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  • Effect of Losmapimod on Cardiovascular Outcomes in Patients Hospitalized With Acute Myocardial Infarction: A Randomized Clinical Trial

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    JAMA. 2016; 315(15):1591-1599. doi: 10.1001/jama.2016.3609

    This randomized trial evaluates the efficacy and safety of losmapimod vs placebo on cardiovascular outcomes in patients hospitalized with an acute myocardial infarction (MI).

  • JAMA April 7, 2015

    Figure 1: Diagram of Patient Flow in the BRIGHT Trial

    AMI indicates acute myocardial infarction; CABG, coronary artery bypass graft; NSTEMI, non–ST-segment elevation MI; PCI, percutaneous coronary intervention; STEMI, ST-segment elevation MI. The total number of patients with AMI who were screened but not enrolled and the reasons for their exclusion are not available.
  • Extent, Location, and Clinical Significance of Non–Infarct-Related Coronary Artery Disease Among Patients With ST-Elevation Myocardial Infarction

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    JAMA. 2014; 312(19):2019-2027. doi: 10.1001/jama.2014.15095

    This retrospective pooled analysis of 8 clinical trials reports that obstructive non–infarct-related artery disease was common among patients presenting with ST-elevation myocardial infarction (STEMI).

  • JAMA November 19, 2014

    Figure 1: Extent, Distribution, and Location of Obstructive Non–Infarct-Related Artery Disease Among Patients With ST-Elevation Myocardial Infarction

    Obstructive coronary artery disease was defined as more than 50% stenosis in major epicardial coronary artery.aThe data are from the Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) I trial, the GUSTO IIb trial, the GUSTO III trial, the Integrilin to Minimise Platelet Aggregation and Coronary Thrombus in Acute Myocardial Infarction (IMPACT-AMI) trial, the GUSTO V trial, the Integrilin and Tenecteplase in Acute Myocardial Infarction (INTEGRITI) trial, the Caldaret in ST Elevation Myocardial Infarction (CASTEMI) trial, and the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX AMI) trial.bPresence or absence of obstructive coronary artery disease on each vessel territory (LAD, LCX, RCA, or LMCA) was counted. The denominators include patients at risk for non-IRA disease in the specified artery who did not have missing data on angiogram-estimated stenosis necessary to determine non-IRA status.
  • Association of Inpatient vs Outpatient Onset of ST-Elevation Myocardial Infarction With Treatment and Clinical Outcomes

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    JAMA. 2014; 312(19):1999-2007. doi: 10.1001/jama.2014.15236

    This retrospective observational analysis of ST-elevation myocardial infarctions (STEMIs) from a California database found that patients who had a STEMI while hospitalized for a non–acute coronary syndrome condition were less likely to undergo invasive testing or intervention and had a higher in-hospital mortality rate than those with outpatient onset of STEMI.

  • JAMA April 16, 2014

    Figure 1: Flow of Patients Through the Glycometabolic Intervention as Adjunct to Primary Coronary Intervention in the ST-Segment Elevation Myocardial Infarction (GIPS-III) Trial

    Patients could be excluded for more than 1 reason; the primary reason for exclusion in each case is shown. CABG indicates coronary artery bypass graft; ICD, implantable cardioverter-defibrillator; LVEF, left ventricular ejection fraction; MRI, magnetic resonance imaging; STEMI, ST-segment elevation myocardial infarction; TIMI, Thrombolysis in Myocardial Infarction; PCI, percutaneous coronary intervention.
  • Effect of Metformin on Left Ventricular Function After Acute Myocardial Infarction in Patients Without Diabetes: The GIPS-III Randomized Clinical Trial

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    JAMA. 2014; 311(15):1526-1535. doi: 10.1001/jama.2014.3315

    Lexis and coauthors conducted a double-blind, placebo-controlled trial in 380 Dutch patients to evaluate the effect of metformin treatment on preservation of left ventricular function in patients without diabetes presenting with ST-segment elevation acute myocardial infarction (AMI).

  • One-Year Follow-up of Intracoronary Stem Cell Delivery on Left Ventricular Function Following ST-Elevation Myocardial Infarction

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    JAMA. 2014; 311(3):301-302. doi: 10.1001/jama.2013.282674
  • JAMA January 15, 2014

    Figure 4: Comparison of the Effects of Varespladib and Placebo on the Incidence of Primary Composite Outcome and Myocardial Infarction in Prespecified Subgroup Patient Characteristics

    The primary efficacy outcome was a composite of cardiovascular mortality, nonfatal myocardial infarction, nonfatal stroke, and unstable angina with evidence of ischemia requiring hospitalization at 16 weeks. Patients were randomized to receive either varespladib (500 mg/d) or placebo for 16 weeks. Non-STEMI indicates non–ST-segment elevation myocardial infarction; PCI, percutaneous coronary intervention; STEMI, ST-segment elevation myocardial infarction. Because of missing data, number of patients in the subgroups do not sum to total number of patients randomized to receive placebo or varespladib.
  • JAMA March 13, 2013

    Figure 2: Number Needed to Harm (NNH) for In-hospital Mortality Related to Major Bleeding in the Propensity-Matched Cohort and in Selected Subgroups

    The dashed line at x = 29 represents the NNH for the overall population. STEMI indicates ST-segment elevation myocardial infarction; NSTEMI, non-STEMI; UA, unstable angina; ACS, acute coronary syndrome; Gp, glycoprotein.
  • Effect of the Use and Timing of Bone Marrow Mononuclear Cell Delivery on Left Ventricular Function After Acute Myocardial Infarction: The TIME Randomized Trial

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    JAMA. 2012; 308(22):2380-2389. doi: 10.1001/jama.2012.28726
    Traverse and coauthors for the Cardiovascular Cell Therapy Research Network report on the effect on left ventricular function of the use and timing of bone marrow mononuclear cell delivery after acute myocardial infarction. In an accompanying Editorial, Marbán and Malliaras discuss the mixed results for bone marrow–derived cell therapy for ischemic heart disease.
  • Association of Public Reporting for Percutaneous Coronary Intervention With Utilization and Outcomes Among Medicare Beneficiaries With Acute Myocardial Infarction

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    JAMA. 2012; 308(14):1460-1468. doi: 10.1001/jama.2012.12922
    To determine if public reporting of percutaneous coronary intervention (PCI) outcomes is associated with lower PCI rates or higher mortality rates, Joynt and coauthors assessed data from fee-for-service Medicare patients (49 660 from reporting states and 48 142 from nonreporting states) hospitalized with acute myocardial infarction. In the related Editorial, Moscucci discusses public reporting of PCI outcomes.
  • Association of Changes in Clinical Characteristics and Management With Improvement in Survival Among Patients With ST-Elevation Myocardial Infarction

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    JAMA. 2012; 308(10):998-1006. doi: 10.1001/2012.jama.11348
    In a comparison of 4 national French registries of a single month for the years 1995, 2000, 2005, and 2010, Danchin and coauthors tracked survival rates among patients with ST-elevation myocardial infarction to determine whether factors other than reperfusion therapy contributed to improved survival rates.
  • JAMA August 22, 2012

    Figure 1: Trial Profile and Flow of Patients

    STEMI indicates ST-segment elevation myocardial infarction; PCI, percutaneous coronary intervention.aA total of 2575 patients underwent primary PCI for treatment of STEMI at 11 international sites during the inclusion period. No reliable data for patients assessed for eligibility are available.bOne patient treated with bare-metal stent did not undergo PCI and was assumed to have 1 lesion.
  • Effect of a Multifaceted Intervention on Use of Evidence-Based Therapies in Patients With Acute Coronary Syndromes in Brazil: The BRIDGE-ACS Randomized Trial

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    JAMA. 2012; 307(19):2041-2049. doi: 10.1001/jama.2012.413
    To evaluate whether a multifaceted quality improvement (QI) intervention can improve the use of evidence-based therapies, Berwanger and coauthors randomly assigned 34 clusters of public hospitals (1150 patients) to receive a multifaceted QI intervention vs routine practice. In the related Editorial, Berwick discusses the complexity inherent in defining QI and implementing QI interventions.
  • JAMA May 16, 2012

    Figure 2: Primary End Point According to Prespecified Subgroups

    The primary end point comprised adherence to all eveidence-based therapies during the first 24 hours in patients without contraindications. ACS indicates acute coronary syndrome; ED, emergency department; NSTE-ACS, non–ST-segment elevation ACS; ORPA, population average odds ratio; PCI, percutaneous coronary intervention; STEMI, ST-segment elevation myocardial infarction.
  • JAMA December 14, 2011

    Figure 2: Forest Plots Comparing In-hospital Mortality Following Percutaneous Coronary Intervention at Sites With and Without Surgery

    Odds ratio (OR) estimates with 95% CIs of all studies for the outcomes of death by indication for percutaneous coronary intervention. In the case of 0 counts, ORs were calculated by adding 0.5 to all cell counts from the study to avoid division by 0. STEMI indicates ST-elevation myocardial infarction.
  • JAMA December 14, 2011

    Figure 3: Funnel Plot to Evaluate Publication Bias

    Studies comparing in-hospital mortality and emergency coronary artery bypass grafting (CABG) surgery after nonprimary (elective for patients without ST elevation myocardial infarction [STEMI]) and primary (patients with STEMI) percutaneous coronary intervention. Trim-and–based estimates of unpublished studies are also shown.
  • JAMA September 21, 2011

    Figure 1: Study Flow

    STEMI indicates ST-elevation myocardial infarction.
  • JAMA July 6, 2011

    Figure 1: PCI Appropriateness Study Cohort

    CT indicates computed tomography; NCDR, National Cardiovascular Data Registry; PCI, percutaneous coronary intervention; STEMI, ST-segment elevation myocardial infarction.aIncluded as part of sensitivity analyses.