Ischemic cardiac outcomes and hospitalizations according to prior macrovascular disease status in patients with type 2 diabetes and recent acute coronary syndrome from the Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care tria


BACKGROUND:Concerns raised regarding adverse cardiovascular (CV) outcomes with new therapies for type 2 diabetes mellitus (T2DM) have led to several large-scale CV outcome trials. The EXAMINE trial confirmed noninferiority of the dipeptidyl dipeptidase 4 inhibitor alogliptin to placebo on major adverse cardiac event rates in a post-acute coronary syndrome (ACS) T2DM population. We present data on additional ischemic cardiac events and CV hospitalizations in EXAMINE. METHODS:Patients with T2DM and an ACS event in the previous 15 to 90 days were randomly assigned to alogliptin or placebo on a background of standard treatment for diabetes. The incident rates of a 5-component composite end point of CV death, stroke, myocardial infarction, unstable angina, and coronary revascularization as well as CV hospitalization were calculated in all participants and according to macrovascular disease at baseline. RESULTS:There were no significant differences between alogliptin (n = 2,701) and placebo (n = 2,679) in the event rate of the 5-component composite endpoint with median follow-up 533 days (21.0% vs 21.5%, hazard ratio [HR] 0.98 [0.87-1.10], P = .72). No differences were observed in terms of CV hospitalization (25.0% vs 25.4%, HR 0.98 [0.88-1.09], P = .70) or coronary revascularization (10.6% vs 10.2%, HR 1.05 [0.88-1.09], P = .60). No interactions were observed for treatment and prior macrovascular disease. CONCLUSIONS:EXAMINE demonstrates that there was no increase in the risk of cardiac ischemic events and CV hospitalizations with alogliptin in a high-risk post-ACS patient population. Because these are major driver of overall health care costs, these data suggest that there would be no adverse impact on health care resource utilization.


Am Heart J


American heart journal


Shimada YJ,Cannon CP,Liu Y,Wilson C,Kupfer S,Menon V,Cushman WC,Mehta CR,Bakris GL,Zannad F,White WB,EXAMINE Investigators.




Has Abstract


2016-05-01 00:00:00












  • Concerns about the implantable cardioverter defibrillator: a determinant of anxiety and depressive symptoms independent of experienced shocks.

    abstract:BACKGROUND:Patients with an implantable cardioverter defibrillator (ICD) are at increased risk of anxiety disorders. In turn, anxiety has been identified as a precipitant of ventricular arrhythmias. Anxiety may in part be attributed to concerns about the ICD firing, but the relationship between ICD concerns, psychologi...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Pedersen SS,van Domburg RT,Theuns DA,Jordaens L,Erdman RA

    更新日期:2005-04-01 00:00:00

  • Presyncopal sympathetic withdrawal is the same in patients with vasodepressor syncope and controls who faint on head-up tilting.

    abstract::Head-up tilt provokes vasodepressor syncope in patients with this disorder but may also cause fainting in unaffected subjects. The aims of this study were to examine autonomic function and sequential changes in heart rate variability and plasma catecholamines during graded head-up tilt in patients with vasodepressor s...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Prinz-Zaiss M,Yeap AN,Moguilevski V,Trigg L,McGrath BP

    更新日期:1997-02-01 00:00:00

  • Microwave ablation of canine atrial tachycardia induced by aconitine.

    abstract::We tested the efficacy of microwave-frequency energy for ablating atrial tachycardia in eight open-chest dogs. Five other dogs served as controls. Atrial tachycardia was induced by direct application of aconitine crystals to the epicardial atrial surface or by injection of aconitine solution (0.15 mg/ml) into the righ...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Rho TH,Ito M,Pride HP,Waller B,Zipes DP

    更新日期:1995-05-01 00:00:00

  • Changes occurring in the postinfarction ECG in relation to age, sex, and previous myocardial infarction.

    abstract::Minnesota codes (MC), expressing Q-QS, ST segment, and T wave abnormalities in ECGs taken during the acute event and at a 1-year follow-up were studied in 256 survivors of myocardial infarction (MI). On the 1-year ECGs large Q waves (MC 1.1) were more common in patients with a history of previous MI than in those with...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Rissanen V,Raunio H,Halinen MO,Rehnberg S

    更新日期:1986-02-01 00:00:00

  • Long-term economic outcomes associated with intensive versus moderate lipid-lowering therapy in coronary artery disease: results from the Treating to New Targets (TNT) Trial.

    abstract:BACKGROUND:In 10,001 patients with stable coronary artery disease (CAD) enrolled in the Treating to New Targets (TNT) trial, 80 mg/d of atorvastatin (high-dose regimen) reduced the composite primary end point of death from CAD, nonfatal myocardial infarction, resuscitation from cardiac arrest, or stroke by 22% relative...

    journal_title:American heart journal

    pub_type: 杂志文章,随机对照试验


    authors: Mark DB,Knight JD,Cowper PA,Davidson-Ray L,Anstrom KJ

    更新日期:2008-10-01 00:00:00

  • Simulated tricuspid valve echoes in tricuspid atresia.

    abstract::A case of tricuspid atresia with unusual echocardiographic findings is presented. The echocardiogram was successful in defining great artery interrelationships, ventricular looping, and cavity sizes. An echo pattern resembling the motion of a small tricuspid valve was observed; this was proven to be spurious at cathet...

    journal_title:American heart journal

    pub_type: 杂志文章


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  • Mitochondrial defects in cardiomyopathy and neuromuscular disease.

    abstract::Over the past 11 years, a considerable body of evidence has accumulated implicating defects in the mitochondrial energy-generating pathway, oxidative phosphorylation, in a wide variety of degenerative diseases including myopathy and cardiomyopathy. Most classes of pathogenic mitochondrial DNA mutations affect the hear...

    journal_title:American heart journal

    pub_type: 杂志文章,评审


    authors: Wallace DC

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  • Diagnosis of Björk-Shiley aortic valve dysfunction by echocardiography.

    abstract::Echocardiography was performed on 26 patients with prosthetic Björk-Shiley aortic valves (BSAV). Technically satisfactory records were obtained in 22 patients. The systolic displacement of the valve disc varied from 1 to 1.8 cm. (mean, 1.4 cm.). Six patients developed valve dysfunction. Two patients had complete absen...

    journal_title:American heart journal

    pub_type: 杂志文章


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  • Ventricular pacing threshold and refractoriness after defibrillation shocks in patients with implantable cardioverter-defibrillators.

    abstract::The aim of this study was to examine the effect of ventricular fibrillation and a subsequent defibrillation shock on ventricular excitability and refractoriness in human beings. We studied 16 consecutive patients with implantable cardioverter-defibrillators undergoing follow-up studies. The pre- and post-shock pacing ...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Yu JC,Lauer MR,Young C,Liem B,Peterson J,Ottoboni L,Sung RJ

    更新日期:1996-06-01 00:00:00

  • Diastolic wall motion abnormality after myocardial infarction: relation to neurohormonal activation and prognostic implications.

    abstract:BACKGROUND:Systolic wall motion abnormality (WMA) after acute myocardial infarction (AMI) is a major determinant of outcome; the presence and importance of diastolic WMA after AMI are unknown. We therefore sought to detect diastolic WMA using color kinesis and to assess its relation to neurohormonal activation and its ...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Husic M,Nørager B,Egstrup K,Lang RM,Møller JE

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  • Comparison of heart rate and blood pressure response to amyl nitrite, isoproterenol, and standing before and during acute beta-adrenergic blockade with intravenous propranolol.

    abstract::Heart rate responses to three different procedures (amyl nitrite inhalation, standing up, and isoproterenol infusion), were studied before and during acute adrenergic beta blockade with intravenous propranolol in three normal and six hypertensive subjects. Propranolol decreased, but did not completely abolish, the hea...

    journal_title:American heart journal

    pub_type: 杂志文章


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    更新日期:1978-07-01 00:00:00

  • Septal ventricular pacing in the immature canine heart: a new perspective.

    abstract::Cardiac pacing initiated from epicardial or transvenous apical right ventricular electrodes causes asynchronous ventricular contraction. This alters myocardial stress vectors and results in adverse cellular and subcellular changes in the experimental animal. Clinically, such changes may contribute to the adverse hemod...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Karpawich PP,Justice CD,Chang CH,Gause CY,Kuhns LR

    更新日期:1991-03-01 00:00:00

  • Adenosine or adenosine triphosphate for supraventricular tachycardias? Comparative double-blind randomized study in patients with spontaneous or inducible arrhythmias.

    abstract::The effects of intravenous adenosine and adenosine triphosphate (ATP) were studied in a double-blind randomized study during 68 episodes of supraventricular tachycardia in 39 patients. Adenosine restored sinus rhythm in 20 patients (25 of 27 episodes) and produced atrioventricular block to reveal atrial arrhythmias in...

    journal_title:American heart journal

    pub_type: 临床试验,杂志文章,随机对照试验


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    更新日期:1990-02-01 00:00:00

  • Combined vasodilator and inotropic therapy of heart failure: experimental and clinical concepts.

    abstract::Vasodilators facilitate ventricular emptying by affording earlier onset of left ventricular (LV) ejection and increased stroke volume with achievement of a reduced end-systolic pressure and volume. Agents with positive inotropic properties increase stroke volume by shifting the end-systolic pressure-volume curve to th...

    journal_title:American heart journal

    pub_type: 杂志文章,评审


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    更新日期:1981-09-01 00:00:00

  • Effectiveness of recanalization of chronic total occlusions: a systematic review and meta-analysis.

    abstract:BACKGROUND:Chronic total occlusion (CTO) recanalizations remain extremely challenging procedures. With improvements in technology and techniques, success rates for recanalization of CTO continue to improve. However, the clinical benefits of this practice remain unclear. The aim of the study was to determine the effecti...

    journal_title:American heart journal

    pub_type: 杂志文章,meta分析,评审


    authors: Joyal D,Afilalo J,Rinfret S

    更新日期:2010-07-01 00:00:00

  • Selecting therapy for sustained ventricular tachycardias: importance of the sensitivity and specificity of programmed electrical stimulation for predicting arrhythmia recurrences.

    abstract::Antiarrhythmic therapy for prevention of sustained ventricular tachycardia is commonly guided by programmed electrical stimulation, and the persistent ability to initiate ventricular tachycardia during drug therapy often leads to the use of nonpharmacologic therapies such as surgery. Prior studies suggest that program...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Stevenson WG,Weiss J,Oye RK

    更新日期:1990-04-01 00:00:00

  • A double-blind, randomized study of the effect of immediate intravenous nitroglycerin on the incidence of postprocedural chest pain and minor myocardial necrosis after elective coronary stenting.

    abstract:BACKGROUND:Anginal chest pain without creatine kinase (CK) elevation is frequently observed in the first hours after coronary stenting. Possible causes of ischemic episodes are microembolism, side branch occlusion, coronary vasospasm, and disturbances of microvascular circulation. In a prospective, double-blind, random...

    journal_title:American heart journal

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Kurz DJ,Naegeli B,Bertel O

    更新日期:2000-01-01 00:00:00

  • Cocaine use is associated with an increased risk of stent thrombosis after percutaneous coronary intervention.

    abstract:BACKGROUND:The treatment of cocaine-related acute coronary syndromes presents unique challenges. Although percutaneous coronary intervention in cocaine abusers appears to be safe in the short term, longer-term outcomes have not been reported. We postulated that cocaine use would be associated with increased risk for st...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: McKee SA,Applegate RJ,Hoyle JR,Sacrinty MT,Kutcher MA,Sane DC

    更新日期:2007-07-01 00:00:00

  • Perivalvular cavities in endocarditis: abscesses versus pseudoaneurysms? A transesophageal Doppler echocardiographic study in 118 patients with endocarditis.

    abstract::The appearance of perivalvular cavities (PCs) in patients with infectious endocarditis (IE) was studied by transesophageal echocardiography (TEE) color Doppler examinations to determine whether the color Doppler TEE presentation was in keeping with the current concept of PCs representing abscesses. Two heart centers p...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Tingleff J,Egeblad H,Gøtzsche CO,Baandrup U,Kristensen BO,Pilegaard H,Pettersson G

    更新日期:1995-07-01 00:00:00

  • Accelerated treatment of endocarditis-The POET II trial: Rationale and design of a randomized controlled trial.

    abstract:BACKGROUND:The optimal antibiotic treatment length for infective endocarditis (IE) is uncertain. International guidelines recommend treatment duration of up to 6 weeks for patients with left-sided IE but are primarily based on historical data and expert opinion. Efficacies of modern therapies, fast recovery seen in man...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Østergaard L,Pries-Heje MM,Hasselbalch RB,Rasmussen M,Åkesson P,Horvath R,Povlsen J,Gill S,Bruun NE,Müllertz K,Tuxen CD,Ihlemann N,Helweg-Larsen J,Moser C,Fosbøl EL,Bundgaard H,Iversen K

    更新日期:2020-09-01 00:00:00

  • Impact of computerized dosing on eptifibatide-associated bleeding and mortality.

    abstract:OBJECTIVE:The study aimed to determine the impact on eptifibatide-associated bleeding by implementing a computerized dosing algorithm in the cardiac catheterization suite. BACKGROUND:Excessive dosing of eptifibatide is associated with increased bleeding rates and hospital mortality. Although dosing adjustments based o...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Putney DR,Kleiman NS,Fromm RE Jr,Buergler JM

    更新日期:2009-12-01 00:00:00

  • Genetic loci associated with ideal cardiovascular health: A meta-analysis of genome-wide association studies.

    abstract:BACKGROUND:Multiple genetic loci are associated with clinical cardiovascular (CV) disease and individual CV risk factors. Individuals with ideal levels of all major CV risk factors have very low risk for CV disease morbidity or mortality. Ideal levels of risk factors can be attained by lifestyle modifications; however,...

    journal_title:American heart journal

    pub_type: 杂志文章,meta分析


    authors: Allen NB,Lloyd-Jones D,Hwang SJ,Rasmussen-Torvik L,Fornage M,Morrison AC,Baldridge AS,Boerwinkle E,Levy D,Cupples LA,Fox CS,Thanassoulis G,Dufresne L,Daviglus M,Johnson AD,Reis J,Rotter J,Palmas W,Allison M,Pankow J

    更新日期:2016-05-01 00:00:00

  • Use of beta-blockers and effects on heart rate and blood pressure post-acute coronary syndromes: are we on target?

    abstract:BACKGROUND:beta-blockers have been shown to benefit patients after myocardial infarction by decreasing mortality, sudden cardiac death, and reinfarction. Although beta-blockers are recommended for all patients with acute coronary syndromes (ACS) without contraindications, a target heart rate (HR) is recommended only fo...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Herman M,Donovan J,Tran M,McKenna B,Gore JM,Goldberg RJ,Tighe DA

    更新日期:2009-09-01 00:00:00

  • Silent myocardial ischemia in patients with non-insulin-dependent diabetes mellitus as judged by treadmill exercise testing and coronary angiography.

    abstract::Patients with diabetes were compared with nondiabetic control subjects, with respect to the prevalence of silent myocardial ischemia, by means of treadmill exercise testing and coronary angiography. Results of treadmill exercise testing showed ischemic ST depression in 41 of the 132 diabetic patients (mean age 61 +/- ...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Naka M,Hiramatsu K,Aizawa T,Momose A,Yoshizawa K,Shigematsu S,Ishihara F,Niwa A,Yamada T

    更新日期:1992-01-01 00:00:00

  • Rationale and design of ApoA-I Event Reducing in Ischemic Syndromes II (AEGIS-II): A phase 3, multicenter, double-blind, randomized, placebo-controlled, parallel-group study to investigate the efficacy and safety of CSL112 in subjects after acute myocardi

    abstract::Acute myocardial infarction (MI) patients remain at high risk for recurrent events. Cholesterol efflux, mediated by apolipoprotein A-I, removes excess cholesterol from atherosclerotic plaque and transports it to the liver for excretion. Impaired cholesterol efflux is associated with higher cardiovascular (CV) event ra...

    journal_title:American heart journal

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Gibson CM,Kastelein JJP,Phillips AT,Aylward PE,Yee MK,Tendera M,Nicholls SJ,Pocock S,Goodman SG,Alexander JH,Lincoff AM,Bode C,Duffy D,Heise M,Berman G,Mears SJ,Tricoci P,Deckelbaum LI,Steg PG,Ridker P,Mehran R

    更新日期:2021-01-01 00:00:00

  • ST-segment elevation resolution and outcome in patients treated with primary angioplasty and glucose-insulin-potassium infusion.

    abstract:BACKGROUND:To evaluate the impact of adjunctive high-dose glucose-insulin-potassium (GIK) on ST-segment elevation resolution in patients with ST-segment elevation myocardial infarction (MI). METHODS:As part of a randomized controlled trial of GIK versus no GIK in patients treated with primary percutaneous coronary int...

    journal_title:American heart journal

    pub_type: 杂志文章,随机对照试验


    authors: van der Horst IC,De Luca G,Ottervanger JP,de Boer MJ,Hoorntje JC,Suryapranata H,Dambrink JH,Gosselink AT,Zijlstra F,van 't Hof AW

    更新日期:2005-06-01 00:00:00

  • Ischemic ST segment depression in leads V2-V3 as the presenting electrocardiographic feature of posterolateral wall myocardial infarction.

    abstract::In this study of 14 patients hospitalized with a first event of myocardial infarction, maximal ST segment depression in precordial leads V2 and V3 was the sole ECG finding during chest pain in the first 24 hours of evolving posterolateral infarction, based upon further two-dimensional echocardiographic examination and...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Sclarovsky S,Topaz O,Rechavia E,Strasberg B,Agmon J

    更新日期:1987-05-01 00:00:00

  • Patients with high baseline exercise capacity benefit from cardiac rehabilitation and exercise training programs.

    abstract::Despite the well-proven benefits of cardiac rehabilitation and exercise training, no data are available on the benefits of this therapy in patients with preserved baseline exercise capacity. Therefore we assessed data before and after phase II cardiac rehabilitation and exercise programs at two large teaching institut...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Lavie CJ,Milani RV

    更新日期:1994-12-01 00:00:00

  • "Non-Q wave," alias "nontransmural," myocardial infarction: a specific entity.

    abstract::Although Q wave and non-Q wave MI are often referred to as "transmural" and "nontransmural," there is no anatomic evidence to justify this distinction. Nevertheless, a distinction is important, because the two entities have a different prognosis. At the present time, between 25% and 35% of MIs are non-Q wave. They are...

    journal_title:American heart journal

    pub_type: 杂志文章,评审


    authors: André-Fouet X,Pillot M,Leizorovicz A,Finet G,Gayet C,Milon H

    更新日期:1989-04-01 00:00:00

  • Temporal trends in gastrointestinal bleeding associated with percutaneous coronary intervention: analysis of the 1998-2006 Nationwide Inpatient Sample (NIS) database.

    abstract:BACKGROUND:Gastrointestinal bleeding (GIB) after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) and coronary artery disease (CAD) is associated with high morbidity and mortality. METHODS:The NIS database from 1998 to 2006 was used to identify 1,216,759 PCIs performed for ACS and CAD. We sou...

    journal_title:American heart journal

    pub_type: 杂志文章


    authors: Shivaraju A,Patel V,Fonarow GC,Xie H,Shroff AR,Vidovich MI

    更新日期:2011-12-01 00:00:00