravenous MCC-135 as an adjunct to primary percutaneous coronary intervention in patients with acute myocardial infarction: Evaluation of MCC-135 for left ventricular salvage in acute myocardial infarction (EVOLVE). American Heart Journal 2007, 155: 113.e1-113.e8. PMID: 18082500, DOI: 10.1016/j.ahj.2007.08.020.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngioplasty, Balloon, CoronaryBenzenesulfonatesCardiac CatheterizationCombined Modality TherapyCoronary AngiographyDose-Response Relationship, DrugDouble-Blind MethodDrug Administration ScheduleElectrocardiographyFemaleFollow-Up StudiesHumansInfusions, IntravenousMaleMiddle AgedMyocardial InfarctionPiperazinesProbabilityReference ValuesRisk AssessmentSalvage TherapyStroke VolumeSurvival RateTreatment OutcomeVentricular Function, LeftConceptsPrimary percutaneous coronary interventionLeft ventricular ejection fractionST-elevation myocardial infarctionPrimary PCIMCC-135Percutaneous coronary interventionAcute myocardial infarctionInfarct sizeMyocardial infarctionDay 5Coronary interventionClinical outcomesCalcium overloadPreservation of LVEFAcute ST-elevation myocardial infarctionEnd pointTarget populationComposite clinical outcomeLeft Ventricular SalvagePlacebo-controlled studyPrimary end pointSecondary end pointsLow-dose groupVentricular ejection fractionHigh-dose groupResolution of Asymptomatic Myocardial Ischemia in Patients With Type 2 Diabetes in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Study
Wackers FJ, Chyun DA, Young LH, Heller GV, Iskandrian AE, Davey JA, Barrett EJ, Taillefer R, Wittlin SD, Filipchuk N, Ratner RE, Inzucchi SE. Resolution of Asymptomatic Myocardial Ischemia in Patients With Type 2 Diabetes in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Study. Diabetes Care 2007, 30: 2892-2898. PMID: 17682123, DOI: 10.2337/dc07-1250.Peer-Reviewed Original ResearchConceptsResolution of ischemiaType 2 diabetesDetection of ischemiaNew ischemiaAsymptomatic Diabetics (DIAD) studyCardiovascular risk factorsAsymptomatic myocardial ischemiaAdenosine stress myocardial perfusionRepeat stressIschemia increasesAsymptomatic patientsCardiac eventsMore patientsACE inhibitorsMyocardial ischemiaRisk factorsIntensive treatmentDiabetic studyIschemiaMyocardial perfusionPatientsMedical treatmentDiabetesInitial evaluationGreater increase
2006
Long-term assessment of cardiac function after dose-dense and -intense sequential doxorubicin (A), paclitaxel (T), and cyclophosphamide (C) as adjuvant therapy for high risk breast cancer
Abu-Khalaf MM, Juneja V, Chung GG, DiGiovanna MP, Sipples R, McGurk M, Zelterman D, Haffty B, Reiss M, Wackers FJ, Lee FA, Burtness BA. Long-term assessment of cardiac function after dose-dense and -intense sequential doxorubicin (A), paclitaxel (T), and cyclophosphamide (C) as adjuvant therapy for high risk breast cancer. Breast Cancer Research And Treatment 2006, 104: 341-349. PMID: 17051423, DOI: 10.1007/s10549-006-9413-7.Peer-Reviewed Original ResearchConceptsLeft ventricular ejection fractionEnd of chemotherapyEquilibrium radionuclide angiographyBreast cancerAdjuvant therapySequential doxorubicinCardiac functionIpsilateral axillary lymph nodesHigh-risk breast cancerRisk breast cancerClinical heart failureInitiation of chemotherapyAxillary lymph nodesVentricular ejection fractionEnd of therapyLong-term cardiotoxicityMedian absolute changeEligible patientsFilgrastim supportLate cardiotoxicityAxillary nodesAsymptomatic declineEjection fractionHeart failureLymph nodesAsymptomatic patients with diabetes mellitus should be screened for coronary artery disease
Wackers F. Asymptomatic patients with diabetes mellitus should be screened for coronary artery disease. Journal Of Nuclear Cardiology 2006, 13: 609-615. PMID: 16945739, DOI: 10.1016/j.nuclcard.2006.06.129.Peer-Reviewed Original Research