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Articles by J Butler
Total Records ( 5 ) for J Butler
  J Butler , A Kalogeropoulos , V Georgiopoulou , N de Rekeneire , N Rodondi , A. L Smith , U Hoffmann , A Kanaya , A. B Newman , S. B Kritchevsky , R. S Vasan , P. W.F Wilson , T. B Harris and for the Health ABC Study
 

Objective— Resistin is associated with inflammation and insulin resistance and exerts direct effects on myocardial cells including hypertrophy and altered contraction. We investigated the association of serum resistin concentrations with risk for incident heart failure (HF) in humans.

Methods and Results— We studied 2902 older persons without prevalent HF (age, 73.6±2.9 years; 48.1% men; 58.8% white) enrolled in the Health, Aging, and Body Composition (Health ABC) Study. Correlation between baseline serum resistin concentrations (20.3±10.0 ng/mL) and clinical variables, biochemistry panel, markers of inflammation and insulin resistance, adipocytokines, and measures of adiposity was weak (all rho <0.25). During a median follow-up of 9.4 years, 341 participants (11.8%) developed HF. Resistin was strongly associated with risk for incident HF in Cox proportional hazards models controlling for clinical variables, biomarkers, and measures of adiposity (HR, 1.15 per 10.0 ng/mL in adjusted model; 95% CI, 1.05 to 1.27; P=0.003). Results were comparable across sex, race, diabetes mellitus, and prevalent and incident coronary heart disease subgroups. In participants with available left ventricular ejection fraction at HF diagnosis (265 of 341; 77.7%), association of resistin with HF risk was comparable for cases with reduced versus preserved ejection fraction.

Conclusions— Serum resistin concentrations are independently associated with risk for incident HF in older persons.

  G. C Fonarow , T Gregory , M Driskill , M. D Stewart , C Beam , J Butler , A. K Jacobs , N. M Meltzer , E. D Peterson , L. H Schwamm , J. A Spertus , C. W Yancy , G. F Tomaselli and R. L. Sacco
 

Cardiovascular disease and stroke remain leading causes of mortality, disability, and rising healthcare expenditures in the United States. Although a number of organizations provide hospital accreditation, recognition, and certification programs, existing programs do not address cardiovascular disease and stroke care in a comprehensive way. Current evidence suggests mixed findings for correlation between accreditation, recognition, and certification programs and hospitals' actual quality of care and outcomes. This advisory discusses potential opportunities to develop and enhance hospital certification programs for cardiovascular disease and stroke. The American Heart Association/American Stroke Association is uniquely positioned as a patient-centered, respected, transparent healthcare organization to help drive improvements in care and outcomes for patients hospitalized with cardiovascular disease and stroke. As a part of its commitment to promoting high-quality, evidence-based care for cardiovascular and stroke patients, it is recommended that the American Heart Association/American Stroke Association explore hospital certification programs to develop truly meaningful programs to facilitate improvements in and recognition for cardiovascular disease and stroke quality of care and outcomes. Future strategies should standardize objective, unbiased assessments of hospital structural, process, and outcome performance while allowing flexibility as technology and methodology advances occur.

  A Kalogeropoulos , B. M Psaty , R. S Vasan , V Georgiopoulou , A. L Smith , N. L Smith , S. B Kritchevsky , P. W. F Wilson , A. B Newman , T. B Harris , J Butler and for the Cardiovascular Health Study
  Background—

The recently developed and internally validated Health ABC HF model uses 9 routinely available clinical variables to determine incident heart failure risk. In this study, we sought to externally validate the Health ABC HF model.

Methods and Results—

Observed 5-year incidence of heart failure, defined as first hospitalization for new-onset heart failure, was compared with 5-year risk estimates derived from the Health ABC HF model among participants without heart failure at baseline in the Cardiovascular Health Study. During follow-up, 400 of 5335 (7.5%) participants developed heart failure over 5 years versus 364 (6.8%) predicted by the Health ABC HF model (predicted-to-observed ratio, 0.90). Observed versus predicted 5-year heart failure probabilities were 3.2% versus 2.8%, 9.0% versus 7.0%, 15.9% versus 13.7%, and 24.6% versus 30.8% for the <5%, 5% to 10%, 10% to 20%, and >20% 5-year risk categories, respectively. The Hosmer-Lemeshow 2 was 14.72 (degrees of freedom, 10; P=0.14), and the C index was 0.74 (95% CI, 0.72 to 0.76). Calibration and discrimination demonstrated adequate performance across sex and race overall; however, risk was underestimated in white men, especially in the 5% to 10% risk category. Model performance was optimal when participants with normal left ventricular function at baseline were assessed separately. Performance was consistent across age groups. Analyses with death as a competing risk yielded similar results.

Conclusions—

The Health ABC HF model adequately predicted 5-year heart failure risk in a large community-based study, providing support for the external validity of the model. This tool may be used to identify individuals to whom to target heart failure prevention efforts.

  A Goyal , C. R Norton , T. N Thomas , R. L Davis , J Butler , V Ashok , L Zhao , V Vaccarino and P. W. F. Wilson
  Background—

Studies on the incidence and predictors of heart failure (HF) are often restricted to elderly persons or identify only inpatient cases.

Methods and Results—

We determined the incidence and predictors of new HF diagnosed in either outpatient or inpatient settings, among 359 947 women and men (age ≥18 years) insured by Kaiser Permanente Georgia at any time during calendar years 2000 to 2005. Subjects were free of HF at baseline, and incident HF was identified with ICD-9 codes (1 inpatient or 2 outpatient HF visits). We developed multivariable Cox models to assess the association of antecedent factors (coronary heart disease, hypertension, diabetes mellitus, atrial fibrillation, and valvular heart disease) with incident HF. Separate models were created for each sex and for newly diagnosed HF in outpatient or inpatient settings. There were 4001 incident HF cases (50% women and 48% in subjects <65 years old), during 1 015 794 person-years of follow-up. The incidence rate of HF was greater in men than in women (4.24 versus 3.68 per 1000 person-years) but was stable across the study interval in both sexes. Two thirds of incident HF cases from this population occurred in outpatients. These 5 antecedent factors and age yielded excellent discrimination for incident HF in both outpatients and inpatients and in both sexes (C >0.85 in all models).

Conclusions—

Common modifiable risk factors accurately discriminate women and men at risk for HF diagnosed in either outpatient or inpatient settings. Approximately two thirds of new HF cases in our insured population were diagnosed in outpatients; more research is needed to characterize these subjects and their prognosis.

  D. J Wiebe , A Croom , K. T Fortenberry , J Butner , J Butler , M. T Swinyard , R Lindsay , D Donaldson , C Foster , M Murray and C. A. Berg
 

Objectives To examine pump duration associations with adolescents’ metabolic control and whether parental involvement moderated this association. Methods This study used a cross-sectional sample of 10- to 14-year-olds with diabetes (N = 252, 53.6% female) and parents’ reported parental involvement; HbA1c was obtained from medical records. Half (50.8%) were on an insulin pump (continuous subcutaneous insulin infusion, CSII), with the remainder prescribed multiple daily injections (MDI). Results Adolescents on CSII displayed better HbA1c than those on MDI. A curvilinear association revealed that participants on CSII for <2 years showed a positive pump duration-HbA1c association, while those on CSII longer showed no association. Parental involvement interacted with pump duration to predict HbA1c. Pump duration was associated with poorer HbA1c only when parents were relatively uninvolved. Conclusions Within the limitations of a cross-sectional design, data suggest that adolescents on CSII have better HbA1c than those on MDI, but may experience a period of deterioration that can be offset by parental involvement.

 
 
 
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