Marc A. Pfeffer

Bio: Marc A. Pfeffer is an academic researcher from Brigham and Women's Hospital. The author has contributed to research in topics: Heart failure & Myocardial infarction. The author has an hindex of 166, co-authored 765 publications receiving 133043 citations. Previous affiliations of Marc A. Pfeffer include Partners HealthCare & University of Miami.

Statins: a brief summary.

Abstract: Despite a totality of evidence indicating clear benefits of statin therapy in secondary and primary prevention of cardiovascular disease (CVD), a large number of additional trials are currently planned or in progress to help us better understand, treat, and prevent CVD. Both monotherapy and combination statin regimens are being studied to optimize treatment of the total patient and to assess mechanisms and benefits of various components of the total lipid profile.

Potassium reduction with sodium zirconium cyclosilicate in patients with heart failure

Abstract: Several patients with heart failure and reduced ejection fraction (HFrEF) do not receive renin–angiotensin–aldosterone system (RAAS) inhibitors at the recommended dose or at all, frequently due to actual or feared hyperkalaemia. Sodium zirconium cyclosilicate (SZC) is an orally administered non‐absorbed intestinal potassium binder proven to lower serum potassium concentrations.

Therapeutic Attenuation of Cardiac Remodeling After Acute Myocardial Infarction: A Conversation With Marc A. Pfeffer, MD, PhD.

Abstract: Marc Pfeffer, MD, PhD, is the Dzau Professor of Medicine at Harvard Medical School; and Senior Physician, Cardiovascular Division at Brigham and Women’s Hospital. He was born in Brooklyn, NY, and obtained his MD and PhD at the University of Oklahoma. He married his late wife and research collaborator, Janice Pfeffer, PhD, in 1970. He has won numerous awards, including the American Heart Association James B. Herrick Award for Outstanding Achievements in Clinical Cardiology (2013) and the American Heart Association Distinguished Scientist Award (2015), the American College of Cardiology Distinguished Scientist Award (Translational Domain; 2017), and an Honorary Doctoral Degree from Sahlgrenska Academy, University of Gothenburg, Sweden (2014). ### Dr Rutherford asks: In the early 1970s, you, and your late wife Janice, studied adrenergic mechanisms and cardiac hypertrophy and ventricular function, as well, in spontaneously hypertensive rats. What led to your initial animal studies on acute myocardial infarction and your interest in the renin-angiotensin-aldosterone system? Dr Pfeffer replies: As graduate students in the Department of Physiology and Biophysics at the University of Oklahoma, my late wife, Janice, and I had the privilege to work under the tutelage of Edward D. Frohlich, MD, who is a pioneer in the hemodynamics of hypertension with a major emphasis on the response of the heart to the augmented workload imposed by hypertension. He was keenly interested in the functional consequences of developing left ventricular hypertrophy and obtained breeding stock of the newly developed Japanese strain of the SHR. We developed methods to assess hemodynamics and left ventricular function to compare normotensive with hypertensive rats during aging. We found a marked age-associated deterioration in contractile performance in the hypertensive rats that could be prevented by a variety of antihypertensive agents. Our studies of the longitudinal changes in ventricular structure and function in an animal model of genetic hypertension caught the attention of Eugene Braunwald, MD, who was organizing a Program Project Grant on the Pathophysiology of Left Ventricular Hypertrophy at the then Peter Bent Brigham Hospital. We moved to the Brigham in 1976 as his postdoctoral fellows (me as a medical intern) …

The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report.

Abstract: "The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure" provides a new guideline for hypertension prevention and management. The following are the key messages(1) In persons older than 50 years, systolic blood pressure (BP) of more than 140 mm Hg is a much more important cardiovascular disease (CVD) risk factor than diastolic BP; (2) The risk of CVD, beginning at 115/75 mm Hg, doubles with each increment of 20/10 mm Hg; individuals who are normotensive at 55 years of age have a 90% lifetime risk for developing hypertension; (3) Individuals with a systolic BP of 120 to 139 mm Hg or a diastolic BP of 80 to 89 mm Hg should be considered as prehypertensive and require health-promoting lifestyle modifications to prevent CVD; (4) Thiazide-type diuretics should be used in drug treatment for most patients with uncomplicated hypertension, either alone or combined with drugs from other classes. Certain high-risk conditions are compelling indications for the initial use of other antihypertensive drug classes (angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, β-blockers, calcium channel blockers); (5) Most patients with hypertension will require 2 or more antihypertensive medications to achieve goal BP (<140/90 mm Hg, or <130/80 mm Hg for patients with diabetes or chronic kidney disease); (6) If BP is more than 20/10 mm Hg above goal BP, consideration should be given to initiating therapy with 2 agents, 1 of which usually should be a thiazide-type diuretic; and (7) The most effective therapy prescribed by the most careful clinician will control hypertension only if patients are motivated. Motivation improves when patients have positive experiences with and trust in the clinician. Empathy builds trust and is a potent motivator. Finally, in presenting these guidelines, the committee recognizes that the responsible physician's judgment remains paramount.

Cochrane Handbook for Systematic Reviews of Interventions

Abstract: The Cochrane Handbook for Systematic Reviews of Interventions is the official document that describes in detail the process of preparing and maintaining Cochrane systematic reviews on the effects of healthcare interventions.

疟原虫var基因转换速率变化导致抗原变异[英]／Paul H, Robert P, Christodoulou Z, et al//Proc Natl Acad Sci U S A

Abstract: 抗原变异可使得多种致病微生物易于逃避宿主免疫应答。表达在感染红细胞表面的恶性疟原虫红细胞表面蛋白1（PfPMP1）与感染红细胞、内皮细胞、树突状细胞以及胎盘的单个或多个受体作用，在黏附及免疫逃避中起关键的作用。每个单倍体基因组var基因家族编码约60种成员，通过启动转录不同的var基因变异体为抗原变异提供了分子基础。

A New Equation to Estimate Glomerular Filtration Rate

Abstract: The Modification of Diet in Renal Disease (MDRD) Study equation underestimates glomerular filtration rate (GFR) in patients with mild kidney disease. Levey and associates therefore developed and va...

Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication

Abstract: Context Little is known about lifetime prevalence or age of onset of DSM-IV disorders. Objective To estimate lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the recently completed National Comorbidity Survey Replication. Design and Setting Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using the fully structured World Health Organization World Mental Health Survey version of the Composite International Diagnostic Interview. Participants Nine thousand two hundred eighty-two English-speaking respondents aged 18 years and older. Main Outcome Measures Lifetime DSM-IV anxiety, mood, impulse-control, and substance use disorders. Results Lifetime prevalence estimates are as follows: anxiety disorders, 28.8%; mood disorders, 20.8%; impulse-control disorders, 24.8%; substance use disorders, 14.6%; any disorder, 46.4%. Median age of onset is much earlier for anxiety (11 years) and impulse-control (11 years) disorders than for substance use (20 years) and mood (30 years) disorders. Half of all lifetime cases start by age 14 years and three fourths by age 24 years. Later onsets are mostly of comorbid conditions, with estimated lifetime risk of any disorder at age 75 years (50.8%) only slightly higher than observed lifetime prevalence (46.4%). Lifetime prevalence estimates are higher in recent cohorts than in earlier cohorts and have fairly stable intercohort differences across the life course that vary in substantively plausible ways among sociodemographic subgroups. Conclusions About half of Americans will meet the criteria for a DSM-IV disorder sometime in their life, with first onset usually in childhood or adolescence. Interventions aimed at prevention or early treatment need to focus on youth.