Author
Ralph B. D'Agostino
Other affiliations: VA Boston Healthcare System, University of Illinois at Urbana–Champaign, Northwestern University ...read more
Bio: Ralph B. D'Agostino is an academic researcher from Wake Forest University. The author has contributed to research in topics: Framingham Heart Study & Framingham Risk Score. The author has an hindex of 226, co-authored 1287 publications receiving 229636 citations. Previous affiliations of Ralph B. D'Agostino include VA Boston Healthcare System & University of Illinois at Urbana–Champaign.
Papers published on a yearly basis
Papers
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TL;DR: In this paper, the authors determined the prevalence of AF from 1968 to 1989 in the Framingham Study cohort aged 65 to 84 years and evaluated the prevalence by sex and in the presence of VHD, prior MI, and CHF.
448 citations
TL;DR: The derivation, validation, and illustration of the revised WHO cardiovascular disease risk prediction charts that have been adapted to the circumstances of 21 global regions are reported.
445 citations
TL;DR: The propensity score for an individual, defined as the conditional probability of being treated given the individual’s covariates, can be used to balance the covariates in the 2 groups and thus reduce this bias.
Abstract: Propensity scores have been used to reduce bias in observational studies in many fields and are becoming more widely used in cardiovascular research.1 The goal of this statistical primer is to present the definition of propensity scores and to illustrate their use by describing some recent examples found in the cardiovascular disease research literature.
Large-scale epidemiological cohort studies such as the Multi-Ethnic Study of Atherosclerosis (MESA)2 are designed to follow a large sample of participants over time without active administration of any interventions. Within MESA, lack of randomization can complicate potential treatment comparisons such as the impact of β-blocker versus angiotensin-converting enzyme inhibitor usage. Nonrandomized comparisons may also arise from within a randomized clinical trial. For instance, the Clopidogrel as Adjunctive Reperfusion Therapy - Thrombolysis in Myocardial Infarction 28 (CLARITY-TIMI 28) trial3 is a randomized study that compares clopidogrel with placebo in 3491 ST-elevation myocardial infarction patients aged 18 to 75 years who have undergone fibrinolysis. In addition to the primary end points, investigators wished to compare the effects of low molecular weight heparin with unfractionated heparin on angiographic and clinical outcomes in participants.4 These treatments were not randomly assigned.
In studies such as these, the treatment groups may markedly differ with respect to the observed pretreatment covariates measured on participants. These differences could lead to biased estimates of treatment effects. The propensity score for an individual, defined as the conditional probability of being treated given the individual’s covariates, can be used to balance the covariates in the 2 groups and thus reduce this bias.
In a randomized experiment, the randomization of participants to different treatments minimizes the chance of differences on observed or unobserved covariates. However, in nonrandomized studies, systematic differences can exist between treatment groups. To control for this potential bias, information on measured …
443 citations
TL;DR: The association between baseline nonfasting plasma total homocysteine levels and incident stroke in a well-characterized, population-based cohort of elderly women and men who at baseline had not had stroke was examined.
Abstract: Nonfasting total homocysteine levels are an independent risk factor for incident stroke in elderly persons.
430 citations
University of Cambridge1, University of Glasgow2, University of Washington3, Uppsala University4, Harvard University5, Ludwig Maximilian University of Munich6, Centers for Disease Control and Prevention7, French Institute of Health and Medical Research8, University of Ulm9, Innsbruck Medical University10, Boston University11, University College London12, Wageningen University and Research Centre13, Istanbul University14, Merck & Co.15, University of Gothenburg16, Medical University of South Carolina17, Cardiff University18, Erasmus University Rotterdam19, University of Pavia20, University of California, San Diego21, University of Oxford22, University of New South Wales23, University of the East24, University of Copenhagen25, University of Amsterdam26, University of Iceland27
TL;DR: In a study of individuals without known CVD, the addition of information on the combination of apolipoprotein B and A-I, lipop protein(a), or lipoprotein-associated phospholipase A2 mass to risk scores containing total cholesterol and HDL-C led to slight improvement in CVD prediction.
Abstract: ContextThe value of assessing various emerging lipid-related markers for prediction of first cardiovascular events is debated.Objective To determine whether adding information on apolipoprotein B a ...
429 citations
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TL;DR: G*Power 3 provides improved effect size calculators and graphic options, supports both distribution-based and design-based input modes, and offers all types of power analyses in which users might be interested.
Abstract: G*Power (Erdfelder, Faul, & Buchner, 1996) was designed as a general stand-alone power analysis program for statistical tests commonly used in social and behavioral research. G*Power 3 is a major extension of, and improvement over, the previous versions. It runs on widely used computer platforms (i.e., Windows XP, Windows Vista, and Mac OS X 10.4) and covers many different statistical tests of thet, F, and χ2 test families. In addition, it includes power analyses forz tests and some exact tests. G*Power 3 provides improved effect size calculators and graphic options, supports both distribution-based and design-based input modes, and offers all types of power analyses in which users might be interested. Like its predecessors, G*Power 3 is free.
40,195 citations
Boston University1, Rush University Medical Center2, University of Tennessee Health Science Center3, University of Michigan4, University at Buffalo5, University of Mississippi6, University of Miami7, University of Alabama at Birmingham8, Case Western Reserve University9, National Institutes of Health10
TL;DR: The most effective therapy prescribed by the most careful clinician will control hypertension only if patients are motivated, and empathy builds trust and is a potent motivator.
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.
24,988 citations
28 Jul 2005
TL;DR: PfPMP1）与感染红细胞、树突状组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�ly.
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。
18,940 citations
TL;DR: Because of the increased complexity of analysis and interpretation of clinical genetic testing described in this report, the ACMG strongly recommends thatclinical molecular genetic testing should be performed in a Clinical Laboratory Improvement Amendments–approved laboratory, with results interpreted by a board-certified clinical molecular geneticist or molecular genetic pathologist or the equivalent.
17,834 citations
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