Lawrence Baruch

James J. Peters VA Medical Center

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Calvin Eng

James J. Peters VA Medical Center

Bhanu Gupta

Dr. Rajendra Prasad Government Medical College

Jay N. Cohn

University of Minnesota

Sanjay Agarwal

Apollo Hospitals

Inder S. Anand

University of Minnesota

Ann F. Haynos

University of Minnesota

Allen Hester

Novartis (United States)

Swapna Johnson

Monash University

Robert Glazer

Novartis (United States)

Katelyn Kelly-Johnson

James J. Peters VA Medical Center

Cooperative Institutions

Icahn School of Medicine at Mount Sinai

James J. Peters VA Medical Center

Mount Sinai Hospital

Veterans Health Administration

University of Minnesota Medical Center

University of Minnesota

Harvard University

Cardiovascular Institute of the South

United States Department of Veterans Affairs

University of Glasgow

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A study of the efficacy and safety of irbesartan in combination with conventional therapy, including ACE inhibitors, in heart failure. Irbesartan Heart Failure Group.

PubMed (2000)

Melvin J. Tonkon Najam A. Awan Imran Khan Niazi Peter C. Hanley Lawrence Baruch

Because heart failure therapy with angiotensin-converting enzyme (ACE) inhibitors may not be optimal, owing to persistent levels of angiotensin II occurring through incomplete blockade and alternate pathways, the benefit of adding irbesartan, an angiotensin receptor antagonist, to conventional therapy, including ACE inhibitors, was examined. In this multicentre, randomised, double-blind, placebo-controlled study, 109 patients with heart failure (New York Heart Association functional class II and III) and left ventricular ejection fraction (LVEF) < or = 40% received stable doses of ACE inhibitors and diuretics before and throughout the study. Irbesartan was titrated as tolerated to 150 mg once daily in all patients. Exercise tolerance time (ETT), LVEF and clinical status were assessed at baseline and after 12 weeks. Compared with placebo, irbesartan in combination with conventional therapy, including ACE inhibitors, produced favourable trends in ETT and LVEF and was well tolerated in patients with mild to moderate heart failure.

Irbesartan

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Abstract P198: Is Directly Measured LDL Clinically Equivalent to Calculated LDL

Circulation Cardiovascular Quality and Outcomes (2011)

Lawrence Baruch Sanjay Agarwal Bhanu Gupta Ann F. Haynos Swapna Johnson

Background: LDL cholesterol can either be calculated or measured directly. Clinical guidelines recommend using calculated LDL to guide therapy, as the evidence base for lipid management is derived almost exclusively from trials using calculated LDL, with direct measurement of LDL being reserved for those not fasting or significant hypertriglyceridemia. Our aim was to determine the clinical equivalence of directly measured LDL and fasting calculated LDL. Design: Eighty-one subjects had at least 1 calculated and direct LDL performed simultaneously; 64 had a repeat lipid assessment after 4 to 6 weeks of therapy, resulting in 145 pairs of calculated and direct LDL. Correlation between direct and calculated LDL was determined using Pearson's correlation coefficient. The relationship between direct and calculated LDL was also evaluated from a clinical perspective. Direct and calculated LDL were considered “clinically concordant” when the difference between calculated and direct LDL fulfilled 3 criteria: 1) < 6% difference (incremental LDL lowering provided by 1 titration of statin dose, e.g. simvastatin 20 to 40 mg), 2) < 10 mg/dL difference, and 3) placement in the same ATP III LDL cut points (e.g. <100, 100-129). Direct and calculated LDL were considered “clinically discordant” when the difference between calculated and direct LDL fulfilled 3 criteria: 1) ≥ 12% difference (incremental LDL lowering provided by 2 statin titration steps, e.g. from simvastatin 20 to 80 mg), 2) ≥ 10 mg/dL difference, and 3) placement in different ATP III LDL cut points. Results: There was significant correlation between direct and calculated LDL(r=0.93). Clinical concordance between calculated and direct LDL was present in 40% of patients. Clinical discordance was noted in 25% of patients. One-third of patients had > 15 mg/dL difference between direct and calculated LDL, while 25% had > 20 mg/dL difference. In 47% of subjects, the difference between direct and calculated LDL at baseline and follow-up changed by a minimum of 10% or 10 mg/dL. Conclusion: Our findings suggest that directly measured LDL is not clinically equivalent to calculated LDL. This puts into question the current recommendation of using direct LDL in situations where calculated LDL would be inaccurate.

Mean difference

10.1161/circoutcomes.4.suppl_1.ap198

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[Use of our model of rehabilitation in chronic schizophrenia].

PubMed (1980)

P Sobczyk A Cielecki W Kurowski Lawrence Baruch

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Effect of jet direction on pulmonary venous flow: Importance for estimation of mitral regurgitation by venous flow pattern

Min Pu Brian P. Griffin Lawrence Baruch Christian S. Breburda James D. Thomas

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Abstract 11900: Should Venous Thromboembolism Patients Treated With DOACs Be Dose Adjusted Like Patients With Atrial Fibrillation: Lessons From Apixaban

Circulation (2022)

Lawrence Baruch Obinna Ofoche Olga Sherman Persio D Lopez Loyo

Introduction: In contrast to atrial fibrillation (AF), dose adjustment of apixaban and other DOACs is not recommended for pts with DVT or PE (VTE). Median DOAC levels were lower in VTE trials (e.g. apixaban 5-mg BID, AF 171 and 103 ng/mL vs. DVT 132 and 63 ng/mL, peak and trough, respectively), the result of a younger, lower weight population with better kidney function. Thus, VTE patients who meet or approach the apixaban dose reduction criteria may have levels far in excess of what’s needed to prevent recurrence. Hypothesis: Apixaban over exposure occurs in VTE pts at risk for elevated apixaban levels. Methods: Patients ≥ 75 yrs of age who had clinical markers that identified them as being at high risk for over exposure, including: 1) apixaban AF dose risk reduction criteria (age ≥ 80, creatinine ≥ 1.5, and wt ≤ 60-kg) and 2) approaching but not meeting dose reduction criteria (e.g. creatine 1.4, weight 65-kg) had a DOAC level measured at their anticoagulation clinic appointment. Levels were determined using liquid chromatography-mass spectrometry. Clinical decisions were made based on the “expected” apixaban levels. Results: Apixaban levels were obtained in 15 male pts. All 10 pts who were initially treated with apixaban 5-mg (2 of whom met the AF dose reduction criteria) had supratherapeutic apixaban levels on 5-mg BID. Of the 5 pts treated initially with apixaban 2.5-mg BID, 3 had adequate apixaban levels, while the other 2 had trough levels that were on the lower side. All 3 pts who met the AF dose reduction criteria (1 treated initially with 2.5-mg) had an adequate apixaban level on 2.5-mg BID. Conclusions: Apixaban treated VTE pts who meet or approach the AF dose reduction criteria are candidates for apixaban dose reduction, especially in light of the fact that peak and trough levels for VTE pts in general are lower than pts with AF.

Apixaban

10.1161/circ.146.suppl_1.11900

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Is directly measured low-density lipoprotein clinically equivalent to calculated low-density lipoprotein?

Journal of clinical lipidology (2010)

Lawrence Baruch Sanjay Agarwal Bhanu Gupta Ann F. Haynos Swapna Johnson

Low-density lipoprotein

Concordance

10.1016/j.jacl.2010.05.003

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Citations (19)