Karen P. Alexander
Duke University
CardiologyPhysical therapyMyocardial infarctionDiabetes mellitusMedicine
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Publications 400
The molecular foundations of longevity are poorly understood. We examined circulating miRNA profiles with the hypothesis that clues to functional longevity despite cardiovascular disease (CVD) may lie in miRNA profiles reflecting differential regulation of gene expression in individuals living to
#1Alexander C. Fanaroff (Leonard Davis Institute of Health Economics)H-Index: 8
#1Alexander C. Fanaroff (Leonard Davis Institute of Health Economics)
Last. Karen P. Alexander (Duke University)H-Index: 58
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BACKGROUND: The primary goal of phase 2 and 3 clinical trials is to evaluate the safety and effectiveness of therapeutic interventions, and efficient and reproducible ascertainment of important clinical events, either as clinical outcome events (COEs) or adverse events (AEs), is critical. Clinical outcomes require consistency and clinical judgment, so these events are often adjudicated centrally by clinical events classification (CEC) physician reviewers using standardized definitions. In contra...
The extent and severity of coronary artery disease (CAD), ischemia and angina may influence revascularization decision making, so their inter-relationship is clinically relevant. We used proportional odds models to examine these associations at baseline in 4050 enrolled ischemia trial participants
BACKGROUND: In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS: We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 mont...
1 CitationsSource
BACKGROUND: Clinical trials that have assessed the effect of revascularization in patients with stable coronary disease have routinely excluded those with advanced chronic kidney disease. METHODS: We randomly assigned 777 patients with advanced kidney disease and moderate or severe ischemia on stress testing to be treated with an initial invasive strategy consisting of coronary angiography and revascularization (if appropriate) added to medical therapy or an initial conservative strategy consist...
4 CitationsSource
BACKGROUND: Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS: We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone an...
10 CitationsSource
We developed a risk model to predict hospitalization for bleeding within 6 months of discharge in older adults hospitalized for acute MI (AMI) and discharged on dual antiplatelet therapy (DAPT). SILVER-AMI is a cohort study of 3041 patients age ≥75 hospitalized with AMI at 96 U.S. hospitals.
#1Angela Lowenstern (Duke University)H-Index: 3
#2Karen P. Alexander (Duke University)H-Index: 58
Last. Pamela S. Douglas (Duke University)H-Index: 116
view all 11 authors...
Importance Although cardiovascular (CV) disease represents the leading cause of morbidity and mortality that increases with age, the best noninvasive test to identify older patients at risk for CV events remains unknown. Objective To determine whether the prognostic utility of anatomic vs functional testing varies based on patient age. Design, Setting, and Participants Prespecified analysis of the Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) study, which used a pr...