2017
Physical inactivity and cardiac events: An analysis of the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study
McCarthy M, Wackers F, Davey J, Chyun D. Physical inactivity and cardiac events: An analysis of the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study. Journal Of Clinical & Translational Endocrinology 2017, 9: 8-14. PMID: 29067262, PMCID: PMC5651289, DOI: 10.1016/j.jcte.2017.05.005.Peer-Reviewed Original ResearchCoronary artery diseaseHigher pulse pressurePremature coronary artery diseaseCAD eventsPhysical inactivityPulse pressureDetection of ischemiaPeripheral numbnessDiabetes durationIndependent predictorsHip ratioFamily historyOlder adultsAsymptomatic Diabetics (DIAD) studyCAD event ratesProportional hazard modelingImportant risk factorType 2 diabetesCause of deathAsymptomatic diabeticsInsulin useBaseline characteristicsCardiac eventsArtery diseaseHemoglobin A1c
2012
The 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 neuropathyGender-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
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 study
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 Study
2007
Resolution 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
2003
Prognostic significance of ischemic electrocardiographic changes during adenosine infusion in patients with normal myocardial perfusion imaging
Abbott B, Afshar M, Berger A, Wackers F. Prognostic significance of ischemic electrocardiographic changes during adenosine infusion in patients with normal myocardial perfusion imaging. Journal Of Nuclear Cardiology 2003, 10: 9-16. PMID: 12569326, DOI: 10.1067/mnc.2002.127625.Peer-Reviewed Original ResearchConceptsNormal myocardial perfusion imagingAdenosine myocardial perfusion imagingST-segment depressionMyocardial perfusion imagingIschemic ECG changesCardiac eventsECG changesAdenosine infusionCardiac deathPrognostic significanceECG groupNormal myocardial perfusion imagesBaseline electrocardiographic abnormalitiesAdverse cardiac eventsIschemic electrocardiographic changesNonfatal myocardial infarctionSubsequent cardiac eventsFuture cardiac eventsNormal myocardial perfusionSex-matched groupPerfusion imagesECG evidenceElectrocardiographic abnormalitiesIndependent predictorsElectrocardiographic changes
1998
Exercise testing with myocardial perfusion imaging in patients with normal baseline electrocardiograms: Cost savings with a stepwise diagnostic strategy
Mattera J, Arain S, Sinusas A, Finta L, Wackers F. Exercise testing with myocardial perfusion imaging in patients with normal baseline electrocardiograms: Cost savings with a stepwise diagnostic strategy. Journal Of Nuclear Cardiology 1998, 5: 498-506. PMID: 9796897, DOI: 10.1016/s1071-3581(98)90181-7.Peer-Reviewed Original ResearchConceptsExercise myocardial perfusion imagingCoronary artery diseaseNormal exercise electrocardiogramMyocardial perfusion imagingNormal myocardial perfusion imagingNormal resting electrocardiogramsExercise electrocardiogramExercise testingArtery diseaseIntermediate likelihoodResting electrocardiogramsAbnormal myocardial perfusion imagingDiagnostic strategiesAbnormal exercise electrocardiogramGroup 3 patientsHard cardiac eventsNonfatal myocardial infarctionNormal baseline electrocardiogramSubsequent coronary revascularizationIncremental diagnostic informationDiagnostic testing strategiesCoronary revascularizationCardiac eventsUnstable anginaConsecutive patientsClinical Value of Acute Rest Technetium-99m Tetrofosmin Tomographic Myocardial Perfusion Imaging in Patients With Acute Chest Pain and Nondiagnostic Electrocardiograms
Heller G, Stowers S, Hendel R, Herman S, Daher E, Ahlberg A, Baron J, de Leon C, Rizzo J, Wackers F. Clinical Value of Acute Rest Technetium-99m Tetrofosmin Tomographic Myocardial Perfusion Imaging in Patients With Acute Chest Pain and Nondiagnostic Electrocardiograms. Journal Of The American College Of Cardiology 1998, 31: 1011-1017. PMID: 9562001, DOI: 10.1016/s0735-1097(98)00057-6.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionTomographic myocardial perfusionMyocardial infarctionChest painNondiagnostic electrocardiogramEmergency departmentHospital periodHospital admissionRest technetiumTetrofosmin SPECTMyocardial perfusionLow cardiac event rateTetrofosmin single photon emissionMultiple logistic regression analysisAcute chest painCardiac event rateNormal SPECT imagesMean cost savingsUnnecessary hospital admissionsLogistic regression analysisSingle photon emissionSPECT imagesAbnormal SPECTCardiac eventsRest Tc
1997
Relevance of Increased Lung Thallium Uptake on Stress Imaging in Patients With Unstable Angina and Non-Q Wave Myocardial Infarction: Results of the Thrombolysis in Myocardial Infarction (TIMI)-IIIB Study fn1fn1This study was supported in part by a research grant from Mallinckrodt Medical Inc., Saint Louis, Missouri.
Jain D, Thompson B, Wackers F, Zaret B, Investigators F. Relevance of Increased Lung Thallium Uptake on Stress Imaging in Patients With Unstable Angina and Non-Q Wave Myocardial Infarction: Results of the Thrombolysis in Myocardial Infarction (TIMI)-IIIB Study fn1fn1This study was supported in part by a research grant from Mallinckrodt Medical Inc., Saint Louis, Missouri. Journal Of The American College Of Cardiology 1997, 30: 421-429. PMID: 9247514, DOI: 10.1016/s0735-1097(97)00164-2.Peer-Reviewed Original ResearchConceptsLung/heart ratioAdverse cardiac eventsNon-Q-wave myocardial infarctionCoronary artery diseaseCardiac eventsPerfusion abnormalitiesMyocardial infarctionUnstable anginaArtery diseaseStress-induced left ventricular dysfunctionHigher cardiac event rateLeft ventricular ejection fractionAggressive interventional managementHigher revascularization rateLung thallium uptakeCardiac event rateTotal exercise timeFrequency of anginaLeft ventricular dysfunctionST-segment depressionLower exercise capacityVentricular ejection fractionPrevious myocardial infarctionMyocardial perfusion abnormalitiesNormal myocardial perfusion
1996
Preoperative Dipyridamole Thallium Imaging and Ambulatory Electrocardiographic Monitoring as a Predictor of Perioperative Cardiac Events and Long-Term Outcome
FLEISHER L, ROSENBAUM S, NELSON A, JAIN D, WACKERS F, ZARET B. Preoperative Dipyridamole Thallium Imaging and Ambulatory Electrocardiographic Monitoring as a Predictor of Perioperative Cardiac Events and Long-Term Outcome. Survey Of Anesthesiology 1996, 40: 324. DOI: 10.1097/00132586-199610000-00066.Peer-Reviewed Original ResearchPerioperative cardiac eventsLong-term outcomesCardiac eventsPreoperative dipyridamole thallium imagingDipyridamole thallium scintigraphyDipyridamole-thallium imagingAmbulatory electrocardiographic monitoringChronic cardiac diseaseNoncardiac surgerySurgical stressHolter electrocardiographyPreoperative testsThallium imagingThallium scintigraphyElectrocardiographic monitoringCertain patientsPhysiologic changesNonsurgical studiesCardiac diseasePredictive valueMarginal predictive valueLong-term predictive accuracyVolume shiftsOutcomesNumerous investigatorsDetection and significance of myocardial ischemia in women versus men within six months of acute myocardial infarction or unstable angina
Moriel M, Benhorin J, Brown M, Raubertas R, Severski P, Van Voorhees L, Bodenheimer M, Tzivoni D, Wackers F, Moss A, Group T. Detection and significance of myocardial ischemia in women versus men within six months of acute myocardial infarction or unstable angina. The American Journal Of Cardiology 1996, 77: 798-804. PMID: 8623730, DOI: 10.1016/s0002-9149(97)89172-2.Peer-Reviewed Original ResearchConceptsAcute coronary eventsThallium-201 stress scintigraphyPrimary end pointCoronary eventsEnd pointUnstable anginaStress scintigraphyPatient 1Myocardial infarctionNoninvasive testsExercise electrocardiogramAmbulatory electrocardiogramIschemia detectionCardiac event rateNonfatal myocardial infarctionSubsequent cardiac eventsAcute myocardial infarctionCardiac eventsIschemia testCardiac deathCox analysisPrognostic significanceMyocardial ischemiaEvent ratesWomen
1995
Preoperative Dipyridamole Thallium Imaging and Ambulatory Electrocardiographic Monitoring as a Predictor of Perioperative Cardiac Events and Long-term Outcome
Fleisher L, Rosenbaum S, Nelson A, Jain D, Wackers F, Zaret B. Preoperative Dipyridamole Thallium Imaging and Ambulatory Electrocardiographic Monitoring as a Predictor of Perioperative Cardiac Events and Long-term Outcome. Anesthesiology 1995, 83: 906-917.. PMID: 7486176, DOI: 10.1097/00000542-199511000-00003.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overDipyridamoleElectrocardiography, AmbulatoryFemaleHeart DiseasesHumansIntraoperative ComplicationsMaleMiddle AgedPostoperative ComplicationsPredictive Value of TestsPreoperative CarePrognosisProspective StudiesRadionuclide AngiographySensitivity and SpecificitySurvival AnalysisThallium RadioisotopesVasodilator AgentsConceptsPerioperative cardiac eventsPredictive valueDipyridamole thalliumCardiac eventsPreoperative dipyridamole thallium imagingLong-term cardiac survivalGreatest likelihood ratioNoncardiac surgery patientsPerioperative cardiac morbidityDipyridamole-thallium imagingLong-term mortalityLong-term prognosisAmbulatory electrocardiographic monitoringShort-term outcomesLong-term outcomesLikelihood ratioPositive predictive valueLog-rank statisticsNuclear cardiology laboratoryCardiac morbidityNoncardiac surgerySurgery patientsThallium imagingCardiac survivalElectrocardiographic monitoringRelationship between reverse redistribution on planar thallium scintigraphy and regional myocardial viability: a correlative PET study.
Soufer R, Dey H, Lawson A, Wackers F, Zaret B. Relationship between reverse redistribution on planar thallium scintigraphy and regional myocardial viability: a correlative PET study. Journal Of Nuclear Medicine 1995, 36: 180-7. PMID: 7830110.Peer-Reviewed Original ResearchConceptsPlanar thallium scintigraphyCardiac eventsThallium scintigraphyReverse redistributionChronic coronary artery diseasePET viabilityAbnormal regional wall motionPlanar thallium imagesMyocardial Infarction trialPercent of patientsFuture cardiac eventsFuture cardiovascular eventsCoronary artery diseaseFavorable clinical outcomeMyocardial metabolic activityRegional wall motion analysisRegional wall motionPercent of segmentsWall motion analysisPET criteriaCardiovascular eventsReperfusion therapyArtery diseaseClinical outcomesPrognostic value
1994
Prognostic significance of a fixed thallium defect one to six months after onset of acute myocardial infarction or unstable angina
Bodenheimer M, Wackers F, Schwartz R, Brown M, Group T. Prognostic significance of a fixed thallium defect one to six months after onset of acute myocardial infarction or unstable angina. The American Journal Of Cardiology 1994, 74: 1196-1200. PMID: 7977089, DOI: 10.1016/0002-9149(94)90547-9.Peer-Reviewed Original ResearchConceptsNonfatal infarctionCardiac eventsUnstable anginaCardiac deathMyocardial infarctionReversible defectsExercise thallium studiesNonfatal myocardial infarctionAcute coronary eventsLarge prospective studiesAcute cardiac eventsKaplan-Meier curvesAcute myocardial infarctionLog-rank statisticsCoronary eventsExercise thalliumPatient 1Prognostic significanceProspective studyMyocardial ischemiaThallium studiesThallium testThallium imagesInfarctionPatientsLimited usefulness of exercise testing and thallium scintigraphy in evaluation of ambulator patients several months after recovery from an acute coronary event: Implications for management of stable coronary heart disease
Krone R, Gregory J, Freedland K, Kleiger R, Wackers F, Bodenheimer M, Benhorin J, Schwartz R, Parker J, van Voorhees L, Moss A, Group F. Limited usefulness of exercise testing and thallium scintigraphy in evaluation of ambulator patients several months after recovery from an acute coronary event: Implications for management of stable coronary heart disease. Journal Of The American College Of Cardiology 1994, 24: 1274-1281. PMID: 7930250, DOI: 10.1016/0735-1097(94)90109-0.Peer-Reviewed Original ResearchConceptsStable coronary diseaseAcute coronary eventsNonfatal myocardial infarctionThallium-201 scintigraphyCardiac eventsCoronary eventsCoronary diseaseCardiac deathHospital admissionMyocardial infarctionNonfatal infarctionEnd pointUnstable anginaExercise testingObstructive coronary artery diseaseStable coronary heart diseaseExercise testing variablesSubsequent cardiac eventsCoronary artery diseaseGroup of patientsCoronary heart diseaseProportional hazards modelThallium perfusionCardiac causesIdentifies patientsOne-year prognosis of patients with normal planar or single-photon emission computed tomographic technetium 99m-labeled sestamibi exercise imaging
Raiker K, Sinusas A, Wackers F, Zaret B. One-year prognosis of patients with normal planar or single-photon emission computed tomographic technetium 99m-labeled sestamibi exercise imaging. Journal Of Nuclear Cardiology 1994, 1: 449-456. PMID: 9420729, DOI: 10.1007/bf02961599.Peer-Reviewed Original ResearchConceptsNondiagnostic exercise electrocardiogramsPositive exercise electrocardiogramExercise electrocardiogramPrognostic significanceSingle photon emissionHigher cardiac event rateCardiac event rateChest pain syndromeNegative exercise electrocardiogramNonfatal myocardial infarctionOne-year prognosisPositive stress electrocardiogramCoronary artery diseaseFavorable prognostic significanceMyocardial perfusion imagingStress perfusion imagesCardiac causesCardiac eventsPain syndromeArtery diseaseConsecutive patientsExercise SPECTMyocardial infarctionFavorable outcomeStress electrocardiogramExercise myocardial perfusion imaging.
Wackers F. Exercise myocardial perfusion imaging. Journal Of Nuclear Medicine 1994, 35: 726-9. PMID: 8151402.Peer-Reviewed Original Research
1990
Silent left ventricular dysfunction during routine activity after thrombolytic Therapy for acute myocardial infarction
Kayden D, Wackers F, Zaret B. Silent left ventricular dysfunction during routine activity after thrombolytic Therapy for acute myocardial infarction. Journal Of The American College Of Cardiology 1990, 15: 1500-1507. PMID: 2345230, DOI: 10.1016/0735-1097(90)92817-l.Peer-Reviewed Original ResearchConceptsTransient left ventricular dysfunctionLeft ventricular dysfunctionSilent left ventricular dysfunctionVentricular dysfunctionMyocardial infarctionCardiac eventsHospital dischargeEjection fractionThrombolytic therapySubmaximal supine bicycle exerciseNormal activityBaseline ejection fractionExercise test resultsSubsequent cardiac eventsSupine bicycle exerciseVentricular function monitoringAcute myocardial infarctionChest painPeak exerciseBicycle exerciseAmbulatory patientsElectrocardiographic changesPoor outcomePrognostic informationFunction monitoring
1987
Usefulness of residual ischemic myocardium within prior infarct zone for identifying patients at high risk late after acute myocardial infarction
Brown K, Weiss R, Clements J, Wackers F. Usefulness of residual ischemic myocardium within prior infarct zone for identifying patients at high risk late after acute myocardial infarction. The American Journal Of Cardiology 1987, 60: 15-19. PMID: 3604929, DOI: 10.1016/0002-9149(87)90975-1.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionTI-201 redistributionCardiac eventsInfarct zoneMyocardial infarctionStepwise multivariate logistic regression analysisPrior acute myocardial infarctionAngiographic coronary artery diseaseMultivariate logistic regression analysisIschemic viable myocardiumResidual ischemic myocardiumTotal cardiac eventsCoronary artery diseaseThallium-201 imagingSignificant predictorsLogistic regression analysisOnly significant predictorCoronary revascularizationChest painArtery diseaseCardiac catheterizationConsecutive patientsPrognostic implicationsViable myocardiumIschemic myocardium