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Kim A. Eagle

Bio: Kim A. Eagle is an academic researcher from University of Michigan. The author has contributed to research in topics: Aortic dissection & Myocardial infarction. The author has an hindex of 129, co-authored 823 publications receiving 75160 citations. Previous affiliations of Kim A. Eagle include University of Wisconsin Hospital and Clinics & Spaulding Rehabilitation Hospital.


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Journal ArticleDOI
TL;DR: Patients previously taking statins had a lower incidence of in-hospital arrhythmic events after acute coronary syndrome than those not previously takingStatins, and another possible benefit from appropriate primary and secondary prevention therapy with statins is suggested.
Abstract: Animal models of myocardial ischemia have demonstrated reduction in arrhythmias using statins. It was hypothesized that previous statin therapy before hospitalization might be associated with reductions of in-hospital arrhythmic events in patients with acute coronary syndromes. In this multinational, prospective, observational study (the Global Registry of Acute Coronary Events [GRACE]), data from 64,679 patients hospitalized for suspected acute coronary syndromes (from 1999 to 2007) were analyzed. The primary outcome of interest was in-hospital arrhythmic events in previous statin users compared with nonusers. The 2 primary end points were atrial fibrillation and the composite end point of ventricular tachycardia, ventricular fibrillation, and/or cardiac arrest. In-hospital death was also examined. Of the 64,679 patients, 17,636 (27%) had received previous statin therapy. Those taking statins had higher crude rates of histories of angina (69% vs 46%), diabetes (34% vs 22%), heart failure (15% vs 8.4%), hypertension (74% vs 58%), atrial fibrillation (9.3% vs 7.0%), and dyslipidemia (85% vs 35%). Patients previously taking statins were less likely to have in-hospital arrhythmias. In propensity-adjusted multivariable models, previous statin use was associated with a lower risk for ventricular tachycardia, ventricular fibrillation, or cardiac arrest (odds ratio 0.81, 95% confidence interval 0.72 to 0.96, p = 0.002); atrial fibrillation (odds ratio 0.81, 95% confidence interval 0.73 to 0.89, p <0.0001); and death (odds ratio 0.82, 95% confidence interval 0.70 to 0.95, p = 0.010). In conclusion, patients previously taking statins had a lower incidence of in-hospital arrhythmic events after acute coronary syndrome than those not previously taking statins. Our study suggests another possible benefit from appropriate primary and secondary prevention therapy with statins.

23 citations

Journal ArticleDOI
TL;DR: TTC seems to exhibit a temporal variation of onset, with preferred peaks during morning and summer, and stress and catecholamines might play a pivotal role.
Abstract: The occurrence of major cardiovascular events is not randomly distributed over time, but exhibits chronobiological patterns, i.e., circadian, weekly, or seasonal. No systematic studies on the temporal preference of onset of Tako-tsubo cardiomyopathy (TTC) are known. We performed a computer-assisted search of the literature (from 2000 to January 2010), with the following search terms: transient left ventricular apical ballooning syndrome, takotsubo-like left ventricular dysfunction, ampulla cardiomyopathy, tako-tsubo or takotsubo cardiomyopathy, tako-tsubo, apical ballooning. Criteria for publication inclusion were (a) reporting of original data, (b) inclusion of at least 30 or more cases, (c) adherence to the requested diagnostic criteria for TTC. We focused on studies including in their purposes the “time of onset” of events. Out of the 19 studies found, 7 (4 from Europe, 1 each from Asia, Australia and USA) specifically addressed this aspect. A circadian (morning) and a seasonal (summer) higher frequency of events was found. TTC seems to exhibit a temporal variation of onset, with preferred peaks during morning and summer. Stress and catecholamines, also according to their temporal organization, might play a pivotal role. The demonstration of time frames characterized by highest frequency of occurrence might help to try to ensure maximal protection during particularly vulnerable periods.

23 citations

Journal ArticleDOI
TL;DR: A 41-year-old woman was transferred to this hospital because of thrombocytopenia, anemia, and changed mental status because of a history of treated hypothyroidism, well-controlled hypertension, and mild anemia of several years' duration accompanied by slight leukopenia.
Abstract: Presentation of Case A 41-year-old woman was transferred to this hospital because of thrombocytopenia, anemia, and changed mental status. There was a history of treated hypothyroidism, well-controlled hypertension, and mild anemia of several years' duration accompanied by slight leukopenia. Hematologic studies were performed seven months before admission (Table 1). A test for antinuclear antibodies, performed 11 months before admission, was negative. The patient was otherwise well until five days before admission, when she was admitted to another hospital because of one week of substernal pain that radiated to the left hand, tingling in the right leg, intermittent headaches, and light . . .

23 citations

Journal ArticleDOI
TL;DR: It is concluded that a chest pain management algorithm in achest pain center can be safe, yet effective, for identifying high-risk patients for admission and low- risk patients for discharge.
Abstract: The iterative lessons from our studies suggest that creation of a chest pain center alone will not change the practice of chest pain management by most physicians. In 1993 we established a chest pain center; in mid-1995 we established a patient management algorithm directing intermediate-risk patients to the chest pain center rather than admit them to the hospital. The creation of a chest pain center did not reduce the rate of chest pain admission by mid-1995. After the patient management algorithm was created, admittances dropped by a rate of 21% (p <0.001) and chest pain center usage increased by +1,726% (p <0.001). Among the 473 patients treated and discharged in the chest pain center after mid-1995, 333 (70%) were considered intermediate risk. No patient died after discharge from the chest pain center and there was 1 non-Q-wave myocardial infarction. We conclude that a chest pain management algorithm in a chest pain center can be safe, yet effective, for identifying high-risk patients for admission and low-risk patients for discharge.

23 citations


Cited by
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TL;DR: In those older than age 50, systolic blood pressure of greater than 140 mm Hg is a more important cardiovascular disease (CVD) risk factor than diastolic BP, and hypertension will be controlled only if patients are motivated to stay on their treatment plan.
Abstract: The National High Blood Pressure Education Program presents the complete Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Like its predecessors, the purpose is to provide an evidence-based approach to the prevention and management of hypertension. The key messages of this report are these: in those older than age 50, systolic blood pressure (BP) of greater than 140 mm Hg is a more important cardiovascular disease (CVD) risk factor than diastolic BP; beginning at 115/75 mm Hg, CVD risk doubles for each increment of 20/10 mm Hg; those who are normotensive at 55 years of age will have a 90% lifetime risk of developing hypertension; prehypertensive individuals (systolic BP 120-139 mm Hg or diastolic BP 80-89 mm Hg) require health-promoting lifestyle modifications to prevent the progressive rise in blood pressure and CVD; for uncomplicated hypertension, thiazide diuretic should be used in drug treatment for most, either alone or combined with drugs from other classes; this report delineates specific high-risk conditions that are compelling indications for the use of other antihypertensive drug classes (angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, beta-blockers, calcium channel blockers); two or more antihypertensive medications will be required to achieve goal BP (<140/90 mm Hg, or <130/80 mm Hg) for patients with diabetes and chronic kidney disease; for patients whose BP is more than 20 mm Hg above the systolic BP goal or more than 10 mm Hg above the diastolic BP goal, initiation of therapy using two agents, one of which usually will be a thiazide diuretic, should be considered; regardless of therapy or care, hypertension will be controlled only if patients are motivated to stay on their treatment plan. Positive experiences, trust in the clinician, and empathy improve patient motivation and satisfaction. This report serves as a guide, and the committee continues to recognize that the responsible physician's judgment remains paramount.

14,975 citations

Journal ArticleDOI
TL;DR: This document provides updated normal values for all four cardiac chambers, including three-dimensional echocardiography and myocardial deformation, when possible, on the basis of considerably larger numbers of normal subjects, compiled from multiple databases.
Abstract: The rapid technological developments of the past decade and the changes in echocardiographic practice brought about by these developments have resulted in the need for updated recommendations to the previously published guidelines for cardiac chamber quantification, which was the goal of the joint writing group assembled by the American Society of Echocardiography and the European Association of Cardiovascular Imaging. This document provides updated normal values for all four cardiac chambers, including three-dimensional echocardiography and myocardial deformation, when possible, on the basis of considerably larger numbers of normal subjects, compiled from multiple databases. In addition, this document attempts to eliminate several minor discrepancies that existed between previously published guidelines.

11,568 citations

Journal ArticleDOI
TL;DR: It is important that the medical profession play a significant role in critically evaluating the use of diagnostic procedures and therapies as they are introduced in the detection, management, and management of diseases.
Abstract: PREAMBLE......e4 APPENDIX 1......e121 APPENDIX 2......e122 APPENDIX 3......e124 REFERENCES......e124 It is important that the medical profession play a significant role in critically evaluating the use of diagnostic procedures and therapies as they are introduced in the detection, management,

8,362 citations

Journal ArticleDOI
TL;DR: Although considerable improvement has occurred in the process of care for patients with ST-elevation myocardial infarction (STEMI), room for improvement exists as discussed by the authors, and the purpose of the present guideline is to focus on the numerous advances in the diagnosis and management of patients
Abstract: Although considerable improvement has occurred in the process of care for patients with ST-elevation myocardial infarction (STEMI), room for improvement exists.[1–3][1][][2][][3] The purpose of the present guideline is to focus on the numerous advances in the diagnosis and management of patients

8,352 citations